A team of researchers has discovered a factor that triggers | Figure 1

PedroPharmacist

•Follow

Pharmacist

Some actions are only available when you log in.

Report case

Report this to our moderators

Next

You can view up to 4 cases without signing up Sign up for unlimited access

A team of researchers has discovered a factor that triggers autoimmune diseases like Crohn's disease, multiple sclerosis and lupus.

The finding, conducted as part of a study conducted by the National Jewish Health organization, also helps to understand why such diseases affect women more than men, and may lead to a therapeutic target to prevent autoimmune diseases in humans .

The research team at that institution had previously conducted a study, led by Philippa Marrack, director of Biomedical Sciences, in which he identified a subtype of B cells that accumulate in autoimmune patients in mice Female and autoimmune diseases.

Transcription factors bind to DNA within cells and cause expression of one or more genes. Researchers believe that T-bet appears inside cells when a combination of receptors on the surface of B-cells TLR7, interferon gamma and B-cell receptor are stimulated. According to Kira Rubtsova, the T-bet transcription factor expressed by B cells causes ABCs to develop.

When we suppressed the T-bet expressed by B cells, mice prone to develop autoimmune disease remained healthy. We think the same process occurs in humans with autoimmune disease, more often in older women.

Our findings demonstrate for the first time that ABCs are not only associated with autoimmune disease but also cause it.

Source: Journal of Clinical Investigation.

5 comments

Sign up to add a comment

More about this case

Resolved

Why you should join Figure 1

Sign up to explore now

Similar cases

\ \ What are the benefits and risks of belimumab for treating systemic lupus erythematosus (an autoimmune disease that affects the whole body)?\ Why is this question important?\ Systemic lupus erythematosus (SLE; or ‘lupus’) is a disease in which the body's immune (defense) system mistakenly attacks healthy tissue in many parts of the body. It is a long‐term disease (one that lasts longer than six weeks and is usually life‐long). Often, SLE causes pain in joints and muscles, and extreme tiredness. Symptoms can improve temporarily, or worsen suddenly (flares).\ There is no cure for SLE. However, treatments can improve symptoms. Inflammation caused by lupus can affect the joints, skin, kidneys, blood cells, brain, heart, and lungs. Most people are treated with glucocorticoids (anti‐inflammation medicines; also called "steroids/prednisone/medrol/solumedrol") at some point in their disease course. These medicines reduce the swelling and pain associated with inflammation, but they can have serious adverse (unwanted) effects, such as kidney damage. This is why it is important to study other treatment options, such as belimumab.\ Belimumab is a human protein (antibody) that is given as an injection to decrease inflammation. In people with SLE, belimumab prevents the development and survival of the cells that attack the body’s healthy tissues (B cells). The aim of belimumab is to reduce the number of B cells, so that people’s symptoms improve.\ To find out about the benefits and risks of belimumab, we reviewed the evidence from research studies.\ What did we find?\ We found six studies that involved a total of 2917 people (mostly women) aged between 22 and 80 years. People were followed for a minimum of 84 days and a maximum of 76 weeks. All studies compared belimumab against placebo.\ Summary of key findings:\ When compared against placebo:\ ‐ belimumab is more likely to reduce SLE disease activity, and to reduce the amount of glucocorticoids needed;\ ‐ belimumab probably makes little to no difference to: health‐related quality of life improvement; numbers of serious adverse events; and deaths; and\ ‐ belimumab may make little to no difference to numbers of serious infections, and numbers of adverse events that cause people to withdraw from studies.\ How‐up‐to date is this review?\ The evidence in this Cochrane Review is current to September 2019.](https://app.figure1.com/case-detail/007a97ff-44de-490e-b18b-329f8ac1778a)

\ \ Mantle cell lymphoma (MCL) is a rare form of non-Hodgkin lymphoma characterized by clonal proliferation of follicular mantle zone B lymphocytes. It is caused by abnormal chromosomal translocation t(11;14) resulting in aberrant expression of cyclin D1. This leads to activation of anti-apoptotic pathways and abnormal proliferation of MCL cells. Patients can present with an indolent course or a fulminant disease with short overall survival. The disease frequently involves extranodal organs, but rarely manifests with neurological symptoms. We report a rare case of aberrant CD5-negative MCL presenting with aseptic meningitis.](https://app.figure1.com/case-detail/01ffe2d4-4b2a-410c-b292-c60dfab89d74)

