Zhao Zeguo, Weinstein Elena, Tuzova Marina, Davidson Anne, Mundel Peter, Marambio Paola, Putterman Chaim
Albert Einstein College of Medicine, Bronx, New York 10461, USA.
Arthritis Rheum. 2005 Feb;52(2):522-30. doi: 10.1002/art.20862.
Cross-reactivity with kidney antigens is believed to be a critical determinant in the renal pathogenicity of anti-double-stranded DNA (anti-dsDNA) antibodies. Murine nephritogenic anti-dsDNA antibodies have been shown to cross-react with alpha-actinin, and anti-alpha-actinin antibodies have been found to be deposited in the kidneys of lupus mice with active nephritis. Furthermore, in humans with systemic lupus erythematosus (SLE), it has been found that a greater proportion of polyclonal IgG anti-dsDNA antibodies from patients with renal involvement bind to alpha-actinin than do those from patients without renal disease. We undertook this study to substantiate a direct link between cross-reactive anti-dsDNA/anti-alpha-actinin antibodies and the pathogenesis of lupus nephritis in humans.
A panel of 10 anti-dsDNA and/or anti-alpha-actinin antibodies was generated by Epstein-Barr virus transformation of lymphocytes from patients with SLE and was extensively characterized. Antibody binding was studied by enzyme-linked immunosorbent assay and Western blotting. Antibody potential for pathogenicity was assessed by measuring binding to isolated glomeruli and mesangial cells and by evaluation of histologic features of the kidney following injection in vivo.
All anti-dsDNA antibodies isolated also bound alpha-actinin. Cross-reactive antibodies bound to mesangial cells and to isolated glomeruli ex vivo. Binding to glomeruli was not inhibited by DNase treatment, but could be abrogated by alpha-actinin. Furthermore, histopathologic abnormalities seen in mice injected intraperitoneally with a cross-reactive cell line included fusion of podocyte foot processes and subepithelial and subendothelial deposition.
These studies provide strong support for the hypothesis that alpha-actinin is a major cross-reactive target for anti-dsDNA antibodies in SLE patients. Cross-reactive anti-dsDNA/anti-alpha-actinin antibodies from SLE patients are pathogenic and may contribute to the kidney lesions in lupus nephritis.
与肾脏抗原的交叉反应被认为是抗双链DNA(抗dsDNA)抗体导致肾脏致病性的关键决定因素。已表明鼠源性致肾炎抗dsDNA抗体可与α - 辅肌动蛋白发生交叉反应,并且在患有活动性肾炎的狼疮小鼠肾脏中发现了抗α - 辅肌动蛋白抗体的沉积。此外,在系统性红斑狼疮(SLE)患者中,已发现与无肾脏疾病的患者相比,有肾脏受累的患者体内更多的多克隆IgG抗dsDNA抗体与α - 辅肌动蛋白结合。我们开展这项研究以证实交叉反应性抗dsDNA /抗α - 辅肌动蛋白抗体与人类狼疮性肾炎发病机制之间的直接联系。
通过对SLE患者淋巴细胞进行爱泼斯坦 - 巴尔病毒转化,产生了一组10种抗dsDNA和/或抗α - 辅肌动蛋白抗体,并对其进行了广泛表征。通过酶联免疫吸附测定和蛋白质印迹研究抗体结合情况。通过测量与分离的肾小球和系膜细胞的结合以及评估体内注射后肾脏的组织学特征来评估抗体的致病潜力。
所有分离出的抗dsDNA抗体也与α - 辅肌动蛋白结合。交叉反应性抗体在体外与系膜细胞和分离的肾小球结合。与肾小球的结合不受DNase处理的抑制,但可被α - 辅肌动蛋白消除。此外,腹腔注射交叉反应性细胞系的小鼠出现的组织病理学异常包括足细胞足突融合以及上皮下和内皮下沉积。
这些研究为α - 辅肌动蛋白是SLE患者抗dsDNA抗体的主要交叉反应靶点这一假说提供了有力支持。SLE患者的交叉反应性抗dsDNA /抗α - 辅肌动蛋白抗体具有致病性,可能导致狼疮性肾炎的肾脏病变。