1
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Shi XY, Zhang QK, Li J, Zhu CY, Jin L, Fan S. Mendelian randomization analysis reveals causal relationships between circulating cell traits and renal disorders. Front Med (Lausanne) 2024; 11:1360868. [PMID: 38828235 PMCID: PMC11140107 DOI: 10.3389/fmed.2024.1360868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 04/30/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose The aim of this study was to investigate the causal relationships between circulating cell traits and risk of renal disorders. Methods We applied a comprehensive two-sample Mendelian randomization (MR) analysis. Single nucleotide polymorphisms (SNPs) from publicly available genome-wide association studies (GWAS) databases were utilized. Genetically predicted instrumental variables of human blood cell traits were extracted from Blood Cell Consortium (BCX) while data on renal diseases was obtained from Finngen consortium. The primary MR analysis was conducted using the inverse variance weighted (IVW) method, with the weighted median (WM) and MR-Egger models used as additional methods. Sensitivity analyses, including MR-PRESSO, radial regression and MR-Egger intercept were conducted to detect outliers and assess horizontal pleiotropy. We further utilized the leave-one-out analysis to assess the robustness of the results. Causal associations were considered significant based on false rate correction (FDR), specifically when the IVW method provided a pFDR < 0.05. Results Our results demonstrated that both white blood cell (WBC) count (OR = 1.50, 95% CI = 1.10-2.06, pFDR = 0.033, pIVW = 0.011) and lymphocyte count (OR = 1.50, 95% CI = 1.13-1.98, pFDR = 0.027, pIVW = 0.005) were causally associated with a higher risk of IgA nephropathy. Furthermore, WBC count was identified as a significant genetic risk factor for renal malignant neoplasms (OR = 1.23, 95% CI = 1.06-1.43, pFDR = 0.041, pIVW = 0.007). Additionally, an increased level of genetically predicted eosinophils was found to be causally associated with a higher risk of diabetic nephropathy (OR = 1.21, 95% CI = 1.08-1.36, pFDR = 0.007, pIVW = 0.001). No evidence of pleiotropy was determined. Conclusion Our findings provide evidence of causal associations of circulating WBC count, lymphocyte count and IgA nephropathy, WBC count and renal malignant neoplasms, and eosinophil count and diabetic nephropathy. These results have the potential to contribute to the development of novel diagnostic options and therapeutic strategies for renal disorders.
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Affiliation(s)
- Xing-yu Shi
- Department of Nephrology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Qian-kun Zhang
- Department of Nephrology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Jie Li
- Department of Nephrology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Chao-yong Zhu
- Department of Nephrology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Lie Jin
- Department of Nephrology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Shipei Fan
- Department of Ophthalmology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
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2
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Del Vecchio L, Allinovi M, Comolli S, Peiti S, Rimoldi C, Locatelli F. Drugs in Development to Treat IgA Nephropathy. Drugs 2024; 84:503-525. [PMID: 38777962 DOI: 10.1007/s40265-024-02036-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/25/2024]
Abstract
IgA nephropathy is a common glomerulonephritis consequent to the autoimmune response to aberrant glycosylated immunoglobulin (Ig) A antibodies. Although it has historically been considered a benign disease, it has since become clear that a substantial percentage of patients reach end-stage kidney failure over the years. Several therapeutic attempts have been proposed, with systemic steroids being the most prevalent, albeit burdened by possible serious adverse events. Thanks to the more in-depth knowledge of the pathogenesis of IgA nephropathy, new treatment targets have been identified and new drugs developed. In this narrative review, we summarise the molecules under clinical development for the treatment of IgA nephropathy. As a search strategy, we used PubMed, Google, ClinicalTrials.gov and abstracts from recent international congresses. TRF budesonide and sparsentan are the two molecules at a more advanced stage, just entering the market. Other promising agents are undergoing phase III clinical development. These include anti-APRIL and anti-BLyS/BAFF antibodies and some complement inhibitors. Other new possible strategies include spleen tyrosine kinase inhibitors, anti-CD40 ligands and anti-CD38 antibodies. In an era increasingly characterised by 'personalised medicine' and 'precision therapy' approaches and considering that the potential therapeutic armamentarium for IgA nephropathy will be very broad in the near future, the identification of biomarkers capable of helping the nephrologist to select the right drug for the right patient should be the focus of future studies.
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Affiliation(s)
| | - Marco Allinovi
- Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, Florence, Italy
| | - Stefania Comolli
- Department of Nephrology and Dialysis, ASST Sette Laghi, Varese, Italy
| | - Silvia Peiti
- Department of Nephrology and Dialysis, ASST Lariana, Como, Italy
| | | | - Francesco Locatelli
- Past Director of the Department of Nephrology and Dialysis, ASST Lecco, Lecco, Italy
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3
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Tam FW, Tumlin J, Barratt J, Rovin BH, Roberts IS, Roufosse C, Cook HT, Bhangal G, Brown AL, Busch M, Dudhiya F, Duliege AM, Fraser DJ, Gale DP, Huang CC, Lai PC, Lee M, Masuda ES, McAdoo SP, Rosenkranz AR, Sommerer C, Sunder-Plassmann G, Szeto CC, Tang SC, Williamson DE, Willcocks L, Vielhauer V, Kim MJ, Todd L, Zayed H, Tong-Starksen S, Lafayette R. Randomized Trial on the Effect of an Oral Spleen Tyrosine Kinase Inhibitor in the Treatment of IgA Nephropathy. Kidney Int Rep 2023; 8:2546-2556. [PMID: 38106605 PMCID: PMC10719605 DOI: 10.1016/j.ekir.2023.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction We reported increased spleen tyrosine kinase (SYK) expression in kidney biopsies of patients with IgA nephropathy (IgAN) and that inhibition of SYK reduces inflammatory cytokines production from IgA stimulated mesangial cells. Methods This study was a double-blind, randomized, placebo-controlled phase 2 trial of fostamatinib (an oral SYK inhibitor) in 76 patients with IgAN. Patients were randomized to receive placebo, fostamatinib at 100 mg or 150 mg twice daily for 24 weeks on top of maximum tolerated dose of renin-angiotensin system inhibitors. The primary end point was reduction of proteinuria. Secondary end points included change from baseline in estimated glomerular filtration rate (eGFR) and kidney histology. Results Although we could not detect significant reduction in proteinuria with fostamatinib overall, in a predetermined subgroup analysis, there was a trend for dose-dependent reduction in median proteinuria (from baseline to 24 weeks by 14%, 27%, and 36% in the placebo, fostamatinib 100 mg, and 150 mg groups, respectively) in patients with baseline urinary protein-to-creatinine ratios (UPCR) more than 1000 mg/g. Kidney function (eGFR) remained stable in all groups. Fostamatinib was well-tolerated. Side effects included diarrhea, hypertension, and increased liver enzymes. Thirty-nine patients underwent repeat biopsy showing reductions in SYK staining associated with therapy at low dose (-1.5 vs. 1.7 SYK+ cells/glomerulus in the placebo group, P < 0.05). Conclusions There was a trend toward reduction in proteinuria with fostamatinib in a predefined analysis of high risk patients with IgAN despite maximal care, as defined by baseline UPCR greater than 1000 mg/g. Further study may be warranted.