\ \ Senescent cells contribute to pathology and dysfunction in animal models. Their sparse distribution and heterogenous phenotype have presented challenges to their detection in human tissues. We developed a senescence eigengene approach to identify these rare cells within large, diverse populations of postmortem human brain cells. Eigengenes are useful when no single gene reliably captures a phenotype, like senescence. They also help to reduce noise, which is important in large transcriptomic datasets where subtle signals from low-expressing genes can be lost. Each of our eigengenes detected ∼2% senescent cells from a population of ∼140,000 single nuclei derived from 76 postmortem human brains with various levels of Alzheimer’s disease (AD) pathology. More than 97% of the senescent cells were excitatory neurons and overlapped with neurons containing neurofibrillary tangle (NFT) tau pathology. Cyclin-dependent kinase inhibitor 2D (CDKN2D/p19) was predicted as the most significant contributor to the primary senescence eigengene. RNAscope and immunofluorescence confirmed its elevated expression in AD brain tissue. The p19-expressing neuron population had 1.8-fold larger nuclei and significantly more cells with lipofuscin than p19-negative neurons. These hallmark senescence phenotypes were further elevated in the presence of NFTs. Collectively, CDKN2D/p19-expressing neurons with NFTs represent a unique cellular population in human AD with a senescence-like phenotype. The eigengenes developed may be useful in future senescence profiling studies as they identified senescent cells accurately in snRNA-Seq datasets and predicted biomarkers for histological investigation.](https://app.figure1.com/case-detail/2a95fa25-99a7-4ae4-8bc6-beccb319299d)

\ \ What is the issue?\ Metastatic breast cancer occurs when the cancer has spread to areas of the body beyond the breast and nearby lymph nodes. Although metastatic breast cancer is generally not curable, it is widely accepted that women with metastatic disease should receive some form of chemotherapy to help ease the severity of disease symptoms, slow cancer progression and improve survival, when compared to no treatment. Chemotherapy containing platinum is known to be effective for treating a number of cancer types including lung, testicular, head and neck, bladder and ovarian cancers. However, it is also known to cause more adverse effects (such as nausea and vomiting, hair loss, anaemia, kidney damage and low white blood cells) than other chemotherapy options. The two platinum agents most used for treating metastatic breast cancer are carboplatin and cisplatin.\ In a previous Cochrane Review, we found that for women with metastatic breast cancer, there is little or no survival benefit, and more side effects related to toxicity, from platinum‐based regimens. In analysing different groups of women with metastatic disease, however, we found preliminary evidence of a survival benefit from platinum‐based regimens for women with the triple‐negative subtype of metastatic breast cancer. The term 'triple‐negative' relates to the fact that this subtype of breast cancer tests negative for oestrogen receptors (ERs) and progesterone receptors (PgRs), and have low levels of a protein called human epidermal growth factor receptor 2 (HER2).\ The current review updates the evidence on platinum‐containing regimens for women with a specific breast cancer subtype of triple‐negative metastatic breast cancer (mTNBC).\ Why does it matter?\ mTNBC makes up approximately 12% to 17% of breast cancers and is associated with shorter survival and higher chance that the cancer returns. In recent years, some researchers have hypothesised that chemotherapy containing platinum might be more effective in treating mTNBC than other chemotherapy options. Randomised controlled trials (RCTs) have been designed and conducted to test this hypothesis.\ We asked:\ Are chemotherapy treatments containing a platinum agent more or less effective for treating women with mTNBC than chemotherapy treatments not containing a platinum agent?\ We found:\ 10 studies involving 1349 women. The evidence is current to September 2019. This review found that for women with mTNBC, a chemotherapy containing platinum:\ ‐ may increase survival time over chemotherapy without platinum;\ ‐ reduces the number of breast cancer recurrences compared to chemotherapy that did not contain platinum but we are uncertain about these results;\ ‐ appears to cause tumours to shrink more than chemotherapy without platinum;\ ‐ may increase the chance of severe nausea and vomiting compared to treatment without platinum; and\ ‐ may increase the chance of anaemia compared to chemotherapy without platinum.\ What does this mean?\ Chemotherapy containing platinum may provide a small survival benefit to mTNBC participants, but still large enough to justify its use. This potential benefit needs to be weighed against the higher risks of toxic side effects from platinum‐based regimens compared to non‐platinum regimens. Further studies are required before a more definitive conclusion can be made.](https://app.figure1.com/case-detail/5db2ead5-a4c9-4691-bc12-bc1e3af27ad8)

Trending now

\ \ A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.\ He had a history of hypertension, long-term smoking, and a sedentary lifestyle.\ On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a)

\ \ A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.\ Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5)

\ \ A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de)

\ \ patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?](https://app.figure1.com/case-detail/2af390e1-ace8-40ed-ba1c-98fb2d72f4c5)