Ka Shuk-Man, Sytwu Huey-Kang, Chang Deh-Ming, Hsieh Shie-Liang, Tsai Pei-Yi, Chen Ann
Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan, ROC.
J Am Soc Nephrol. 2007 Sep;18(9):2473-85. doi: 10.1681/ASN.2006111242. Epub 2007 Aug 8.
Autoimmune crescentic glomerulonephritis (ACGN) is a variant of crescentic glomerulonephritis. The outcome of treatment of crescentic glomerulonephritis is poor. Binding of decoy receptor 3 (DCR3) to its ligand is capable of downregulating the alloresponsiveness of T cells. DCR3 has also been shown to benefit an experimental autoimmune model of diabetes. This study tested the hypothesis that a potential immune regulator, DCR3, could prevent the evolution of ACGN. With the use of an established ACGN model in mice, mice were treated with 100 microg/10 g body wt human DCR3 by hydrodynamics-based gene delivery at 14-d intervals. The results showed that the gene therapy resulted in (1) suppression of T and B cell activation and T cell proliferation; (2) a reduction in serum levels of proinflammatory cytokines; (3) improvement of proteinuria and renal dysfunction; (4) prevention of glomerular crescent formation, renal interstitial inflammation, and glomerulosclerosis; (5) a reduction in serum levels of autoantibodies and glomerular immune deposits; (6) inhibition of apoptosis in the spleen and kidney; (7) prevention of T cell and macrophage infiltration of the kidney; and (8) suppression of fibrosis-related gene expression in the kidney compared with empty vector-treated (disease control) ACGN mice. On the basis of these findings, it is proposed that human DCR3 exerts its preventive and protective effects on ACGN through modulation of T cell activation/proliferation, B cell activation, protection against apoptosis, and suppression of mononuclear leukocyte infiltration in the kidney.
自身免疫性新月体性肾小球肾炎(ACGN)是新月体性肾小球肾炎的一种变体。新月体性肾小球肾炎的治疗效果不佳。诱饵受体3(DCR3)与其配体的结合能够下调T细胞的同种异体反应性。DCR3也已被证明对糖尿病的实验性自身免疫模型有益。本研究检验了一种潜在的免疫调节剂DCR3可预防ACGN进展的假说。利用已建立的小鼠ACGN模型,通过基于流体动力学的基因递送,以14天的间隔给小鼠注射100μg/10g体重的人DCR3。结果显示,基因治疗导致:(1)T细胞和B细胞活化及T细胞增殖受到抑制;(2)促炎细胞因子血清水平降低;(3)蛋白尿和肾功能障碍得到改善;(4)肾小球新月体形成、肾间质炎症和肾小球硬化得到预防;(5)自身抗体血清水平和肾小球免疫沉积物减少;(6)脾脏和肾脏中的细胞凋亡受到抑制;(7)肾脏中T细胞和巨噬细胞浸润得到预防;(8)与空载体处理的(疾病对照)ACGN小鼠相比,肾脏中纤维化相关基因表达受到抑制。基于这些发现,提出人DCR3通过调节T细胞活化/增殖、B细胞活化、抗细胞凋亡以及抑制肾脏中的单核白细胞浸润,对ACGN发挥预防和保护作用。