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Affiliation(s)
- Frederick W.K. Tam
- Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - James Tumlin
- Department of Nephrology, Emory University School Medicine, Atlanta, Georgia, USA
| | - Jonathan Barratt
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Brad H. Rovin
- Division of Nephrology, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Ian S.D. Roberts
- Department of Cellular Pathology, John Radcliffe Hospital, Oxford University Hospital NHS FT, Oxford, UK
| | - Candice Roufosse
- Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - H. Terence Cook
- Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Gurjeet Bhangal
- Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | | | - Martin Busch
- Department of Internal Medicine III, University Hospital Jena, Friedrich Schiller University, Jena, Germany
| | - Fayaz Dudhiya
- Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Anne-Marie Duliege
- Department of Clinical Development, Rigel Pharmaceuticals, Inc., South San Francisco, California, USA
| | - Donald J. Fraser
- Wales Kidney Research Unit, Cardiff University, School of Medicine, Heath Park, Cardiff, UK
| | - Daniel P. Gale
- Department of Renal Medicine, University College London, London, UK
| | - Chiu-Ching Huang
- Division of Nephrology, China Medical University Hospital, Taichung, Taiwan
| | - Ping-Chin Lai
- Division of Nephrology, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Meng Lee
- Department of Clinical Development, Rigel Pharmaceuticals, Inc., South San Francisco, California, USA
| | - Esteban S. Masuda
- Department of Clinical Development, Rigel Pharmaceuticals, Inc., South San Francisco, California, USA
| | - Stephen P. McAdoo
- Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Alexander R. Rosenkranz
- Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | | | - Gere Sunder-Plassmann
- Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Cheuk-Chun Szeto
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong SAR, China
| | - Sydney C.W. Tang
- Division of Nephrology, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | | | | | - Volker Vielhauer
- Medizinische Klinik und Poliklinik IV, Nephrologisches Zentrum, Klinikum der Universität München, Munich, Germany
| | - Min Jeong Kim
- Division of Nephrology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Leslie Todd
- Department of Clinical Development, Rigel Pharmaceuticals, Inc., South San Francisco, California, USA
| | - Hany Zayed
- Department of Clinical Development, Rigel Pharmaceuticals, Inc., South San Francisco, California, USA
| | - Sandra Tong-Starksen
- Department of Clinical Development, Rigel Pharmaceuticals, Inc., South San Francisco, California, USA
| | - Richard Lafayette
- Department of Nephrology, Stanford University Medical Center, Stanford, California, USA
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4
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DESAKI YUYA, KANAMARU YUTAKA, MONTEIRO RENATO, SUZUKI YUSUKE. Fcα Receptor Type I and Its Association with Atherosclerosis Development. JUNTENDO IJI ZASSHI = JUNTENDO MEDICAL JOURNAL 2023; 69:231-239. [PMID: 38855431 PMCID: PMC11153080 DOI: 10.14789/jmj.jmj23-0003-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/28/2023] [Indexed: 06/11/2024]
Abstract
Objectives Atherosclerosis is a chronic inflammatory disease characterized by lipid accumulation and local inflammation, which are regulated by the immune system. The immunological aspects of this disease are unclear. Immunoglobulin A regulates many cell responses through interactions with Fcα receptor type I (FcαRI). Anti-FcαRI antibody inhibits activating receptors by inducing an inhibitory immunoreceptor tyrosine-based activation motif configuration. However, the role of FcαRI in atherosclerosis development is unclear. Here, we investigated the utility of FcαRI targeting to induce inhibitory immunoreceptor tyrosine-based activation motif signaling in atherosclerosis treatment. Materials ApoE-/- transgenic mice expressing the FcαRIR209L/FcRγ chimeric protein (FcαRIR209L/FcRγApoE-/- mice) were generated. We prepared an FcαRIR209L/FcRγ transfectant (I3D) from a mouse macrophage cell line (RAW264.7). Methods Anti-FcαRI or control antibody was used to investigate a high-fat-diet-induced FcαRIR209L/FcRγApoE-/- mouse model of atherosclerosis. The antibody was also used to assess macrophage foam cell formation via Oil Red O staining and mitogen-activated protein kinase signaling via immunoblotting in the FcαRIR209L/FcRγ-expressing RAW264.7 macrophage cell line I3D. Results Targeting of monovalent FcαRI induced inhibitory effects in the FcαRIR209L/FcRγApoE-/- mouse model of atherosclerosis by inhibiting macrophage infiltration. FcαRI targeting using the anti-FcαRI antibody also reduced mitogen-activated protein kinase signaling and foam cell formation, leading to decreased interleukin (IL)-1b and monocyte chemoattractant protein (MCP)-1. Conclusions We demonstrated that targeting monovalent FcαRI suppresses atherosclerosis development. These findings can support the future clinical exploration of FcαRI targeting for atherosclerosis treatment.
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Affiliation(s)
| | | | | | - YUSUKE SUZUKI
- Corresponding author: Yusuke Suzuki, Department of Nephrology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan, TEL: +81-3-5802-1591 FAX: +81-3-3813-5512 E-mail:
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5
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Roe K. Treatment alternatives for multidrug-resistant fungal pathogens. Drug Discov Today 2023; 28:103596. [PMID: 37086779 DOI: 10.1016/j.drudis.2023.103596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 04/24/2023]
Abstract
Several fungal pathogens are becoming resistant to conventional fungal infection treatments, and some fungal pathogens have become multidrug resistant. Alternative treatments include fungal vaccines, natural or synthetic monoclonal antibody (mAb) injections, or potentially natural or synthetic mAbs produced in vivo by packaged mRNA. Specifically synthesized proteins can mask distinctive pathogenic fungal surface proteins and target pathogenic fungal proteins to stop fungal infections. Treatments could use direct injections or injections of packaged mRNA with instructions for patient synthesis of either the natural or synthetic mAbs. These alternative treatments offer potentially significant advantages compared with existing treatments for fungal pathogens. Teaser: New fungal pathogen treatment approaches can use natural or synthetic monoclonal antibodies to activate immune cells and treat specific fungal infections that are now multidrug resistant to conventional antifungal drugs.
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6
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Chen XQ, Tu L, Tang Q, Huang L, Qin YH. An Emerging Role for Neutrophil Extracellular Traps in IgA Vasculitis: A Mini-Review. Front Immunol 2022; 13:912929. [PMID: 35799774 PMCID: PMC9253285 DOI: 10.3389/fimmu.2022.912929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
Immunoglobulin A vasculitis (IgAV) is the most common systemic small vessel vasculitis in childhood. Its clinical manifestations are non-thrombocytopenic purpura, accompanied by gastrointestinal tract, joint, kidney and other organ system involvement. The pathogenesis of IgAV has not been fully elucidated. It may be related to many factors including genetics, infection, environmental factors, and drugs. The most commonly accepted view is that galactose-deficient IgA1 and the deposition of IgA and complement C3 in small blood vessel walls are key contributors to the IgAV pathogenesis. Extensive neutrophil extracellular traps (NETs) in the peripheral circulation and skin, kidney, and gastrointestinal tissue of patients with IgAV has been identified in the past two years and is associated with disease activity. This mini-review provides a possible mechanism for NETs involvement in the pathogenesis of IgAV.
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7
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Is There a Role for Gut Microbiome Dysbiosis in IgA Nephropathy? Microorganisms 2022; 10:microorganisms10040683. [PMID: 35456735 PMCID: PMC9031807 DOI: 10.3390/microorganisms10040683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 02/06/2023] Open
Abstract
Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis and one of the leading causes of renal failure worldwide. The pathophysiology of IgAN involves nephrotoxic IgA1-immune complexes. These complexes are formed by galactose-deficient (Gd) IgA1 with autoantibodies against the hinge region of Gd-IgA1 as well as soluble CD89, an immune complex amplifier with an affinity for mesangial cells. These multiple molecular interactions result in the induction of the mesangial IgA receptor, CD71, injuring the kidney and causing disease. This review features recent immunological and microbiome studies that bring new microbiota-dependent mechanisms developing the disease based on data from IgAN patients and a humanized mouse model of IgAN. Dysbiosis of the microbiota in IgAN patients is also discussed in detail. Highlights of this review underscore that nephrotoxic IgA1 in the humanized mice originates from mucosal surfaces. Fecal microbiota transplantation (FMT) experiments in mice using stools from patients reveal a possible microbiota dysbiosis in IgAN with the capacity to induce progression of the disease whereas FMT from healthy hosts has beneficial effects in mice. The continual growth of knowledge in IgAN patients and models can lead to the development of new therapeutic strategies targeting the microbiota to treat this disease.
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8
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Gong S, Jin S, Li Y, Jiang W, Zhang Z, Shen Z, Wang J, Zhou H, Liu X, Xu X, Ding X, Shi Y, Liu H. Urinary Soluble CD163 Levels Predict IgA Nephropathy Remission Status. Front Immunol 2022; 12:769802. [PMID: 35003086 PMCID: PMC8733336 DOI: 10.3389/fimmu.2021.769802] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/08/2021] [Indexed: 01/20/2023] Open
Abstract
Noninvasive biomarkers of disease activity are needed to predict disease remission status in patients with IgA nephropathy (IgAN). Soluble CD163 (sCD163), shed by monocytes and macrophages, is a potential biomarker in diseases associated with excessive macrophage activation. We investigated the association of urinary sCD163 (u-sCD163) with histopathological activity and clinical manifestations in 349 patients with biopsy-diagnosed IgAN. U-sCD163 was measured via enzyme-linked immunosorbent assay. In patients with IgAN, higher u-sCD163 levels were associated with histological lesions of greater severity, as well as more proteinuria and poorer renal function. Additionally, u-sCD163 was correlated with infiltration of tubulointerstitial CD163+ macrophages. High u-sCD163 levels (>3.57 ng/mg Cr) were associated with a 2.66-fold greater risk for IgAN remission failure in adjusted analyses. Adding u-sCD163 levels to the model containing clinical data at biopsy and MEST-C score significantly improved the risk prediction of IgAN remission status (AUC 0.788). Together, our results suggest that u-sCD163 may be a useful noninvasive biomarker to evaluate disease severity and remission status of IgAN.
