Li Cheuk Wun, Osman Roman, Menconi Francesca, Concepcion Erlinda S, Tomer Yaron
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Department of Structural and Chemical Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
J Autoimmun. 2017 Jan;76:1-9. doi: 10.1016/j.jaut.2016.09.007. Epub 2016 Sep 23.
Autoimmune polyglandular syndrome 3 variant (APS3v) refers to the co-occurrence of autoimmune thyroiditis (AITD) and type 1 diabetes (T1D) within the same individual. HLA class II confers the strongest susceptibility to APS3v. We previously identified a unique amino acid signature of the HLA-DR pocket (designated APS3v HLA-DR pocket) that predisposes to APS3v. We hypothesized that both thyroid and islet peptides can be presented by the unique APS3v HLA-DR pocket, triggering AITD + T1D together. To test this hypothesis we screened islet and thyroid peptides for their ability to bind to the APS3v HLA-DR pocket. Virtual screen of all possible thyroglobulin (Tg), thyroid-stimulating hormone receptor (TSHR), thyroid peroxidase (TPO), insulin (Ins), and glutamic acid decarboxylase 65 (GAD65) peptides identified 36 peptides that bound to this unique pocket. In vitro binding assays using baculovirus-produced recombinant APS3v HLA-DR identified 11 thyroid/islet peptides (of the 36 predicted binders) that bound with high affinity. By immunizing humanized HLA-DR3 mice carrying the APS3v HLA-DR pocket we identified 4 peptides (Tg.1571, GAD.492, TPO.758, TPO.338) that were presented by antigen presenting cells and elicited T-cell response. We conclude that both thyroid and islet peptides can bind to this flexible APS3v HLA-DR pocket and induce thyroid and islet specific T-cell responses. These findings set the stage to developing specific inhibitors of the APS3v HLA-DR pocket as a precision medicine approach to treating or preventing APS3v in patients that carry this genetic HLA-DR pocket variant.
自身免疫性多腺体综合征3型变异体(APS3v)是指同一个体内自身免疫性甲状腺炎(AITD)和1型糖尿病(T1D)同时出现。HLA II类分子赋予了对APS3v最强的易感性。我们之前鉴定出了HLA-DR口袋的一种独特氨基酸特征(称为APS3v HLA-DR口袋),它易导致APS3v。我们推测甲状腺和胰岛肽都可以由独特的APS3v HLA-DR口袋呈递,从而共同引发AITD + T1D。为了验证这一假设,我们筛选了胰岛和甲状腺肽与APS3v HLA-DR口袋结合的能力。对所有可能的甲状腺球蛋白(Tg)、促甲状腺激素受体(TSHR)、甲状腺过氧化物酶(TPO)、胰岛素(Ins)和谷氨酸脱羧酶65(GAD65)肽进行虚拟筛选,鉴定出36种与这个独特口袋结合的肽。使用杆状病毒产生的重组APS3v HLA-DR进行的体外结合试验,确定了36种预测结合肽中的11种甲状腺/胰岛肽以高亲和力结合。通过免疫携带APS3v HLA-DR口袋的人源化HLA-DR3小鼠,我们鉴定出4种由抗原呈递细胞呈递并引发T细胞反应的肽(Tg.1571、GAD.492、TPO.758、TPO.338)。我们得出结论,甲状腺和胰岛肽都可以与这个灵活的APS3v HLA-DR口袋结合,并诱导甲状腺和胰岛特异性T细胞反应。这些发现为开发APS3v HLA-DR口袋的特异性抑制剂奠定了基础,作为一种精准医学方法,用于治疗或预防携带这种遗传性HLA-DR口袋变异体的患者的APS3v。