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Open Access Highly Accessed Research article

Dysfunctional interferon-α production by peripheral plasmacytoid dendritic cells upon Toll-like receptor-9 stimulation in patients with systemic lupus erythematosus

Seung-Ki Kwok1, June-Yong Lee12, Se-Ho Park2, Mi-La Cho1, So-Youn Min1, Sung-Hwan Park1, Ho-Youn Kim1* and Young-Gyu Cho1*

Author affiliations

1 Department of Medicine, Division of Rheumatology, Center for Rheumatic Diseases and Rheumatism Research Center, Catholic Research Institutes of Medical Sciences, Catholic University of Korea, Banpo-Dong, Seocho-Gu, Seoul, 137-701, Korea

2 School of Life Sciences and Biotechnology, Korea University, Anam-Dong, Seongbuk-Gu, Seoul, 136-701, Korea

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Citation and License

Arthritis Research & Therapy 2008, 10:R29  doi:10.1186/ar2382

Published: 6 March 2008

Abstract

Background

It is well known that interferon (IFN)-α is important to the pathogenesis of systemic lupus erythematosus (SLE). However, several reports have indicated that the number of IFN-α producing cells are decreased or that their function is defective in patients with SLE. We studied the function of plasmacytoid dendritic cells (pDCs) under persistent stimulation of Toll-like receptor (TLR)9 via a TLR9 ligand (CpG ODN2216) or SLE serum.

Methods

The concentrations of IFN-α were determined in serum and culture supernatant of peripheral blood mononuclear cells (PBMCs) from SLE patients and healthy controls after stimulation with CpG ODN2216 or SLE serum. The numbers of circulating pDCs were analyzed by fluoresence-activated cell sorting analysis. pDCs were treated with CpG ODN2216 and SLE serum repeatedly, and levels of produced IFN-α were measured. The expression of IFN-α signature genes and inhibitory molecules of TLR signaling were examined in PBMCs from SLE patients and healthy control individuals.

Results

Although there was no significant difference in serum concentration of IFN-α and number of circulating pDCs between SLE patients and healthy control individuals, the IFN-α producing capacity of PBMCs was significantly reduced in SLE patients. Interestingly, the degree which TLR9 ligand-induced IFN-α production in SLE PBMCs was inversely correlated with the SLE serum-induced production of IFN-α in healthy PMBCs. Because repeated stimulation pDCs with TLR9 ligands showed decreased level of IFN-α production, continuous TLR9 stimulation may lead to decreased production of IFN-α in SLE PBMCs. In addition, PBMCs isolated from SLE patients exhibited higher expression of IFN-α signature genes and inhibitory molecules of TLR signaling, indicating that these cells had already undergone IFN-α stimulation and had become desensitized to TLR signaling.

Conclusion

We suggest that the persistent presence of endogenous IFN-α inducing factors induces TLR tolerance in pDCs of SLE patients, leading to impaired production of IFN-α.