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Affiliation(s)
- Shaomin Gong
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Shi Jin
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Wuhua Jiang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Zhen Zhang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Ziyan Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Jialin Wang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Huili Zhou
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiao Liu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xialian Xu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Yiqin Shi
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Hong Liu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
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9
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Chen XQ, Tu L, Zou JS, Zhu SQ, Zhao YJ, Qin YH. The Involvement of Neutrophil Extracellular Traps in Disease Activity Associated With IgA Vasculitis. Front Immunol 2021; 12:668974. [PMID: 34539623 PMCID: PMC8446352 DOI: 10.3389/fimmu.2021.668974] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives This aim of this study was to determine whether neutrophil extracellular traps (NETs) are involved in the pathogenesis of IgA vasculitis (IgAV) and investigate whether the circulating NETs levels are associated with disease activity in children. Methods We performed a case-control study and collected blood samples from 193 children with different stages of IgAV (61 were at the onset stage, 64 at the remission stage, 43 at the active stage, and 25 were undergoing drug withdrawal). A total of 192 healthy children were recruited as controls. Circulating cell free DNA (cf-DNA) was obtained from the plasma and quantified by using the Quant-iT PicoGreen DNA quantification kit. NETs-associated myeloperoxidase-DNA (MPO-DNA), citrullinated-histone H3 (cit-H3), neutrophil elastase (NE), and the deoxyribonuclease I (DNase I) concentrations were measured using enzyme-linked immunosorbent assays. The presence of NETs in the kidney and gastrointestinal tissues of onset and active IgAV patients was determined by multiple immunofluorescence staining in 15 IgAV nephritis patients and 9 IgAV patients without IgAV nephritis, respectively. NETs degradation potency of collected sera samples from IgAV patients were checked in vitro. Relationships between circulating levels of cf-DNA with MPO-DNA, NE, and DNase I and the patients were analyzed. Results Circulating levels of cf-DNA in onset and active IgAV patients were significantly higher than those in remission and drug withdrawal patients as well as healthy controls. The results were similar for MPO-DNA and NE. The levels of circulating cf-DNA correlated significantly with MPO-DNA, NE and DNase I. A significantly decreased degradation of NETs from the onset and active IgAV patients was observed, but was normal in healthy controls. Furthermore, presence of NETs was also confirmed in all renal and gastrointestinal tissues obtained from the onset and active IgAV patients but not control samples. Conclusions Our data showed that NETs were released into the circulation of IgAV patients and are involved in the disease activity. The circulating levels of NETs maybe used to assess disease severity in children with IgAV.
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Affiliation(s)
- Xiu-Qi Chen
- Department of Pediatrics, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Li Tu
- Department of Pediatrics, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Jia-Sen Zou
- Department of Pediatrics, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Shi-Qun Zhu
- Department of Pediatrics, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Yan-Jun Zhao
- Department of Pediatrics, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Yuan-Han Qin
- Department of Pediatrics, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
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10
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Are there animal models of IgA nephropathy? Semin Immunopathol 2021; 43:639-648. [PMID: 34230994 DOI: 10.1007/s00281-021-00878-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/08/2021] [Indexed: 12/18/2022]
Abstract
Immunoglobulin A (IgA) nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. Up to 40% of IgAN patients develop end-stage kidney disease after 15-20 years. Despite the poor prognosis associated with this multifactorial disease, no clear treatment strategy has been identified, primarily due to the lack of understanding of its pathogenesis. Clinical observations indicate that aberrant IgAN immune systems, rather than intrinsic renal abnormalities, may be involved in its pathogenesis. Moreover, nephritogenic IgA and its related immune complexes are considered to be produced not only in the mucosa, but also in systemic immune sites, such as the bone marrow; however, there are numerous challenges to understanding this dynamic and complex immune axis in humans. Thus, several investigators have used experimental animal models. Although there are inter-strain differences in IgA molecules and immune responses between humans and rodents, animal models remain a powerful tool for investigating IgAN's pathogenesis, and the subsequent development of effective treatments. Here, we introduced some classical models of IgAN with or without genetic manipulation and recent translational approaches with some promising models. This includes humanized mouse models expressing human IgA1 and human IgA Fc receptor (CD89) that develops spontaneously the disease. Pre-clinical studies targeting IgA1 are discussed. Together, animal models are very useful tools to study pathophysiology and to validate new therapeutic approaches for IgAN.
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11
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Pawluczyk IZA, Soares MSF, Barratt WA, Brown JR, Bhachu JS, Selvaskandan H, Zeng Y, Sarania R, Molyneux K, Roberts ISD, Barratt J. Macrophage interactions with collecting duct epithelial cells are capable of driving tubulointerstitial inflammation and fibrosis in immunoglobulin A nephropathy. Nephrol Dial Transplant 2021; 35:1865-1877. [PMID: 32830258 DOI: 10.1093/ndt/gfaa079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Tubulointerstitial fibrosis is a powerful predictor of future progression inimmunoglobulin A (IgA) nephropathy (IgAN). Proximal tubular epithelial cells (PTECs), in concert with infiltrating macrophages, are regarded as the agents provocateurs for driving this fibrotic process. However, evidence is now emerging for a contributory role of the distal nephron. The aim of this study was to examine the potential influence of macrophages on collecting duct epithelial cells (CDECs) and their combined role in the progression of IgAN. METHODS CDECs were cultured with macrophage-conditioned media (MCM) generated from human monocyte cell lines U937 and THP-1 stimulated with or without 100 μg/mL galactose-deficient IgA1. CDECs were analysed for evidence of inflammation and fibrosis. RESULTS Staining of IgAN biopsies for CD68+ macrophages revealed the presence of macrophages juxtaposed to collecting ducts and within their lumina. CDEC exposed to MCM from IgA1-stimulated THP-1 cells (THP-1-IgA-MCM) exhibited markedly increased expression of neutrophil-associated gelatinase (NGAL) and proinflammatory cytokinesinterleukin (IL)-1β, tumour necrosis factor-α, IL-6 and IL-8 compared with MCM from non-IgA-stimulated THP-1 cells (THP-1-MCM). U937-IgA-MCM increased fibronectin levels and reduced E-cadherinmRNA expression. THP-1-IgA-MCM-derived exosomes induced similar increases in NGAL and cytokine expression while in cross-over experiments exosomes extracted from IL-1β-exposed CDEC induced IL-1β and IL-6 mRNA expression in both sets of macrophages. MiRnome analysis revealed that microRNA (miR)-146a, -155 and -200b exhibited a >2-fold increase in expression in CDEC treated with THP-1-IgA-MCM compared with THP-1-MCM. Enforced miR-146a suppression further enhanced NGAL expression, while ectopic miR-146a over-expression downregulated it. NGAL mRNA and miR-146a were upregulated in the biopsies of patients with progressive IgAN compared with non-progressive IgAN. CONCLUSIONS Taken together, these data suggest that CDEC-macrophage interactions potentially contribute to the tubulointerstitial fibrosis characteristic of progressive IgAN.
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Affiliation(s)
| | - Maria S F Soares
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | | | | | | | | | | | | | - Ian S D Roberts
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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12
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Ben Mkaddem S, Benhamou M, Monteiro RC. Understanding Fc Receptor Involvement in Inflammatory Diseases: From Mechanisms to New Therapeutic Tools. Front Immunol 2019; 10:811. [PMID: 31057544 PMCID: PMC6481281 DOI: 10.3389/fimmu.2019.00811] [Citation(s) in RCA: 167] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 03/27/2019] [Indexed: 12/21/2022] Open
Abstract
Fc receptors (FcRs) belong to the ITAM-associated receptor family. FcRs control the humoral and innate immunity which are essential for appropriate responses to infections and prevention of chronic inflammation or auto-immune diseases. Following their crosslinking by immune complexes, FcRs play various roles such as modulation of the immune response by released cytokines or of phagocytosis. Here, we review FcR involvement in pathologies leading notably to altered intracellular signaling with functionally relevant consequences to the host, and targeting of Fc receptors as therapeutic approaches. Special emphasis will be given to some FcRs, such as the FcαRI, the FcγRIIA and the FcγRIIIA, which behave like the ancient god Janus depending on the ITAM motif to inhibit or activate immune responses depending on their targeting by monomeric/dimeric immunoglobulins or by immune complexes. This ITAM duality has been recently defined as inhibitory or activating ITAM (ITAMi or ITAMa) which are controlled by Src family kinases. Involvement of various ITAM-bearing FcRs observed during infectious or autoimmune diseases is associated with allelic variants, changes in ligand binding ability responsible for host defense perturbation. During auto-immune diseases such as rheumatoid arthritis, lupus or immune thrombocytopenia, the autoantibodies and immune complexes lead to inflammation through FcR aggregation. We will discuss the role of FcRs in autoimmune diseases, and focus on novel approaches to target FcRs for resolution of antibody-mediated autoimmunity. We will finally also discuss the down-regulation of FcR functionality as a therapeutic approach for autoimmune diseases.
