Heymann Felix, Meyer-Schwesinger Catherine, Hamilton-Williams Emma E, Hammerich Linda, Panzer Ulf, Kaden Sylvia, Quaggin Susan E, Floege Jürgen, Gröne Hermann-Josef, Kurts Christian
Institutes for Molecular Medicine and Experimental Immunology, Friedrich-Wilhelms-Universität, Bonn, Germany.
J Clin Invest. 2009 May;119(5):1286-97. doi: 10.1172/JCI38399. Epub 2009 Apr 20.
The progression of kidney disease to renal failure correlates with infiltration of mononuclear immune cells into the tubulointerstitium. These infiltrates contain macrophages, DCs, and T cells, but the role of each cell type in disease progression is unclear. To investigate the underlying immune mechanisms, we generated transgenic mice that selectively expressed the model antigens ovalbumin and hen egg lysozyme in glomerular podocytes (NOH mice). Coinjection of ovalbumin-specific transgenic CD8+ CTLs and CD4+ Th cells into NOH mice resulted in periglomerular mononuclear infiltrates and inflammation of parietal epithelial cells, similar to lesions frequently observed in human chronic glomerulonephritis. Repetitive T cell injections aggravated infiltration and caused progression to structural and functional kidney damage after 4 weeks. Mechanistic analysis revealed that DCs in renal lymph nodes constitutively cross-presented ovalbumin and activated CTLs. These CTLs released further ovalbumin for CTL activation in the lymph nodes and for simultaneous presentation to Th cells by distinct DC subsets residing in the kidney tubulointerstitium. Crosstalk between tubulointerstitial DCs and Th cells resulted in intrarenal cytokine and chemokine production and in recruitment of more CTLs, monocyte-derived DCs, and macrophages. The importance of DCs was established by the fact that DC depletion rapidly resolved established kidney immunopathology. These findings demonstrate that glomerular antigen-specific CTLs and Th cells can jointly induce renal immunopathology and identify kidney DCs as a mechanistic link between glomerular injury and the progression of kidney disease.
肾脏疾病进展为肾衰竭与单核免疫细胞浸润至肾小管间质相关。这些浸润细胞包含巨噬细胞、树突状细胞(DCs)和T细胞,但每种细胞类型在疾病进展中的作用尚不清楚。为了研究潜在的免疫机制,我们构建了在肾小球足细胞中选择性表达模型抗原卵清蛋白和鸡卵溶菌酶的转基因小鼠(NOH小鼠)。将卵清蛋白特异性转基因CD8⁺CTL和CD4⁺Th细胞共注射到NOH小鼠体内,导致肾小球周围单核细胞浸润和壁层上皮细胞炎症,类似于人类慢性肾小球肾炎中常见的病变。重复注射T细胞会加重浸润,并在4周后导致肾脏结构和功能损伤的进展。机制分析表明,肾淋巴结中的DCs持续交叉呈递卵清蛋白并激活CTL。这些CTL释放更多的卵清蛋白用于在淋巴结中激活CTL,并同时由驻留在肾小管间质中的不同DC亚群呈递给Th细胞。肾小管间质DCs与Th细胞之间的串扰导致肾内细胞因子和趋化因子的产生,并招募更多的CTL、单核细胞来源的DCs和巨噬细胞。DCs的重要性通过以下事实得以确立:去除DCs能迅速消除已形成的肾脏免疫病理学改变。这些发现表明,肾小球抗原特异性CTL和Th细胞可共同诱导肾脏免疫病理学改变,并确定肾脏DCs是肾小球损伤与肾脏疾病进展之间的机制性联系。