Allograft Inflammatory Factor-1 Links T-Cell Activation, Interferon Response, and Macrophage Activation in Chronic
Anne H Rowley1,2,3, Susan C Baker4, Kwang-Youn A Kim5
1Departments of Pediatrics.
Insights
Persistent immune responses, including T lymphocytes and type I interferon, are found in chronic Kawasaki disease (KD) arteritis. Allograft inflammatory factor-1 (AIF1) links these responses and macrophage activation, suggesting its role in KD pathogenesis.
Area of Science:
- Immunology
- Cardiovascular Pathology
- Pediatric Rheumatology
Background:
- Kawasaki disease (KD) is primarily viewed as acute arteritis, but chronic inflammation and arterial stenosis can persist.
- Acute KD tissues show upregulated T lymphocyte, type I interferon, and allograft inflammatory factor-1 (AIF1) genes.
- The persistence of these immune responses and the role of AIF1 in chronic KD are not well understood.
Purpose of the Study:
- To determine if immune responses identified in acute KD persist in chronic KD arteritis.
- To investigate the role of allograft inflammatory factor-1 (AIF1) in chronic KD immune responses.
Main Methods:
- Gene and protein expression analysis (RT-PCR, immunohistochemistry, immunofluorescence) in chronic KD and control arteries.
- In vitro studies using AIF1 small-interfering RNA to assess AIF1's role in macrophage and T lymphocyte activation.
Main Results:
- Allograft inflammatory factor-1 (AIF1) protein is highly expressed in stenotic KD arteries, co-localizing with macrophages.
- Genes related to T lymphocyte and interferon pathways remain significantly upregulated in chronic KD coronary arteries.
- AIF1 is crucial for macrophage activation (CD80, MHC class II expression) and subsequent antigen-specific T lymphocyte activation.
Conclusions:
- Allograft inflammatory factor-1 (AIF1) is significantly upregulated in KD stenotic arteries, indicating its involvement beyond acute phases.
- Persistent T lymphocyte and type I interferon responses are characteristic of chronic KD arteritis.
- AIF1 likely bridges type I interferon signaling, macrophage activation, and T lymphocyte responses, highlighting lymphocyte-myeloid cell crosstalk in KD pathogenesis and potential therapeutic targets.
Background:
Kawasaki disease (KD) is widely viewed as an acute arteritis. However, our pathologic studies show that chronic coronary arteritis can persist long after disease onset and is closely linked with arterial stenosis. Transcriptome profiling of acute KD arteritis tissues revealed upregulation of T lymphocyte, type I interferon, and allograft inflammatory factor-1 (AIF1) genes. We determined whether these immune responses persist in chronic KD arteritis, and we investigated the role of AIF1 in these responses.
Methods:
Gene expression in chronic KD and childhood control arteries was determined by real-time reverse-transcriptase polymerase chain reaction, and arterial protein expression was determined by immunohistochemistry and immunofluorescence. Allograft inflammatory factor-1 small-interfering ribonucleic acid macrophage treatment was performed to investigate the role of AIF1 in macrophage and T lymphocyte activation.
Results:
Allograft inflammatory factor-1 protein was highly expressed in stenotic KD arteries and colocalized with the macrophage marker CD68. T lymphocyte and interferon pathway genes were significantly upregulated in chronic KD coronary artery tissues. Alpha interferon-induced macrophage expression of CD80 and major histocompatibility complex class II was dependent on AIF1, and macrophage expression of AIF1 was required for antigen-specific T lymphocyte activation.
Conclusions:
Allograft inflammatory factor-1, originally identified in posttransplant arterial stenosis, is markedly upregulated in KD stenotic arterial tissues. T lymphocyte and type I interferon responses persist in chronic KD arteritis. Allograft inflammatory factor-1 may play multiple roles linking type I interferon response, macrophage activation, and antigen-specific T lymphocyte activation. These results suggest the likely importance of lymphocyte-myeloid cell cross-talk in the pathogenesis of KD arteritis and can inform selection of new immunotherapies for clinical trials in high-risk KD children.
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