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Affiliation(s)
- Sanae Ben Mkaddem
- INSERM U1149, Centre de Recherche sur l'Inflammation, Paris, France.,CNRS ERL8252, Paris, France.,Faculté de Médecine, Université Paris Diderot, Sorbonne Paris Cité, Site Xavier Bichat, Paris, France.,Inflamex Laboratory of Excellence, Paris, France
| | - Marc Benhamou
- INSERM U1149, Centre de Recherche sur l'Inflammation, Paris, France.,CNRS ERL8252, Paris, France.,Faculté de Médecine, Université Paris Diderot, Sorbonne Paris Cité, Site Xavier Bichat, Paris, France.,Inflamex Laboratory of Excellence, Paris, France
| | - Renato C Monteiro
- INSERM U1149, Centre de Recherche sur l'Inflammation, Paris, France.,CNRS ERL8252, Paris, France.,Faculté de Médecine, Université Paris Diderot, Sorbonne Paris Cité, Site Xavier Bichat, Paris, France.,Inflamex Laboratory of Excellence, Paris, France.,Service d'Immunologie, DHU Fire, Hôpital Bichat-Claude Bernard, Assistance Publique de Paris, Paris, France
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13
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de Tymowski C, Heming N, Correia MD, Abbad L, Chavarot N, Le Stang MB, Flament H, Bex J, Boedec E, Bounaix C, Soler-Torronteras R, Denamur E, Galicier L, Oksenhendler E, Fehling HJ, Pinheiro da Silva F, Benhamou M, Monteiro RC, Ben Mkaddem S. CD89 Is a Potent Innate Receptor for Bacteria and Mediates Host Protection from Sepsis. Cell Rep 2019; 27:762-775.e5. [DOI: 10.1016/j.celrep.2019.03.062] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 01/11/2019] [Accepted: 03/15/2019] [Indexed: 12/28/2022] Open
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14
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Monteiro RC. Recent advances in the physiopathology of IgA nephropathy. Nephrol Ther 2018; 14 Suppl 1:S1-S8. [PMID: 29606255 DOI: 10.1016/j.nephro.2018.02.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/01/2018] [Indexed: 01/01/2023]
Abstract
Immunoglobulin A nephropathy or Berger's disease is the most common type of primary glomerulonephritis, which is characterized by IgA1-containing immune-deposits in the glomerular mesangium. Microscopic haematuria and proteinuria are the most common presentations. Mesangial cell proliferation with IgA deposition is found on renal biopsy. Mechanims of the disease implicate at least four key molecules have been implicated in immune complex formation: galactose-deficient IgA1, autoantibodies anti-galactose-deficient-IgA1, soluble CD89 (Fc receptor for IgA) and the CD71 mesangial IgA receptor (transferrin receptor). These factors associated with environmental factors (antigens, food and microbiota) are correlated with disease progression and recurrence after transplantation. This review exploits recent data on the role of these molecular players of the disease, which may improve future therapeutic management of immunoglobulin A nephropathy.
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Affiliation(s)
- Renato C Monteiro
- Inserm U1149 centre de recherche sur l'inflammation, 16, rue Henri-Huchard, 75018 Paris, France; CNRS ERL8252, 16, rue Henri-Huchard, 75018 Paris, France; Laboratoire d'excellence Inflamex, faculté de médecine Bichat, université Paris-Diderot, 16, rue Henri-Huchard, 75018 Paris, France; Service d'immunologie, DHU Fire, hôpital Bichat, 16, rue Henri-Huchard, 75018 Paris, France.
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15
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Saha C, Das M, Patil V, Stephen-Victor E, Sharma M, Wymann S, Jordi M, Vonarburg C, Kaveri SV, Bayry J. Monomeric Immunoglobulin A from Plasma Inhibits Human Th17 Responses In Vitro Independent of FcαRI and DC-SIGN. Front Immunol 2017; 8:275. [PMID: 28352269 PMCID: PMC5349300 DOI: 10.3389/fimmu.2017.00275] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 02/24/2017] [Indexed: 12/27/2022] Open
Abstract
Circulating immunoglobulins including immunoglobulin G (IgG) and IgM play a critical role in the immune homeostasis by modulating functions of immune cells. These functions are mediated in part by natural antibodies. However, despite being second most abundant antibody in the circulation, the immunoregulatory function of IgA is relatively unexplored. As Th17 cells are the key mediators of a variety of autoimmune, inflammatory, and allergic diseases, we investigated the ability of monomeric IgA (mIgA) isolated from pooled plasma of healthy donors to modulate human Th17 cells. We show that mIgA inhibits differentiation and amplification of human Th17 cells and the production of their effector cytokine IL-17A. mIgA also suppresses IFN-γ responses under these experimental conditions. Suppressive effect of mIgA on Th17 responses is associated with reciprocal expansion of FoxP3-positive regulatory T cells. The effect of mIgA on Th17 cells is dependent on F(ab′)2 fragments and independent of FcαRI (CD89) and DC-SIGN. Mechanistically, the modulatory effect of mIgA on Th17 cells implicates suppression of phosphorylation of signal transducer and activator of transcription 3. Furthermore, mIgA binds to CD4+ T cells and recognizes in a dose-dependent manner the receptors for cytokines (IL-6Rα and IL-1RI) that mediate Th17 responses. Our findings thus reveal novel anti-inflammatory functions of IgA and suggest potential therapeutic utility of mIgA in autoimmune and inflammatory diseases that implicate Th17 cells.
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Affiliation(s)
- Chaitrali Saha
- Institut National de la Santé et de la Recherche Médicale , Paris , France
| | - Mrinmoy Das
- Institut National de la Santé et de la Recherche Médicale, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, Centre de Recherche des Cordeliers, Paris, France
| | | | - Emmanuel Stephen-Victor
- Institut National de la Santé et de la Recherche Médicale, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, Centre de Recherche des Cordeliers, Paris, France
| | - Meenu Sharma
- Institut National de la Santé et de la Recherche Médicale , Paris , France
| | - Sandra Wymann
- Research Department, CSL Behring AG , Bern , Switzerland
| | - Monika Jordi
- Research Department, CSL Behring AG , Bern , Switzerland
| | | | - Srini V Kaveri
- Institut National de la Santé et de la Recherche Médicale, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, Centre de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jagadeesh Bayry
- Institut National de la Santé et de la Recherche Médicale, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, Centre de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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16
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Lin TJ, Yang SS, Hua KF, Tsai YL, Lin SH, Ka SM. SPAK plays a pathogenic role in IgA nephropathy through the activation of NF-κB/MAPKs signaling pathway. Free Radic Biol Med 2016; 99:214-224. [PMID: 27519267 DOI: 10.1016/j.freeradbiomed.2016.08.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 08/05/2016] [Accepted: 08/08/2016] [Indexed: 01/13/2023]
Abstract
Sterile 20/SPS1-related proline/alanine-rich kinase (SPAK) can stimulate production of proinflammatory cytokines and interact with inflammation-related molecules. However, it has yet to be determined whether SPAK plays a pathophysiological role in the complicated pathological mechanisms of IgA nephropathy (IgAN), which is mainly characterized by mesangial cell (MC) proliferation and is the most common form of glomerulonephritis. In the present study, we examined the pathophysiological role of SPAK in IgAN using a mouse model and cell models. Our results clearly showed that (1) SPAK deficiency prevents the development of IgAN and inhibits production of immune/inflammatory mediators and T cell activation and proliferation; and (2) when primed with IgA immune complexes (IgA IC), both peritoneal macrophages and primary MCs from SPAK knockout mice show markedly reduced production of proinflammatory cytokines and inhibition of NF-κB/MAPKs activation. We proposed that activation of SPAK and the NF-κB/MAPKs signaling pathway in MCs, macrophages and T cells of the glomerulus may be a mechanism underlying the pathogenesis of IgAN. The activation of SPAK in renal tubuloepithelial cells either directly by IgA IC or an indirect action of the activated MCs or infiltrating mononuclear leukocytes seen in the kidney may further aggravate the disease process of IgAN. Our results suggest that SPAK is a potential therapeutic target for the glomerular disorder.
