在小鼠中慢性药理学拮抗 GM-CSF 受体不会复制肺表面活性物质蛋白沉积症表型,但会改变肺表面活性剂的转化。
Chronic pharmacological antagonism of the GM-CSF receptor in mice does not replicate the pulmonary alveolar proteinosis phenotype but does alter lung surfactant turnover.
机构信息
Research and Early Development, Respiratory & Immunology (R&I), AstraZeneca, Cambridge, U.K.
Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, U.K.
出版信息
Clin Sci (Lond). 2021 Nov 26;135(22):2559-2573. doi: 10.1042/CS20210713.
Granulocyte macrophage colony stimulating factor (GM-CSF) is a key participant in, and a clinical target for, the treatment of inflammatory diseases including rheumatoid arthritis (RA). Therapeutic inhibition of GM-CSF signalling using monoclonal antibodies to the α-subunit of the GM-CSF receptor (GMCSFRα) has shown clear benefit in patients with RA, giant cell arteritis (GCAs) and some efficacy in severe SARS-CoV-2 infection. However, GM-CSF autoantibodies are associated with the development of pulmonary alveolar proteinosis (PAP), a rare lung disease characterised by alveolar macrophage (AM) dysfunction and the accumulation of surfactant lipids. We assessed how the anti-GMCSFRα approach might impact surfactant turnover in the airway. Female C57BL/6J mice received a mouse-GMCSFRα blocking antibody (CAM-3003) twice per week for up to 24 weeks. A parallel, comparator cohort of the mouse PAP model, GM-CSF receptor β subunit (GMCSFRβ) knock-out (KO), was maintained up to 16 weeks. We assessed lung tissue histopathology alongside lung phosphatidylcholine (PC) metabolism using stable isotope lipidomics. GMCSFRβ KO mice reproduced the histopathological and biochemical features of PAP, accumulating surfactant PC in both broncho-alveolar lavage fluid (BALF) and lavaged lung tissue. The incorporation pattern of methyl-D9-choline showed impaired catabolism and not enhanced synthesis. In contrast, chronic supra-pharmacological CAM-3003 exposure (100 mg/kg) over 24 weeks did not elicit a histopathological PAP phenotype despite some changes in lung PC catabolism. Lack of significant impairment of AM catabolic function supports clinical observations that therapeutic antibodies to this pathway have not been associated with PAP in clinical trials.
粒细胞巨噬细胞集落刺激因子 (GM-CSF) 是治疗炎症性疾病(包括类风湿关节炎)的关键参与者和临床靶点。使用 GM-CSF 受体 (GMCSFRα) 的 α 亚单位单克隆抗体抑制 GM-CSF 信号传导,已在类风湿关节炎、巨细胞动脉炎和一些严重 SARS-CoV-2 感染患者中显示出明显的益处。然而,GM-CSF 自身抗体与肺肺泡蛋白沉积症(PAP)的发展有关,这是一种罕见的肺部疾病,其特征是肺泡巨噬细胞(AM)功能障碍和表面活性剂脂质的积累。我们评估了抗 GMCSFRα 方法可能对气道中表面活性剂周转的影响。雌性 C57BL/6J 小鼠每周接受两次抗 GM-CSF 受体α亚单位(CAM-3003)阻断抗体治疗,最多持续 24 周。同时,维持了一个 GM-CSF 受体β亚单位(GMCSFRβ)敲除(KO)的小鼠 PAP 模型对照队列,最多持续 16 周。我们使用稳定同位素脂质组学评估了肺组织病理学和肺磷脂酰胆碱(PC)代谢。GMCSFRβ KO 小鼠复制了 PAP 的组织病理学和生化特征,在支气管肺泡灌洗液(BALF)和灌洗肺组织中积累了表面活性剂 PC。甲基-D9-胆碱的掺入模式表明代谢受损,而不是增强合成。相比之下,24 周内慢性超药理学 CAM-3003 暴露(100mg/kg)尽管肺 PC 代谢发生了一些变化,但并未引起 PAP 表型的组织病理学变化。AM 代谢功能没有明显受损,这支持了临床试验中观察到的针对该途径的治疗性抗体不会与 PAP 相关的临床观察结果。