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A Unifying Theory of Autoimmune Disease
Harvard Medical School ^ | May 5, 2011 | NA

Posted on 05/25/2011 2:10:48 PM PDT by neverdem

Carbohydrate activates B cells in skin, connective tissues

Researchers led by HMS Associate Professor of Medicine Julia Wang offer a new, unifying theory on the origins of autoimmune diseases. In two related papers in the May 2011 issue of the American Journal of Pathology, the team outlines a process by which a carbohydrate abundant in skin and connective tissue called dermatan sulfate turns traitorous. The resulting disease may be systemic, as in lupus or rheumatoid arthritis, or localized, as in Type 1 diabetes or Graves’ disease.

Only a tiny subset of molecules in the body are known to have the potential to become autoantigens, targets of an immune system that mistakes “self” as foreign. Immune B cells play a key role by producing autoantibodies to these autoantigens.

In mice, Wang, along with current and former research fellows Jongmin Lee, Ming Yan, Jung-hyun Rho and Michael Roehrl, demonstrate that dermatan sulfate plays a pivotal role in regulating a type of B cell called B-1a. Levels of both dermatan sulfate and B-1a cells are elevated when cell turnover is high, as in wound healing.

The researchers suggest that, when dead cells pile up, dermatan sulfate may help speed the clearing of these cells by the immune system. Dermatan sulfate has a downside, however. When cells with a high affinity for the molecule die, the resulting complexes can become unrecognizable as self. These complexes stimulate the proliferation of B-1a cells and the production of autoantibodies, which in turn mark healthy tissues for destruction. When auto­antibodies bind to autoantigens on healthy cells, other autoimmune B cells infiltrate the tissue, and damage ensues.


Lymphocytes, such as the one shown here, include B cells that play a key role in autoimmunity. Image by Triche/National Cancer Institute

In an accompanying patient study, Wang and colleagues Rho, Roehrl, Wei Zhang and Mandakolathur Murali found that the full complement of autoantigens in humans—more than 200—could be classified by their affinity for dermatan sulfate. “It is those molecules that can associate with dermatan sulfate which have a propensity to become autoantigens,” Wang said.

Wang and her coauthors came to their conclusion by an unconventional route. “We did not investigate this in the traditional immunological way, using genetic approaches,” Wang explained, referring to the strategy of tinkering with genes to heighten or dial back certain proteins in B cells or other autoimmune-response components.

Instead, Wang said, “we used immunological, biochemical and proteomic tactics to isolate a common denominator among autoantigens” in cell cultures, in a mouse model, and in humans. With most research focused on proteins, she said, dermatan sulfate has not been an obvious target for study.

Autoimmune diseases “are ripe for a real breakthrough,” said Wang, who with colleagues has begun developing personalized molecular serum testing for patients to help diagnose autoimmune diseases at a more precise molecular level.

“Many therapies target over-reactive B cells,” Wang said. “Now, with a new mechanism for B-1a cell activation in mind, scientists have a chance to disrupt the start of that dangerous process.” —Mary Bates

To learn more, students may contact Julia Wang at julia_wang@rics.bwh.harvard.edu


TOPICS: Culture/Society; News/Current Events
KEYWORDS: autoimmune; autoimmunedisease; biabcells; dermatansulfate; immunology
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Dermatan Sulfate Interacts with Dead Cells and Regulates CD5(+) B-Cell Fate Implications for a Key Role in Autoimmunity.

Human proteins with affinity for dermatan sulfate have the propensity to become autoantigens.

1 posted on 05/25/2011 2:10:50 PM PDT by neverdem
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To: Mother Abigail; EBH; vetvetdoug; Smokin' Joe; Global2010; Battle Axe; null and void; ...

immunology ping


2 posted on 05/25/2011 2:14:07 PM PDT by neverdem (Xin loi minh oi)
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To: neverdem
dermatan sulfate = one of the glycosaminoglycans.

Thye are a suspicious bunch. Never trusted them. Figures a rogue GAG would make all that trouble.

3 posted on 05/25/2011 2:30:08 PM PDT by corkoman (Steadfast and Loyal)
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To: neverdem

Thank you!


4 posted on 05/25/2011 2:42:17 PM PDT by fightinJAG (I am sick of people adding their comments to titles in the title box. Thank you.)
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To: neverdem

Thanks for the interesting post. I have alopicia, and the doctor has told me that it’s a typr of auto-immune disorder. I wonder if this research will benefit me.