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Affiliation(s)
- Tsai-Jung Lin
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Sung-Sen Yang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan; Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Institute of BioMedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Kuo-Feng Hua
- Department of Biotechnology and Animal Science, National Ilan University, Ilan, Taiwan
| | - Yu-Ling Tsai
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Shih-Hua Lin
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shuk-Man Ka
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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17
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Lechner SM, Abbad L, Boedec E, Papista C, Le Stang MB, Moal C, Maillard J, Jamin A, Bex-Coudrat J, Wang Y, Li A, Martini PGV, Monteiro RC, Berthelot L. IgA1 Protease Treatment Reverses Mesangial Deposits and Hematuria in a Model of IgA Nephropathy. J Am Soc Nephrol 2016; 27:2622-9. [PMID: 26850635 DOI: 10.1681/asn.2015080856] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 01/04/2016] [Indexed: 01/01/2023] Open
Abstract
IgA nephropathy (IgAN), characterized by mesangial IgA1 deposits, is a leading cause of renal failure worldwide. IgAN pathogenesis involves circulating hypogalactosylated IgA1 complexed with soluble IgA Fc receptor I (sCD89) and/or anti-hypogalactosylated-IgA1 autoantibodies, but no specific treatment is available for IgAN. The absence of IgA1 and CD89 homologs in the mouse has precluded in vivo proof-of-concept studies of specific therapies targeting IgA1. However, the α1KI‑CD89Tg mouse model of IgAN, which expresses human IgA1 and human CD89, allows in vivo testing of recombinant IgA1 protease (IgA1‑P), a bacterial protein that selectively cleaves human IgA1. Mice injected with IgA1‑P (1-10 mg/kg) had Fc fragments of IgA1 in both serum and urine, associated with a decrease in IgA1-sCD89 complexes. Levels of mesangial IgA1 deposits and the binding partners of these deposits (sCD89, transferrin receptor, and transglutaminase 2) decreased markedly 1 week after treatment, as did the levels of C3 deposition, CD11b(+) infiltrating cells, and fibronectin. Antiprotease antibodies did not significantly alter IgA1‑P activity. Moreover, hematuria consistently decreased after treatment. In conclusion, IgA1‑P strongly diminishes human IgA1 mesangial deposits and reduces inflammation, fibrosis, and hematuria in a mouse IgAN model, and therefore may be a plausible treatment for patients with IgAN.
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Affiliation(s)
- Sebastian M Lechner
- National French Institute of Health and Medical Research (INSERM) Unit 1149, Center of Research on Inflammation, Paris, France; Laboratory of Inflamex Excellency, Faculty of Medicine, Xavier Bichat Site, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; National French Center of Scientific Research (CNRS) ERL8252, Paris, France
| | - Lilia Abbad
- National French Institute of Health and Medical Research (INSERM) Unit 1149, Center of Research on Inflammation, Paris, France; Laboratory of Inflamex Excellency, Faculty of Medicine, Xavier Bichat Site, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; National French Center of Scientific Research (CNRS) ERL8252, Paris, France
| | - Erwan Boedec
- National French Institute of Health and Medical Research (INSERM) Unit 1149, Center of Research on Inflammation, Paris, France; Laboratory of Inflamex Excellency, Faculty of Medicine, Xavier Bichat Site, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; National French Center of Scientific Research (CNRS) ERL8252, Paris, France
| | - Christina Papista
- National French Institute of Health and Medical Research (INSERM) Unit 1149, Center of Research on Inflammation, Paris, France; Laboratory of Inflamex Excellency, Faculty of Medicine, Xavier Bichat Site, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; National French Center of Scientific Research (CNRS) ERL8252, Paris, France
| | - Marie-Bénédicte Le Stang
- National French Institute of Health and Medical Research (INSERM) Unit 1149, Center of Research on Inflammation, Paris, France; Laboratory of Inflamex Excellency, Faculty of Medicine, Xavier Bichat Site, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; National French Center of Scientific Research (CNRS) ERL8252, Paris, France
| | - Christelle Moal
- National French Institute of Health and Medical Research (INSERM) Unit 1149, Center of Research on Inflammation, Paris, France; Laboratory of Inflamex Excellency, Faculty of Medicine, Xavier Bichat Site, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; National French Center of Scientific Research (CNRS) ERL8252, Paris, France
| | - Julien Maillard
- National French Institute of Health and Medical Research (INSERM) Unit 1149, Center of Research on Inflammation, Paris, France; Laboratory of Inflamex Excellency, Faculty of Medicine, Xavier Bichat Site, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; National French Center of Scientific Research (CNRS) ERL8252, Paris, France
| | - Agnès Jamin
- National French Institute of Health and Medical Research (INSERM) Unit 1149, Center of Research on Inflammation, Paris, France; Laboratory of Inflamex Excellency, Faculty of Medicine, Xavier Bichat Site, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; National French Center of Scientific Research (CNRS) ERL8252, Paris, France
| | - Julie Bex-Coudrat
- National French Institute of Health and Medical Research (INSERM) Unit 1149, Center of Research on Inflammation, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; National French Center of Scientific Research (CNRS) ERL8252, Paris, France
| | - Yong Wang
- Shire, Bioprocess Development and Discovery Biology and Translational Research, Lexington, Massachusetts; and
| | - Aiqun Li
- Shire, Bioprocess Development and Discovery Biology and Translational Research, Lexington, Massachusetts; and
| | - Paolo G V Martini
- Shire, Bioprocess Development and Discovery Biology and Translational Research, Lexington, Massachusetts; and
| | - Renato C Monteiro
- National French Institute of Health and Medical Research (INSERM) Unit 1149, Center of Research on Inflammation, Paris, France; Laboratory of Inflamex Excellency, Faculty of Medicine, Xavier Bichat Site, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; National French Center of Scientific Research (CNRS) ERL8252, Paris, France; Immunology Department, Bichat Hospital, Paris Public Assistance Hospitals, Department of Hospital and University (DHU) Fire, Paris, France
| | - Laureline Berthelot
- National French Institute of Health and Medical Research (INSERM) Unit 1149, Center of Research on Inflammation, Paris, France; Laboratory of Inflamex Excellency, Faculty of Medicine, Xavier Bichat Site, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; National French Center of Scientific Research (CNRS) ERL8252, Paris, France;
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18
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Molecular Insights into the Pathogenesis of IgA Nephropathy. Trends Mol Med 2015; 21:762-775. [DOI: 10.1016/j.molmed.2015.10.003] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 10/17/2015] [Accepted: 10/19/2015] [Indexed: 01/04/2023]
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19
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Lechner SM, Papista C, Chemouny JM, Berthelot L, Monteiro RC. Role of IgA receptors in the pathogenesis of IgA nephropathy. J Nephrol 2015; 29:5-11. [PMID: 26572664 DOI: 10.1007/s40620-015-0246-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 10/29/2015] [Indexed: 11/28/2022]
Abstract
Immunoglobulin A nephropathy (IgAN) or Berger's disease is the most common form of primary glomerulonephritis in the world and one of the first causes of end-stage renal failure. IgAN is characterized by the accumulation of immune complexes containing polymeric IgA1 in mesangial areas. The pathogenesis of this disease involves the deposition of polymeric and hypogalactosylated IgA1 (Gd-IgA1) in the mesangium. Quantitative and structural changes of Gd-IgA1 play a key role in the development of the disease due to functional abnormalities of two IgA receptors: the FcαRI (CD89) expressed by blood myeloid cells and the transferrin receptor (CD71) on mesangial cells. Abnormal Gd-IgA1 induces release of soluble CD89, which participates in the formation of circulating IgA1 complexes. These complexes are trapped by CD71 that is overexpressed on mesangial cells in IgAN patients together with the crosslinking enzyme transglutaminase 2 allowing pathogenic IgA complex formation in situ and mesangial cell activation. A humanized mouse model expressing IgA1 and CD89 develops IgAN in a similar manner as patients. In this model, a food antigen, the gliadin, was shown to be crucial for circulating IgA1 complex formation and deposition, which could be prevented by a gluten-free diet. Identification of these new partners opens new therapeutic prospects for IgAN treatment.
