Graft-versus-host-like disease complicating thymoma: lack of AIRE expression as a cause of non-hereditary autoimmunity?

Immunol Lett. 2007 Nov 30;114(1):31-7. doi: 10.1016/j.imlet.2007.08.010. Epub 2007 Sep 29.

Abstract

Three patients with graft-versus-host-like enterocolonopathy are reported. Their history was remarkable for thymoma and other autoimmune manifestations such as thrombocytopenia, red cell aplasia, interface dermatitis, Sjogren sialadenits, vanishing bile ducts and rheumatoid arthritis. In all patients, microsatellite analysis showed the autologous nature of the lymphocytes in the affected organs ruling out GVHD. In search for mechanisms that could mediate loss of tolerance to self-antigens we found in a panel of thymomas, including those of the three patients, a complete lack of autoimmune regulator (AIRE) and minimal expression of the transcription factor FOXP3 in the intra-tumoral T cells. AIRE is a recently discovered transcription factor which plays a key role in the maintenance of central tolerance and is mutated in the autosomal recessive autoimmune polyendocrinopathy syndrome APS-1. Our observations indicate that thymoma-related autoimmunity can potentially be elicited by an incomplete deletion of 'self'-specific T cells in concert with an insufficient formation of natural Tregs.

Publication types

  • Case Reports

MeSH terms

  • AIRE Protein
  • Adult
  • Autoimmunity*
  • Colitis / immunology*
  • Female
  • Forkhead Transcription Factors / metabolism
  • Graft vs Host Disease / immunology
  • Humans
  • Male
  • Middle Aged
  • Mucous Membrane / cytology
  • Mucous Membrane / immunology
  • Mucous Membrane / metabolism
  • T-Lymphocytes, Regulatory / immunology
  • T-Lymphocytes, Regulatory / metabolism
  • Thymoma / immunology*
  • Thymoma / metabolism
  • Thymus Gland / immunology
  • Thymus Gland / metabolism
  • Thymus Neoplasms / immunology*
  • Thymus Neoplasms / metabolism
  • Transcription Factors / metabolism*

Substances

  • FOXP3 protein, human
  • Forkhead Transcription Factors
  • Transcription Factors