In this project we seek to understand how alterations in the oral and gut microbial flora might contribute to the pathogenesis of lgG4-related disease. Recent studies on this disease and the dominance of clonal interferon gamma expressing helper T cells suggests broad similarities to Crohn's disease as well as to mycobacterial diseases, disorders in which the role of microbes in not in question. The presence of a unique polarized T cell population also suggests the potential involvement of specific intestinal microbial species or communities in the disease process. There is a strong case to be made therefore to look at the microbiome in lgG4-related disease. There are three aspects to these studies. In one aspect we will directly examine tissue samples from diseased organs for the presence of microbial components using Next Generation Sequencing approaches. We will also look at the oral microbial flora comparing patients with salivary gland and palatal disease with those in which these organs are not involved and also segregate patients based on clinical and immunological characteristics and genetic differences. We will also examine the intestinal microbial flora in subjects with different clinical, immunological and genetically distinct disease subtypes for distinct bacterial community memberships to see whether community memberships contribute to disease or are potentially altered by the disease process. We will monitor changes in community memberships after treatment to attempt to answer this issue. Finally we will ask if defined subgroups of subjects with lgG4-RD have differences in terms of the metagenome or the metatranscriptome.

Public Health Relevance

The underlying basis for individuals developing lgG4-related disease with severe tissue scarring is unclear. This autoimmune disease may owe its origins in part in part to the presence of different microbes in our mouths or intestines. Microbes may be present in the damages tissue itself or changes in microbes in the mouth or intestine may cause the expansion of the immune cells that cause disease.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Research Program--Cooperative Agreements (U19)
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Special Emphasis Panel (ZAI1)
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Massachusetts General Hospital
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Alsufyani, Faisal; Mattoo, Hamid; Zhou, Dawang et al. (2018) The Mst1 Kinase Is Required for Follicular B Cell Homing and B-1 B Cell Development. Front Immunol 9:2393
Wallace, Zachary S; Khosroshahi, Arezou; Carruthers, Mollie D et al. (2018) An International Multispecialty Validation Study of the IgG4-Related Disease Responder Index. Arthritis Care Res (Hoboken) 70:1671-1678
Perugino, Cory A; AlSalem, Sultan B; Mattoo, Hamid et al. (2018) Identification of galectin-3 as an autoantigen in patients with IgG4-related disease. J Allergy Clin Immunol :
Maehara, Takashi; Mattoo, Hamid; Mahajan, Vinay S et al. (2018) The expansion in lymphoid organs of IL-4+ BATF+ T follicular helper cells is linked to IgG4 class switching in vivo. Life Sci Alliance 1:
Della-Torre, Emanuel; Bozzalla-Cassione, Emanuele; Sciorati, Clara et al. (2018) A CD8?- Subset of CD4+SLAMF7+ Cytotoxic T Cells Is Expanded in Patients With IgG4-Related Disease and Decreases Following Glucocorticoid Treatment. Arthritis Rheumatol 70:1133-1143
Jubair, Widian K; Hendrickson, Jason D; Severs, Erin L et al. (2018) Modulation of Inflammatory Arthritis in Mice by Gut Microbiota Through Mucosal Inflammation and Autoantibody Generation. Arthritis Rheumatol 70:1220-1233
Fraschilla, Isabella; Pillai, Shiv (2017) Viewing Siglecs through the lens of tumor immunology. Immunol Rev 276:178-191
Mattoo, Hamid; Stone, John H; Pillai, Shiv (2017) Clonally expanded cytotoxic CD4+T cells and the pathogenesis of IgG4-related disease. Autoimmunity 50:19-24
Perugino, Cory A; Mattoo, Hamid; Mahajan, Vinay S et al. (2017) Emerging Treatment Models in Rheumatology: IgG4-Related Disease: Insights Into Human Immunology and Targeted Therapies. Arthritis Rheumatol 69:1722-1732
Maehara, Takashi; Mattoo, Hamid; Ohta, Miho et al. (2017) Lesional CD4+ IFN-?+ cytotoxic T lymphocytes in IgG4-related dacryoadenitis and sialoadenitis. Ann Rheum Dis 76:377-385

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