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Affiliation(s)
- Sebastian M Lechner
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1149 Centre de Recherche sur l'Inflammation, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Paris, France.,Inflamex Laboratory of Excellence Site Xavier Bichat, Paris, France.,CNRS ERL8252, Paris, France
| | - Christina Papista
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1149 Centre de Recherche sur l'Inflammation, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Paris, France.,Inflamex Laboratory of Excellence Site Xavier Bichat, Paris, France.,CNRS ERL8252, Paris, France
| | - Jonathan M Chemouny
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1149 Centre de Recherche sur l'Inflammation, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Paris, France.,Inflamex Laboratory of Excellence Site Xavier Bichat, Paris, France.,CNRS ERL8252, Paris, France
| | - Laureline Berthelot
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1149 Centre de Recherche sur l'Inflammation, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Paris, France.,Inflamex Laboratory of Excellence Site Xavier Bichat, Paris, France.,CNRS ERL8252, Paris, France
| | - Renato C Monteiro
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1149 Centre de Recherche sur l'Inflammation, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, Paris, France. .,Inflamex Laboratory of Excellence Site Xavier Bichat, Paris, France. .,CNRS ERL8252, Paris, France. .,Service d'Immunologie, Assistance Publique de Paris, DHU Fire, Hôpital Bichat, Paris, France.
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20
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Liu C, Kanamaru Y, Watanabe T, Tada N, Horikoshi S, Suzuki Y, Liu Z, Tomino Y. Targeted IgA Fc receptor I (FcαRI) therapy in the early intervention and treatment of pristane-induced lupus nephritis in mice. Clin Exp Immunol 2015; 181:407-16. [PMID: 25907714 DOI: 10.1111/cei.12647] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 11/24/2022] Open
Abstract
The Fc receptor I for IgA (FcαRI) down-regulates humoral immune responses and modulates the risk of autoimmunity. This study aimed to investigate whether FcαRI targeting can affect progression of pristine-induced lupus nephritis. In the first experiment (early intervention), four groups of animals were evaluated: untreated FcαRI/FcRγ transgenic (Tg) mice and Tg mice administered control antibody (Ctr Fab), saline and anti-FcαRI Fab [macrophage inflammatory protein (MIP)-8a], respectively, three times a week for 29 weeks, after being injected once intraperitoneally with 0·5 ml pristane. In the second experiment, antibody injection started after the onset of nephritis and was carried out for 2 months, with similar groups as described above. MIP-8a improved proteinuria, decreased the amounts of glomerular injury markers, serum interleukin (IL)-6, IL-1 and monocyte chemoattractant protein (MCP)-1, and F4/80 macrophages in the interstitium and glomeruli, in both experiments. When MIP-8a was used as early intervention, a decrease in mouse serum anti-nuclear antibody (ANA) titres and reduced deposition of immunoglobulins in glomeruli were observed. This effect was associated with reduced serum titres of immunoglobulin (Ig)G2a but not IgG1, IgG2b and IgG3. Furthermore, pathological analysis showed lower glomerular activity index and less fibronectin in MIP-8a treated mice. This study suggests that FcαRI targeting could halt disease progression and lupus activation by selective inhibition of cytokine production, leucocyte recruitment and renal inflammation. Our findings provide a basis for the use of FcαRI as a molecular target for the treatment of lupus.
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Affiliation(s)
- C Liu
- Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.,National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Y Kanamaru
- Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - T Watanabe
- Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - N Tada
- Research Institute for Diseases of Old Age, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - S Horikoshi
- Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Y Suzuki
- Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Z Liu
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Y Tomino
- Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
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21
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Novak J, Raska M, Mestecky J, Julian BA. IgA Nephropathy and Related Diseases. Mucosal Immunol 2015. [DOI: 10.1016/b978-0-12-415847-4.00105-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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22
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Abstract
PURPOSE OF REVIEW In this article, we review recent findings on the pathogenesis and genetics of immunoglobulin A (IgA) nephropathy. RECENT FINDINGS During the past 2 years, the understanding of the pathogenesis of IgA nephropathy has evolved as a result of progress in technology and new tools that have been developed. Since 1968, when IgA nephropathy was described as an IgA-IgG immune-complex disease, the knowledge base expanded to allow definition of IgA nephropathy as an autoimmune disease with a multihit pathogenetic process. Specifically, galactose-deficient immunoglobulin A1 (IgA1) is recognized by unique autoantibodies, resulting in the formation of pathogenic immune complexes that ultimately deposit in the glomerular mesangium and induce renal injury. New approaches using high-resolution mass spectrometry have provided unique insight at the molecular level into IgA1 O-glycosylation. Cutting-edge genome-wide association studies revealed multiple disease-associated risk loci and have mapped their geographic and racial distribution. SUMMARY Recent studies of molecular and genetic defects operating in IgA nephropathy can define new biomarkers specific for the disease that can be developed into clinical assays to aid in the diagnosis, assessment of prognosis, and monitoring of disease progression. Moreover, disease-specific targets are being discovered that may lead to development of new approaches for treatment.
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Saez F, Reverte V, Paliege A, Moreno JM, Llinás MT, Bachmann S, Salazar FJ. Sex-dependent hypertension and renal changes in aged rats with altered renal development. Am J Physiol Renal Physiol 2014; 307:F461-70. [DOI: 10.1152/ajprenal.00198.2014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Numerous studies have evaluated blood pressure (BP) and renal changes in several models of developmental programming of hypertension. The present study examined to what extent BP, renal hemodynamic, and renal structure are affected at an old age in male and female animals with altered renal development. It also evaluated whether renal damage is associated with changes in cyclooxygenase (COX)-2 and neuronal nitric oxide synthase (NOS1) expression and immunoreactivity. Experiments were carried out in rats at 10–11 and 16–17 mo of age treated with vehicle or an ANG II type 1 receptor antagonist during the nephrogenic period (ARAnp). A progressive increment in BP and a deterioration of renal hemodynamics were found in both sexes of ARAnp-treated rats, with these changes being greater ( P < 0.05) in male rats. The decrease in glomerular filtration rate at the oldest age was greater ( P < 0.05) in male (74%) than female (32%) ARAnp-treated rats. Sex-dependent deterioration of renal structure was demonstrated in optical and electron microscopic experiments. COX-2 and NOS1 immunoreactivity were enhanced in the macula densa of male but not female ARAnp-treated rats. The present study reports novel findings suggesting that stimuli that induce a decrease of ANG II effects during renal development lead to a progressive increment in BP and renal damage at an old age in both sexes, but these BP and renal changes are greater in males than in females. The renal damage is associated with an increase of COX-2 and NOS1 in the macula densa of males but not females with altered renal development.
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Affiliation(s)
- Fara Saez
- Department of Physiology, University of Murcia, Regional Campus of International Excellence “Mare Nostrum,” Murcia, Instituto Murciano de Investigación Biomédica, Spain; and
| | - Virginia Reverte
- Department of Physiology, University of Murcia, Regional Campus of International Excellence “Mare Nostrum,” Murcia, Instituto Murciano de Investigación Biomédica, Spain; and
| | - Alexander Paliege
- Anatomisches Institut, Charité, Humboldt Universität, Berlin, Germany
| | - Juan Manuel Moreno
- Department of Physiology, University of Murcia, Regional Campus of International Excellence “Mare Nostrum,” Murcia, Instituto Murciano de Investigación Biomédica, Spain; and
| | - María T. Llinás
- Department of Physiology, University of Murcia, Regional Campus of International Excellence “Mare Nostrum,” Murcia, Instituto Murciano de Investigación Biomédica, Spain; and
| | | | - F. Javier Salazar
- Department of Physiology, University of Murcia, Regional Campus of International Excellence “Mare Nostrum,” Murcia, Instituto Murciano de Investigación Biomédica, Spain; and
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Chirumbolo S. Immunotherapy in allergy and cellular tests: state of art. Hum Vaccin Immunother 2014; 10:1595-610. [PMID: 24717453 PMCID: PMC5396242 DOI: 10.4161/hv.28592] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/10/2014] [Accepted: 03/18/2014] [Indexed: 12/13/2022] Open
Abstract
The basophil activation test (BAT) is an in vitro assay where the activation of basophils upon exposure to various IgE-challenging molecules is measured by flow cytometry. It is a cellular test able to investigate basophil behavior during allergy and allergy immunotherapy. A panoply of critical issues and suggestive advances have rendered this assay a promising yet puzzling tool to endeavor a full comprehension of innate immunity of allergy desensitization and manage allergen or monoclonal anti-IgE therapy. In this review a brief state of art of BAT in immunotherapy is described focusing onto the analytical issue pertaining BAT performance in allergy specific therapy.
