Department of Rheumatology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
Department of Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Arch Pharm Res. 2024 Jul;47(7):632-644. doi: 10.1007/s12272-024-01505-1. Epub 2024 Jul 8.
Systemic lupus erythematosus (SLE) is a common autoimmune disease, and its pathogenesis mainly involves the aberrant activation of B cells through follicular helper T (Tfh) cells to produce pathogenic antibodies, which requires more effective and safe treatment methods. Dihydroartemisinin (DHA) is the main active ingredient of artemisinin and has immunosuppressive effects. In this study, in vitro experiments confirmed that DHA inhibited Tfh cell induction and weakened its auxiliary function in B cell differentiation; furthermore, DHA directly inhibited B cell activation, differentiation, and antibody production. Furthermore, a mouse model of SLE was established, and we confirmed that DHA significantly reduced the symptoms of SLE and lupus nephritis, and decreased serum immunoglobulin (Ig)G, IgM, IgA, and anti-dsDNA levels. Moreover, DHA reduced the frequencies of total Tfh cells, activated Tfh cells, and B cell lymphoma 6, and interleukin (IL)-21 levels in Tfh cells from the spleen and lymph nodes, as well as the levels of B cells, germinal center B cells, and plasma cells in the spleen, lymph nodes, and kidneys. Additionally, DHA inhibited Tfh cells by blocking IL-2-inducible T cell kinase (ITK) signaling and its downstream nuclear factor (NF)-κB, nuclear factor of activated T cell, and activating protein-1 pathways, and directly inhibited B cells by blocking Bruton's tyrosine kinase (BTK) signaling and the downstream NF-κB and Myc pathways. Overall, our results demonstrated that DHA inhibited Tfh cells by blocking ITK signaling and also directly inhibited B cells by blocking BTK signaling. Therefore, reducing the production of pathogenic antibodies might effectively treat SLE.
系统性红斑狼疮(SLE)是一种常见的自身免疫性疾病,其发病机制主要涉及滤泡辅助 T(Tfh)细胞通过异常激活 B 细胞产生致病性抗体,这需要更有效和安全的治疗方法。二氢青蒿素(DHA)是青蒿素的主要活性成分,具有免疫抑制作用。在这项研究中,体外实验证实 DHA 抑制了 Tfh 细胞的诱导,并削弱了其对 B 细胞分化的辅助功能;此外,DHA 直接抑制了 B 细胞的活化、分化和抗体产生。此外,建立了 SLE 小鼠模型,我们证实 DHA 显著减轻了 SLE 和狼疮肾炎的症状,并降低了血清免疫球蛋白(Ig)G、IgM、IgA 和抗 dsDNA 水平。此外,DHA 降低了脾和淋巴结中总 Tfh 细胞、活化 Tfh 细胞和 B 细胞淋巴瘤 6 以及 Tfh 细胞中白细胞介素(IL)-21 的水平,以及脾、淋巴结和肾脏中 B 细胞、生发中心 B 细胞和浆细胞的水平。此外,DHA 通过阻断 IL-2 诱导的 T 细胞激酶(ITK)信号及其下游核因子(NF)-κB、激活 T 细胞核因子和激活蛋白-1 途径来抑制 Tfh 细胞,通过阻断布鲁顿酪氨酸激酶(BTK)信号及其下游 NF-κB 和 Myc 途径来直接抑制 B 细胞。总之,我们的结果表明,DHA 通过阻断 ITK 信号抑制 Tfh 细胞,通过阻断 BTK 信号直接抑制 B 细胞。因此,减少致病性抗体的产生可能有效治疗 SLE。