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Publication Detail
Investigating the biology of IL23 in monocyte-derived macrophages in enthesitis related arthritis
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Publication Type:Thesis/Dissertation
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Authors:Fisher C
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Date awarded:2022
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Status:Unpublished
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Awarding institution:UCL (University College London)
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Language:English
Abstract
Enthesitis related arthritis (ERA) is a subtype of juvenile arthritis with many similarities to
the adult spondyloarthropathies (SpA). The innate immune system, intracellular stress
responses (including the unfolded protein response (UPR)) and IL23/IL17 pathway are
implicated in the pathogenesis of adult SpA. However, these systems remain relatively
unexplored in ERA. Novel treatments for SpA which inhibit the IL23/IL17 pathway are now
available but their role in the treatment of ERA remains unclear.
The aim of this thesis was to study the biology of IL23 in the innate immune system (in
particular in monocyte-derived macrophages (MDMs)) and other relevant cytokines in
patients with ERA, compared to a group of age-matched controls and also adult patients
with SpA. A bioassay was developed to produce MDMs which were then stimulated with
lipopolysaccharide (LPS). Cytokine production at the protein and RNA level and
phosphorylation of p38 MAP kinase were used as outputs for this assay. The effect of
induction of the UPR on cytokine production was also studied, as well as a number of serum
biomarkers known to be relevant in adult SpA.
Key differences were observed in the production of IL23 and other cytokines from LPSstimulated MDMs with higher levels from patients with ERA compared to healthy controls.
Enthesitis, HLA B27 and male sex were especially associated with high levels of cytokine
production. Induction of the UPR was not associated with increased cytokine production
with the exception of GMCSF and there was no evidence of UPR upregulation in patients
with ERA or adult SpA. Higher levels of biomarkers including CRP, calprotectin and Dkk1
were observed in patients with ERA compared to healthy controls.
The results obtained in this thesis indicate important differences in the biology of IL23 and
other cytokines in patients with ERA compared to healthy controls which warrants further
study.
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