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Affiliation(s)
- Salvatore Chirumbolo
- Department of Medicine; University of Verona; Verona, Italy
- Laboratory of Physiopathology of Obesity; Depertment of Medicine-University of Verona; LURM Est Policlinico GB Rossi; Verona, Italy
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New insights into the pathogenesis of IgA nephropathy. Semin Immunopathol 2014; 36:431-42. [PMID: 24442210 DOI: 10.1007/s00281-013-0411-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 11/26/2013] [Indexed: 01/10/2023]
Abstract
IgA nephropathy (IgAN) is the most common diagnosis amongst primary glomerular diseases in most countries where renal biopsies are regularly performed. Only a fraction of these patients is at high risk of losing glomerular filtration rate (GFR) in particular those with high grade proteinuria, uncontrolled hypertension or already impaired GFR at diagnosis, and those with renal scars in the renal biopsy. Genetic modifiers of IgAN onset and/or course are emerging. Spontaneous animal models of IgAN are problematic given considerable species differences between the rodent and human IgA system. However, new transgenic models help to better understand the pathogenesis. A key pathogenetic role appears to be played by underglycated IgA1 as well as autoantibodies to these IgA glycoforms and IgA receptors such as CD89 and transferrin receptor 1. Once IgA and/or IgA-containing immune complexes are deposited or formed in the mesangium, secondary effector mechanisms become important including complement activation, release of mesangial growth factors (in particular platelet-derived growth factor), and finally non-IgAN-specific events that culminate in glomerular and subsequently renal tubulointerstitial scaring. Here, we review these processes and describe potential novel therapeutic targets in IgAN.
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Berthelot L, Monteiro RC. [Formation of IgA deposits in Berger's disease: what we learned from animal models]. Biol Aujourdhui 2013; 207:241-7. [PMID: 24594572 DOI: 10.1051/jbio/2013022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Indexed: 11/14/2022]
Abstract
Immunoglobulin A (IgA) nephropathy (N) is the most common form of primary glomerulonephritis in the world and one of the first cause of end-stage renal failure. IgAN is characterized by the accumulation in mesangial areas of immune complexes containing IgA1. While epidemiology and clinical studies of IgAN are well-established, the mechanism(s) underlying disease development is poorly understood. The pathogenesis of this disease involves the deposition of polymeric and undergalactosylated IgA1 in the mesangium. Quantitative and structural changes of IgA1 play a key role in the development of the disease, due to functional abnormalities of two IgA receptors: the FcαR (CD89) expressed by blood myeloid cells and the transferrin receptor (TfR1) on mesangial cells. Abnormal IgA induces release of soluble CD89, responsible for the formation of circulating IgA complexes. These complexes are trapped by the TfR1 that is overexpressed on mesangial cells in IgAN patients, inducing the expression of transglutaminase 2. This enzyme stabilises IgA deposits at the surface of mesangial cells. These cells are then activated, proliferate and produce proinflammatory cytokines, leading to the loss of renal function.
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Affiliation(s)
- Laureline Berthelot
- INSERM U699, Faculté Bichat, 16 rue Henri Huchard, 75018 Paris, France - Université Paris Diderot, Faculté de Médecine, Site Bichat, 16 rue Henri Huchard, 75890 Paris Cedex 18, France - Laboratoire d'Excellence Inflamex, Sorbonne Paris Cité, 75890 Paris Cedex 18, France
| | - Renato C Monteiro
- INSERM U699, Faculté Bichat, 16 rue Henri Huchard, 75018 Paris, France - Université Paris Diderot, Faculté de Médecine, Site Bichat, 16 rue Henri Huchard, 75890 Paris Cedex 18, France - Laboratoire d'Excellence Inflamex, Sorbonne Paris Cité, 75890 Paris Cedex 18, France
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Novak J, Julian BA, Mestecky J, Renfrow MB. Glycosylation of IgA1 and pathogenesis of IgA nephropathy. Semin Immunopathol 2012; 34:365-82. [PMID: 22434325 DOI: 10.1007/s00281-012-0306-z] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 03/02/2012] [Indexed: 12/18/2022]
Abstract
IgA nephropathy, described in 1968 as IgA-IgG immune-complex disease, is an autoimmune disease. Galactose-deficient IgA1 is recognized by unique autoantibodies, resulting in the formation of pathogenic immune complexes that ultimately induce glomerular injury. Thus, formation of the galactose-deficient IgA1-containing immune complexes is a critical factor in the pathogenesis of IgA nephropathy. Studies of molecular defects of IgA1 can define new biomarkers specific for IgA nephropathy that can be developed into clinical assays to aid in the diagnosis, assessment of prognosis, and monitoring of disease progression.
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Affiliation(s)
- Jan Novak
- University of Alabama at Birmingham, Birmingham, AL 35294, USA.
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Qi S, Sui W, Yang M, Chen J, Dai Y. CpG array analysis of histone H3 lysine 4 trimethylation by chromatin immunoprecipitation linked to microarrays analysis in peripheral blood mononuclear cells of IgA nephropathy patients. Yonsei Med J 2012; 53:377-85. [PMID: 22318827 PMCID: PMC3282964 DOI: 10.3349/ymj.2012.53.2.377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The purpose of the present study was to investigate the aberrance of histone H3 lysine 4 trimethylation (H3K4me3) in patients with IgA Nephropathy (IgAN). MATERIALS AND METHODS In this study, H3K4me3 variations in peripheral blood mononuclear cells (PBMCs) from 15 IgAN patients and 15 healthy subjects were analyzed using chromatin immunoprecipitation linked to microarrays analysis (ChIP-chip). ChIP real-time PCR was used to validate the microarray results. Expression analysis by quantitative real-time PCR (qRT-PCR) revealed correlations between mRNA and H3K4me3 levels. DNA methylation status was analyzed by quantitative methylation-specific PCR. RESULTS We found that 321 probes displayed significant H3K4me3 differences in IgAN patients compared with healthy controls. Among these probes, 154 probes displayed increased H3K4me3 and 167 probes demonstrated decreased H3K4me3. For further validation, we selected 4 key relevant genes (FCRL4, GALK2, PTPRN2 and IL1RAPL1) to study. The results of ChIP real-time PCR coincided well with the microarray data. Quantitative RT-PCR revealed the correlations between the mRNA expression and the methylation levels of H3K4me3. Different degrees of DNA methylation alterations appeared on the selected positive genes. CONCLUSION Our studies indicated that there were significant alterations in H3K4me3 in IgAN patients. These findings may help to explain the disturbed immunity and abnormal glycosylation involved in IgAN patients.
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Affiliation(s)
- Suwen Qi
- Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, Chongqing Medical University, Chongqing, China
| | - Weiguo Sui
- Kidney Transplantation and Hemopurification Center of PLA, 181th Hospital of Guangzhou Military Area of PLA, Guangxi, China
| | - Ming Yang
- Kidney Transplantation and Hemopurification Center of PLA, 181th Hospital of Guangzhou Military Area of PLA, Guangxi, China
| | - Jiejing Chen
- Kidney Transplantation and Hemopurification Center of PLA, 181th Hospital of Guangzhou Military Area of PLA, Guangxi, China
| | - Yong Dai
- Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, Chongqing Medical University, Chongqing, China
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IgG1 and IVIg induce inhibitory ITAM signaling through FcγRIII controlling inflammatory responses. Blood 2012; 119:3084-96. [PMID: 22337713 DOI: 10.1182/blood-2011-08-376046] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Intravenous immunoglobulin (IVIg) has been used in the treatment of several autoimmune and inflammatory diseases. However, its mechanism of action remains incompletely understood. Here, we investigated the possibility that IVIg induces its anti-inflammatory effects through activating Fcγ receptors bearing an immunoreceptor tyrosine-based activation motif (ITAM) in the FcRγ signaling adaptor. Recently, the concept of inhibitory ITAM (ITAMi) has emerged as a new means to negatively control the immune response. We found that interaction of FcRγ-associated mouse or human FcγRIII with uncomplexed IgG1 or IVIg, or with bivalent anti-FcγRIII F(ab')(2) reduced calcium responses, reactive oxygen species production, endocytosis, and phagocytosis, induced by heterologous activating receptors on monocyte/macrophages and FcγRIII(+) transfectants. Inhibition required the ITAMi configuration of the FcγRIII-associated FcRγ subunit and SHP-1 recruitment involving formation of intracellular "inhibisome" clusters containing FcγRIII, and the targeted heterologous activating receptor. IVIg as well as anti-FcγRIII treatments controlled the development of nonimmune mediated inflammation in vivo independently of FcγRIIB. These results demonstrate that circulating immunoglobulins (Ig)Gs are not functionally inert but act through continuous interaction with FcγRIII-inducing ITAMi signaling to maintain immune homeostasis. These data support a new mechanism of action for IVIg and demonstrate the therapeutic potential of FcγRIIIA targeting in inflammation.