5 posted on 05/25/2011 2:48:29 PM PDT by catbertz
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To: fightinJAG

I autoimmuned an ex wife once


6 posted on 05/25/2011 2:56:05 PM PDT by BubbaJunebug
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To: neverdem

An alternate hypothesis would be:
iron loading in the liver reduces HCl secretions in the stomach and eventually in the gut. Deficient HCl in the gut
causes incomplete digestion, huge proteins that resemble pathogens, massive over-growths of alien flora in the gut and absorption of huge proteins into the blood that are mis-identified as pathogens. The immune response would stay on high alert 24/7/365 while attacking the huge food proteins.
The iron in the liver reduces the levels of hydroxylated vitamin d which upregulates the autoimmune pathology.


7 posted on 05/25/2011 3:00:57 PM PDT by kruss3 (Kruss3@gmail.com)
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To: catbertz

I hope this research will prove fruitful. I suffer from a few auto-immune disorders. Usually when you have one you get more. They tend to cluster. Sadly.


8 posted on 05/25/2011 3:03:07 PM PDT by Paved Paradise
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To: kruss3

I like yours better. Enough vitamin D seems to reduce a lot of autoimmune activity, and avoiding grains makes the gut flora more beneficial as well as keeping these large proteins from slipping into the bloodstream. I am going with your hypothesis.


9 posted on 05/25/2011 3:07:18 PM PDT by Yaelle
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To: Paved Paradise

I have at least one auto-immune disease as well, they are testing me for a couple of others as whatever it is, is flaring up with a vengence right now.


10 posted on 05/25/2011 3:10:31 PM PDT by Calm_Cool_and_Elected ("The truth does not change according to our ability to stomach it." --Flannery O'Connor)
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To: Yaelle

I feel like I should be able to understand this, but I don’t. :(


11 posted on 05/25/2011 3:11:54 PM PDT by brytlea (If you don't know what APOD is you'd better find out!)
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To: Calm_Cool_and_Elected

I have been very busy and have not taken time to look into an anti-inflammation diet, but most autoimmune disease have some kind of inflammatory element to them.


12 posted on 05/25/2011 3:13:07 PM PDT by Paved Paradise
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To: brytlea

I don’t much either, really! All I know is that since we started supplementing with vitamin D around here, no one seems to get sick. Including the little autoimmune things. We don’t have a big autoimmune thing here, thank G-d, but I one of us did, I’d add testing and supplementation of D.

And when you eat grains, especially glutens, they are so hard to digest and they mess up the digestion process in your gut, which takes place because of the gut bacteria, the GOOD ones. Also, when you are eating grains, big particles can get through some of the intestinal holes and these proteins get into your bloodstream and can make you sick or give you neurological problems. Avoiding grains is a very healthy thing to do. Many of the digestive disorders like celiac, IBF, and Crohn’s can be avoided by avoiding glutens or (better) all grains.


13 posted on 05/25/2011 3:21:26 PM PDT by Yaelle
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To: Yaelle

Well the two things that have seemed to help me the most have been vitamin D (and B complex) and not eating any wheat. I have been doing that for about a year now. I am not 100% but I would say I am at least 70% better. Enough better that I wouldn’t change back and my Doctor wants me to continue.


14 posted on 05/25/2011 3:29:57 PM PDT by brytlea (If you don't know what APOD is you'd better find out!)
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To: brytlea
I just lost my husband six weeks ago to the complications of Rheumatoid Arthritis. His debilitation and deterioration broke my heart. This is a horrible disease. He was only 52 years old.
15 posted on 05/25/2011 4:07:36 PM PDT by fierycelt1
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To: Paved Paradise

I have an inflammatory myopathy.


16 posted on 05/25/2011 5:48:00 PM PDT by Calm_Cool_and_Elected ("The truth does not change according to our ability to stomach it." --Flannery O'Connor)
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To: fierycelt1

I’m so sorry for your loss.


17 posted on 05/25/2011 5:53:39 PM PDT by Calm_Cool_and_Elected ("The truth does not change according to our ability to stomach it." --Flannery O'Connor)
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To: fierycelt1

So sorry to hear of your husband’s passing. Praying right now for God’s sustaining grace and comfort for you.


18 posted on 05/25/2011 6:49:20 PM PDT by TruthSetsUFree
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To: fierycelt1

I am really sorry to hear that. My condolences.


19 posted on 05/25/2011 7:13:59 PM PDT by brytlea (If you don't know what APOD is you'd better find out!)
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To: fierycelt1
You have my sympathies.
I suffer from psoriasis, eczema, dandruff and hope that that pain in my thumbs is just carpal tunnel and that in my knee is from being overweight. Splinter hemorrhage are not promising. Going to find out soon enough.
20 posted on 05/26/2011 11:50:50 PM PDT by rmlew (No Blood for Sarkozy's re-election and Union for the Mediterranean)
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