Werwitzke S, Trick D, Sondermann P, Kamino K, Schlegelberger B, Kniesch K, Tiede A, Jacob U, Schmidt R E, Witte T
Department of Clinical Immunology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
Ann Rheum Dis. 2008 Feb;67(2):154-61. doi: 10.1136/ard.2006.068981. Epub 2007 Jun 8.
Systemic lupus erythematosus (SLE) is a classical autoimmune disorder characterised by the production of IgG autoantibodies against double-stranded DNA (dsDNA). Activation of Fc gamma R-bearing effector cells by immune complexes (ICs) is a key event in SLE pathogenesis as lupus-prone NZB/NZW F(1) hybrids lacking activating Fc gamma receptors (Fc gamma R) are protected against inflammatory kidney damage despite glomerular deposition of ICs. Moreover, soluble Fc gamma Rs inhibit IC-caused Arthus reaction in vivo. Therefore, recombinant human soluble Fc gamma RII (CD32) was evaluated as a novel therapeutic strategy in lupus-like disease in NZB/NZW F(1) hybrids.
Binding of husCD32 to murine IgG was studied in vitro by binding to IgG-coated erythrocytes and inhibition of phagocytosis of IgG-opsonised murine erythrocytes. In order to examine therapeutic impact of husCD32 in vivo, female NZB/NZW F(1) mice were treated either from week 16 to 20 ("prophylactic", 150 microg/week husCD32) or continuously from week 24 ("therapeutic"; 100 microg/week husCD32) by subcutaneous injections. Controls received buffered saline.
In vitro investigations of husCD32 revealed binding to murine erythrocytes coated with murine IgG. Moreover, husCD32 substantially diminished phagocytosis of murine IgG-opsonised murine red blood cells by peritoneal macrophages indicating disruption of IgG-Fc gamma R interaction. There was a therapeutic efficacy of husCD32 to attenuate lupus pathology indicated by significantly delayed onset of proteinuria and weight loss, reduced histopathological findings, delayed development of anaemia and improved survival by prophylactic application. Therapeutic treatment did not reverse nephritis but significantly prolonged survival despite apparent kidney damage. B cell count, concentration of IgG anti-dsDNA autoantibodies and deposition of glomerular ICs was not significantly affected by the application of husCD32.
The results demonstrate binding properties of husCD32 to ICs in vitro and as a proof-of-principle therapeutic efficacy in inhibiting chronic murine lupus pathology in vivo.
系统性红斑狼疮(SLE)是一种典型的自身免疫性疾病,其特征是产生针对双链DNA(dsDNA)的IgG自身抗体。免疫复合物(ICs)激活携带FcγR的效应细胞是SLE发病机制中的关键事件,因为缺乏激活型Fcγ受体(FcγR)的狼疮易感NZB/NZW F1杂交小鼠尽管ICs在肾小球沉积,但可免受炎症性肾损伤。此外,可溶性FcγR在体内可抑制ICs引起的阿瑟斯反应。因此,对重组人可溶性FcγRII(CD32)作为NZB/NZW F1杂交小鼠狼疮样疾病的一种新型治疗策略进行了评估。
通过与IgG包被的红细胞结合以及抑制IgG调理的小鼠红细胞的吞噬作用,在体外研究重组人可溶性FcγRII(husCD32)与小鼠IgG的结合。为了研究husCD32在体内的治疗作用,对雌性NZB/NZW F1小鼠从第16周开始至第20周(“预防性”,150μg/周husCD32)或从第24周开始持续(“治疗性”;100μg/周husCD32)进行皮下注射治疗。对照组接受缓冲盐水。
对husCD32的体外研究显示其与小鼠IgG包被的小鼠红细胞结合。此外,husCD32显著减少了腹膜巨噬细胞对IgG调理的小鼠红细胞的吞噬作用,表明IgG-FcγR相互作用被破坏。预防性应用husCD32可减轻狼疮病理,表现为蛋白尿和体重减轻的发病明显延迟、组织病理学结果减轻、贫血发展延迟以及生存率提高,具有治疗效果。治疗性治疗虽未逆转肾炎,但尽管存在明显的肾损伤,仍显著延长了生存期。husCD32的应用对B细胞计数、IgG抗dsDNA自身抗体浓度和肾小球ICs沉积无显著影响。
结果证明了husCD32在体外与ICs的结合特性,并作为一种原理验证,证明其在体内抑制慢性小鼠狼疮病理方面具有治疗效果。