Background: Type 1 autoimmune pancreatitis (AIP) is a pancreatic manifestation of IgG4-related disease (IgG4-RD). Although AIP and IgG4-RD are characterized by multiple organ involvement including salivary glands, lung, and kidney, co-occurrence of chronic rhinosinusitis (CRS) and AIP/IgG4-RD has been poorly defined.

Objective: We explored molecular mechanism accounting for the co-occurrence of CRS and AIP/IgG4-RD.

Methods: Serum concentrations of IFN-α and IL-33 were measured by enzyme-linked immune-sorbent assay.

Results: We encountered a patient with concurrent type 1 AIP/IgG4-RD and CRS. Induction of remission by prednisolone (PSL) for type 1 AIP/IgG4-RD led to a marked improvement of CRS. Serum cytokine analysis after PSL treatment revealed a marked reduction in serum concentrations of IFN-α and IL-33, both of which are candidate pathogenic cytokines for AIP/IgG4-RD.

Conclusions: Given that IL-33 is shared as one of pathogenic cytokines by type 1 AIP/IgG4-RD and CRS, enhanced IL33 responses may cause concurrent type 1 AIP/IgG4-RD and CRS.

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http://dx.doi.org/10.12932/AP-311020-0990DOI Listing

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Article Synopsis
  • Plasmacytoid dendritic cells (pDCs) produce type 1 interferons (IFN-I), which are important for fighting viral infections but can lead to autoimmune diseases like systemic lupus erythematosus (SLE) and psoriasis if overly activated.
  • Autoimmune pancreatitis (AIP) is linked to the broader condition of immunoglobulin G4-related disease (IgG4-RD), characterized by chronic inflammation and elevated IgG4 antibodies, although the exact mechanisms behind their development are not well understood.
  • Research indicates that the activation of pDCs plays a crucial role in AIP and IgG4-RD through increased production of IFN-I and interleukin-33 (IL
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Background: Type 1 autoimmune pancreatitis (AIP) is a pancreatic manifestation of IgG4-related disease (IgG4-RD). Although AIP and IgG4-RD are characterized by multiple organ involvement including salivary glands, lung, and kidney, co-occurrence of chronic rhinosinusitis (CRS) and AIP/IgG4-RD has been poorly defined.

Objective: We explored molecular mechanism accounting for the co-occurrence of CRS and AIP/IgG4-RD.

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Mechanistic Insights into Autoimmune Pancreatitis and IgG4-Related Disease.

Trends Immunol

November 2018

Mucosal Immunity Section, Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA. Electronic address:

Autoimmune pancreatitis (AIP) is a pancreatic manifestation of a recently defined disease form known as IgG4-related disease (AIP/IgG4-RD). AIP/IgG4-RD is characterized by elevated systemic IgG4 antibody concentrations and lesional tissues infiltrated by IgG4-expressing plasmacytes. In addition, recent studies have revealed that, in common with other autoimmune diseases, such as systemic lupus erythematosus (SLE) and psoriasis, AIP/IgG4-RD is associated with increased type I IFN (IFN-I) production by plasmacytoid dendritic cells (pDCs).

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