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Common connective tissue disorder and anti-cytokine autoantibodies are enriched in idiopathic multicentric castleman disease patients
Stanford Univ, Sch Med, Dept Med, Div Immunol & Rheumatol, Stanford, CA 94305 USA; Stanford Univ, Sch Med, Inst Immun Transplantat & Infect, Stanford, CA 94305 USA.
Univ Penn, Ctr Cytokine Storm Treatment & Lab, Philadelphia, PA 19104 USA.
Stanford Univ, Sch Med, Dept Med, Div Immunol & Rheumatol, Stanford, CA 94305 USA; Stanford Univ, Sch Med, Inst Immun Transplantat & Infect, Stanford, CA 94305 USA.
Stanford Univ, Sch Med, Dept Med, Div Immunol & Rheumatol, Stanford, CA 94305 USA; Stanford Univ, Sch Med, Inst Immun Transplantat & Infect, Stanford, CA 94305 USA.
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2025 (English)In: Frontiers in Immunology, E-ISSN 1664-3224, Vol. 16, article id 1528465Article in journal (Refereed) Published
Abstract [en]

Introduction Idiopathic Multicentric Castleman Disease (iMCD) is a polyclonal lymphoproliferative disorder involving cytokine storms that can lead to organ failure and death. The cause of iMCD is unknown, but some clinical evidence suggests an autoimmune etiology. For example, connective tissue disorders (CTDs) and iMCD share many clinical features, and autoantibodies have been anecdotally reported in individual iMCD patients. This study investigates whether common autoantibodies are shared across iMCD patients.Methods We assembled custom bead-based protein arrays consisting of 52 autoantigens traditionally associated with CTDs and 38 full-length cytokines and screened serum samples from 101 iMCD patients for IgG autoantibodies. We also screened samples with a 1,103-plex array of recombinant human protein fragments to identify additional autoantibody targets. Finally, we performed receptor blocking assays on select samples with anti-cytokine autoantibodies (ACAs) identified by array.Results We found that an increased proportion of iMCD patients (47%) tested positive for at least one CTD-associated autoantibody compared to healthy controls (HC) (17%). Commonly detected CTD-associated autoantibodies were associated with myositis and overlap syndromes as well as systemic lupus erythematosus (SLE) and Sj & ouml;gren's Syndrome (SS). ACAs were also detected in a greater proportion of iMCD patients (38%) compared to HC (10%), while the protein fragment array identified a variety of other autoantibody targets. One iMCD sample tested positive for receptor blocking against interferon-omega (IFN omega).Discussion IgG autoantibodies binding autoantigens associated with common CTDs and cytokines are elevated in iMCD patients compared to HC, suggesting that autoimmunity may be involved in iMCD pathogenesis.

Place, publisher, year, edition, pages
Frontiers Media SA , 2025. Vol. 16, article id 1528465
Keywords [en]
iMCD, TAFRO, luminex, protein array, autoantibody, connective tissue disorders, autoimmunity
National Category
Immunology in the Medical Area
Identifiers
URN: urn:nbn:se:kth:diva-363139DOI: 10.3389/fimmu.2025.1528465ISI: 001457818400001PubMedID: 40181993Scopus ID: 2-s2.0-105001684344OAI: oai:DiVA.org:kth-363139DiVA, id: diva2:1956530
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QC 20250506

Available from: 2025-05-06 Created: 2025-05-06 Last updated: 2025-05-06Bibliographically approved

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Dodig-Crnkovic, TeaSchwenk, Jochen M.

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