TNF-producing Th1 cells are selectively expanded in liver infiltrates of patients with autoimmune hepatitis

CS Bovensiepen, M Schakat, M Sebode… - The Journal of …, 2019 - journals.aai.org
CS Bovensiepen, M Schakat, M Sebode, R Zenouzi, J Hartl, M Peiseler, J Li, L Henze…
The Journal of Immunology, 2019journals.aai.org
Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease that is believed to be
driven by a CD4+ T cell response to liver Ags. However, the pathogenic function of CD4+
effector T cells in AIH is not fully understood. To characterize liver-infiltrating lymphocytes in
AIH, we determined the cytokine production of infiltrating cells obtained from biopsy material
by quantitative RT-PCR and flow cytometry. A cytokine quantitiative RT-PCR array of AIH
specimens revealed that TNF was the most strongly upregulated cytokine, as compared with …
Abstract
Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease that is believed to be driven by a CD4+ T cell response to liver Ags. However, the pathogenic function of CD4+ effector T cells in AIH is not fully understood. To characterize liver-infiltrating lymphocytes in AIH, we determined the cytokine production of infiltrating cells obtained from biopsy material by quantitative RT-PCR and flow cytometry. A cytokine quantitiative RT-PCR array of AIH specimens revealed that TNF was the most strongly upregulated cytokine, as compared with control livers. To confirm this finding, we determined the frequencies of TNF-producing CD4+ T cells in peripheral blood and in liver biopsy specimens in comparison with those of CD4+ T cells producing IFN-γ or IL-17. In AIH, TNF-producing CD4+ T cells were significantly expanded, both in blood and liver, whereas IL-17–producing CD4+ T cells were not. However, the majority of the TNF-producing CD4+ T cells in AIH also produced IFN-γ, suggesting that TNF producers might represent a pathogenic activation state of Th1 cells. Ag-specific stimulation of PBMC from AIH patients with the AIH-associated autoantigen SEPSECS resulted in significant TNF production only in patients manifesting SLA/LP autoantibodies targeting SEPSEC but not in healthy individuals who do not manifest this reactivity. Taken together, our findings indicated that TNF-producing CD4+ T cells are expanded in AIH, both in blood and in liver. TNF-producing CD4+ T cells in AIH seem to be aberrantly activated Th1 cells. Our findings provide a rationale for therapeutic efforts using TNF blockade in AIH.
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