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A positive cytokine/chemokine feedback loop establishes plasmacytoid DC–driven autoimmune pancreatitis in IgG4-related disease
Akane Hara, Tomohiro Watanabe, Kosuke Minaga, Tomoe Yoshikawa, Masayuki Kurimoto, Ikue Sekai, Yasuhiro Masuta, Ryutaro Takada, Yasuo Otsuka, Ken Kamata, Shiki Takamura, Masatoshi Kudo, Warren Strober
Akane Hara, Tomohiro Watanabe, Kosuke Minaga, Tomoe Yoshikawa, Masayuki Kurimoto, Ikue Sekai, Yasuhiro Masuta, Ryutaro Takada, Yasuo Otsuka, Ken Kamata, Shiki Takamura, Masatoshi Kudo, Warren Strober
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Research Article Gastroenterology

A positive cytokine/chemokine feedback loop establishes plasmacytoid DC–driven autoimmune pancreatitis in IgG4-related disease

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Abstract

The pathogenesis of the murine model of autoimmune pancreatitis associated with IgG4-related disease (AIP/IgG4-RD) induced by administration of polyinosinic-polycytidylic acid (poly[I:C]) is incompletely understood. While it is known that murine and human AIP/IgG4-RD is driven by plasmacytoid dendritic cells (pDCs) producing IFN-α, the origin of these cells and their relation to effector T cells is not known. Here, we show that murine AIP was initiated by TLR3-bearing conventional DCs in the uninflamed pancreas whose activation by the TLR3 ligand poly(I:C) caused IFN-α, CXCL9, and CXCL10 secretion. This, in turn, induced pancreatic recruitment of CXCR3+ T cells and these T cells, via their secretion of CCL25, facilitated migration of pDCs bearing CCR9 into the pancreas. This established a feedback loop anchored by the now dominant pDC production of IFN-α and the continued CXCR3+ T cell facilitation of pDC migration. Remarkably, the interaction between CXCR3+ T cells and pDCs also existed at the functional level since this interaction enhanced the production of CCL25 and IFN-α by CXCR3+ T cells and pDCs, respectively. Evidence presented here that a similar disease mechanism was present in human AIP/IgG4-RD creates new avenues of disease treatment.

Authors

Akane Hara, Tomohiro Watanabe, Kosuke Minaga, Tomoe Yoshikawa, Masayuki Kurimoto, Ikue Sekai, Yasuhiro Masuta, Ryutaro Takada, Yasuo Otsuka, Ken Kamata, Shiki Takamura, Masatoshi Kudo, Warren Strober

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Figure 11

Serum concentrations of CXCL9, CXCL10, CCL25, and CCL22 in patients with autoimmune pancreatitis/IgG4-related disease.

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Serum concentrations of CXCL9, CXCL10, CCL25, and CCL22 in patients with...
Serum samples were collected from healthy controls (HC, n = 8), chronic alcoholic pancreatitis (CP) patients (n = 12), and autoimmune pancreatitis (AIP)/IgG4-related disease (IgG4-RD) patients (n = 33). (A) Serum concentrations of CXCL9, CXCL10, CCL25, and CCL22; each dot corresponds to a value in 1 patient. Statistical analyses: Kruskal-Wallis test and Bonferroni-corrected Mann-Whitney U test. Results are expressed as mean ± SEM. (B) Serum chemokine levels from patients with AIP/IgG4-RD (n = 14) before and after induction of remission with prednisolone (PSL) therapy. Statistical analyses: Wilcoxon’s signed-rank test. (C and D) Correlation between serum IgG4 or IFN-α levels and chemokines in patients with AIP/IgG4-RD. Each dot represents 1 patient. P values and correlation coefficient (r) values, as determined by Spearman’s rank correlation test, are shown. *P < 0.05; **P < 0.01.

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