Seattle Children's Research Institute, Seattle, Washington, USA.
Department of Immunology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Kidney Int. 2018 Oct;94(4):728-740. doi: 10.1016/j.kint.2018.03.012. Epub 2018 Jun 12.
B cells are known to promote the pathogenesis of systemic lupus erythematosus (SLE) via the production of pathogenic anti-nuclear antibodies. However, the signals required for autoreactive B cell activation and the immune mechanisms whereby B cells impact lupus nephritis pathology remain poorly understood. The B cell survival cytokine B cell activating factor of the TNF Family (BAFF) has been implicated in the pathogenesis of SLE and lupus nephritis in both animal models and human clinical studies. Although the BAFF receptor has been predicted to be the primary BAFF family receptor responsible for BAFF-driven humoral autoimmunity, in the current study we identify a critical role for signals downstream of Transmembrane Activator and CAML Interactor (TACI) in BAFF-dependent lupus nephritis. Whereas transgenic mice overexpressing BAFF develop progressive membranoproliferative glomerulonephritis, albuminuria and renal dysfunction, TACI deletion in BAFF-transgenic mice provided long-term (about 1 year) protection from renal disease. Surprisingly, disease protection in this context was not explained by complete loss of glomerular immune complex deposits. Rather, TACI deletion specifically reduced endocapillary, but not mesangial, immune deposits. Notably, although excess BAFF promoted widespread breaks in B cell tolerance, BAFF-transgenic antibodies were enriched for RNA- relative to DNA-associated autoantigen reactivity. These RNA-associated autoantibody specificities were specifically reduced by TACI or Toll-like receptor 7 deletion. Thus, our study provides important insights into the autoantibody specificities driving proliferative lupus nephritis, and suggests that TACI inhibition may be novel and effective treatment strategy in lupus nephritis.
B 细胞被认为通过产生致病性抗核抗体来促进系统性红斑狼疮 (SLE) 的发病机制。然而,自身反应性 B 细胞激活所需的信号以及 B 细胞影响狼疮肾炎病理的免疫机制仍知之甚少。肿瘤坏死因子家族的 B 细胞激活因子 (BAFF) 是一种 B 细胞存活因子,已被认为与 SLE 和狼疮肾炎的发病机制有关,在动物模型和人类临床研究中均有报道。虽然 BAFF 受体被预测为负责 BAFF 驱动的体液自身免疫的主要 BAFF 家族受体,但在本研究中,我们发现跨膜激活剂和钙调蛋白相互作用因子 (TACI) 下游信号在 BAFF 依赖性狼疮肾炎中起着关键作用。尽管过表达 BAFF 的转基因小鼠会发展出进行性膜性增殖性肾小球肾炎、白蛋白尿和肾功能障碍,但在 BAFF 转基因小鼠中敲除 TACI 可提供长期(约 1 年)的肾脏疾病保护。令人惊讶的是,在这种情况下,疾病的保护并不是由于肾小球免疫复合物沉积的完全缺失。相反,TACI 缺失特异性地减少了内皮层,而不是系膜的免疫沉积。值得注意的是,尽管过量的 BAFF 促进了 B 细胞耐受的广泛破坏,但 BAFF 转基因抗体对 RNA 相关自身抗原的反应性高于 DNA 相关自身抗原。TACI 或 Toll 样受体 7 的缺失特异性地减少了这些 RNA 相关自身抗体特异性。因此,我们的研究为驱动增生性狼疮肾炎的自身抗体特异性提供了重要的见解,并表明 TACI 抑制可能是狼疮肾炎的一种新的有效治疗策略。