Journal
FRONTIERS IN IMMUNOLOGY
Volume 11, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2020.605214
Keywords
IgG4 autoimmune disease; MHC; autoimmunity; HLA-DRB1; HLA-DQB1; etiology; HLA class II
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Funding
- Hertha Firnberg Fellowship by the Austrian Science Fund, Austria [T996-B30]
- German Research Foundation (DFG) [LE 2593/3-1]
- German Ministry of Education and Research [01GM1908A]
- E-Rare Joint Transnational research support (ERA-Net) [LE3064/2-1]
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IgG4 autoimmune diseases are a group of emerging autoimmune diseases characterized by pathogenic autoantibodies of the IgG4 subclass. Patients in this group respond well to rituximab and share a genetic predisposition, with studies suggesting an association with HLA class II genes.
IgG4 autoimmune diseases (IgG4-AID) are an emerging group of autoimmune diseases that are caused by pathogenic autoantibodies of the IgG4 subclass. It has only recently been appreciated, that members of this group share relevant immunobiological and therapeutic aspects even though different antigens, tissues and organs are affected: glomerulonephritis (kidney), pemphigus vulgaris (skin), thrombotic thrombocytopenic purpura (hematologic system) muscle-specific kinase (MuSK) in myasthenia gravis (peripheral nervous system) and autoimmune encephalitis (central nervous system) to give some examples. In all these diseases, patients' IgG4 subclass autoantibodies block protein-protein interactions instead of causing complement mediated tissue injury, patients respond favorably to rituximab and share a genetic predisposition: at least five HLA class II genes have been reported in individual studies to be associated with several different IgG4-AID. This suggests a role for the HLA class II region and specifically the DR beta 1 chain for aberrant priming of autoreactive T-cells toward a chronic immune response skewed toward the production of IgG4 subclass autoantibodies. The aim of this review is to provide an update on findings arguing for a common pathogenic mechanism in IgG4-AID in general and to provide hypotheses about the role of distinct HLA haplotypes, T-cells and cytokines in IgG4-AID.
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