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Floege J. The Pathogenesis of IgA Nephropathy: What Is New and How Does It Change Therapeutic Approaches? Am J Kidney Dis 2011; 58:992-1004. [DOI: 10.1053/j.ajkd.2011.05.033] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Accepted: 05/26/2011] [Indexed: 02/07/2023]
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Ka SM, Hsieh TT, Lin SH, Yang SS, Wu CC, Sytwu HK, Chen A. Decoy receptor 3 inhibits renal mononuclear leukocyte infiltration and apoptosis and prevents progression of IgA nephropathy in mice. Am J Physiol Renal Physiol 2011; 301:F1218-30. [PMID: 21900455 DOI: 10.1152/ajprenal.00050.2011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The progression of IgA nephropathy (IgAN), the most frequent type of primary glomerulonephritis, is associated with high levels of mononuclear leukocyte infiltration into the kidney. These cells consist mainly of T cells and macrophages. Our previous study showed that a decoy receptor 3 (DCR3) gene therapy can prevent the development of a mouse autoimmune glomerulonephritis model by its potent immune modulating effects (Ka SM, Sytwu HK, Chang DM, Hsieh SL, Tsai PY, Chen A. J Am Soc Nephrol 18: 2473-2485, 2007). Here, we tested the hypothesis that DCR3 might prevent the progression of IgAN, an immune complex-mediated primary glomerulonephritis, by inhibiting T cell activation, renal T cell/macrophage infiltration, and protecting the kidney from apoptosis. We used a progressive IgAN (Prg-IgAN) model in B cell-deficient mice, because the mice are characterized by a dramatic proliferation of activated T cells systemically and progressive NF-κB activation in the kidney. We treated the animals with short-term gene therapy with DCR3 plasmids by hydrodynamics-based gene delivery. When the mice were euthanized on day 21, we found that, compared with empty vector-treated (disease control) Prg-IgAN mice, DCR3 gene therapy resulted in 1) systemic inhibition of T cell activation and proliferation; 2) lower serum levels of proinflammatory cytokines; 3) improved proteinuria, renal function, and renal pathology (inhibiting the development of marked glomerular proliferation, crescent formation, glomerulosclerosis, and interstitial inflammation); 5) suppression of T cell and macrophage infiltration into the periglomerular interstitium of the kidney; and 5) a reduction in apoptotic figures in the kidney. On the basis of these findings, DCR3 might be useful therapeutically in preventing the progression of IgAN.
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Affiliation(s)
- Shuk-Man Ka
- Dept. of Pathology, Tri-Service General Hospital, National Defense Medical Center, No. 325 Sec. 2 Cheng-Gung Road, Taipei, Taiwan
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Maillard N, Thibaudin L, Abadja F, Masson I, Garraud O, Berthoux F, Alamartine E, Mariat C. Single nucleotidic polymorphism 844 A->G of FCAR is not associated with IgA nephropathy in Caucasians. Nephrol Dial Transplant 2011; 27:656-60. [PMID: 21750160 DOI: 10.1093/ndt/gfr246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND IgA nephropathy is characterized by a high heterogeneity of clinical expression with 10-30% of patients progressing to end-stage renal failure. The gene of the FcαRI or CD89 presents a single-nucleotide polymorphism responsible for a proinflammatory phenotype of neutrophils in vitro and ex vivo. The aim of our study was to assess whether this CD89 polymorphism 844 A->G is (i) a marker of disease susceptibility and/or (ii) associated with a more severe prognosis. METHODS All patients diagnosed with IgA nephropathy and for whom DNA frozen sample was available were included in this European monocentric retrospective analysis and compared to a cohort of healthy volunteers. Allelic discrimination was performed by real-time quantitative polymerase chain reaction (Applied Biosystems™). We first compared the distribution of A and G alleles between patients and volunteers and then studied the relationships between alleles and renal survival, histological score, proteinuria and renal function at diagnosis. RESULTS Seven hundred and twenty-six patients were analyzed for the study of susceptibility and 425 in the association study. The presence of the G allele was not associated with the occurrence of IgA nephropathy (χ(2) test 0.57, ns). Likewise, renal survival and the criteria for disease activity at time of diagnosis were not affected by the presence of the G allele. CONCLUSIONS No significant association between 844 A->G CD89 polymorphism and the expression of the IgA nephropathy in Caucasians exists. This result does, however, not preclude the implication of other CD89 polymorphisms neither the possibility for a role of CD89 in the pathogenesis of IgA nephropathy.
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Papista C, Berthelot L, Monteiro RC. Dysfunctions of the Iga system: a common link between intestinal and renal diseases. Cell Mol Immunol 2011; 8:126-34. [PMID: 21278767 DOI: 10.1038/cmi.2010.69] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Immunoglobulin A (Iga)-isotype antibodies play an important role in immunity owing to their structure, glycosylation, localization and receptor interactions. Dysfunctions in this system can lead to multiple types of pathology. This review describes the characteristics of Iga and discusses the involvement of abnormalities in the Iga system on the development of celiac disease and Iga nephropathy.
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Waterman PM, Cambier JC. The conundrum of inhibitory signaling by ITAM-containing immunoreceptors: potential molecular mechanisms. FEBS Lett 2010; 584:4878-82. [PMID: 20875413 PMCID: PMC2998577 DOI: 10.1016/j.febslet.2010.09.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Revised: 09/14/2010] [Accepted: 09/17/2010] [Indexed: 11/28/2022]
Abstract
Immunoreceptor signals must be appropriately transduced and regulated to achieve effective immunity while controlling inflammation and autoimmunity. It is generally held that these processes are mediated by the interplay of distinct activating and inhibitory receptors via conserved activating (ITAM) and inhibitory (ITIM) signaling motifs. However, recent evidence indicates that under certain conditions incomplete phosphorylation of ITAM tyrosines leads to inhibitory signaling. This new regulatory function of ITAMs has been termed ITAMi (inhibitory ITAM). Here we discuss the potential molecular mechanisms of inhibitory signaling by ITAM-containing receptors.
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Affiliation(s)
- Paul M Waterman
- Integrated Department of Immunology, University of Colorado School of Medicine, Denver CO 80206, USA
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Scandiuzzi L, Beghdadi W, Daugas E, Abrink M, Tiwari N, Brochetta C, Claver J, Arouche N, Zang X, Pretolani M, Monteiro RC, Pejler G, Blank U. Mouse mast cell protease-4 deteriorates renal function by contributing to inflammation and fibrosis in immune complex-mediated glomerulonephritis. THE JOURNAL OF IMMUNOLOGY 2010; 185:624-33. [PMID: 20530261 DOI: 10.4049/jimmunol.0902129] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Mast cells exert protective effects in experimental antiglomerular basement membrane-induced glomerulonephritis (GN), yet the responsible mediators have not been identified. In this study, we investigated the role of mouse mast cell protease (mMCP)-4, the functional homolog of human chymase, using mMCP-4-deficient mice. Compared with wild type animals, mMCP-4-deficient mice exhibited lower proteinuria, blood creatinine, and blood urea nitrogen levels, indicating an aggravating role of mMCP-4. Kidney histology confirmed less severe renal damage in mMCP-4-deficient mice with reduced deposits, glomerular and interstitial cellularity, and fibrosis scores. High amounts of mMCP-4 were detected in renal capsules, but not in the whole kidney, from wild type mice. Its expression in renal capsules was markedly decreased after GN induction, suggesting that locally released enzyme by degranulated mast cells could contribute to the functional and physiopathological hallmarks of GN. Supporting a proinflammatory role, glomerular and interstitial macrophage and T cell infiltration, levels of proinflammatory TNF and MCP-1 mRNA, and the expression of the profibrotic peptide angiotensin II together with type I collagen were markedly downregulated in kidneys of mMCP-4-deficient mice. We conclude that mMCP-4 chymase, contrary to the global anti-inflammatory action of mast cells, aggravates GN by promoting kidney inflammation. These results highlight the complexity of mast cell-mediated inflammatory actions and suggest that chymase inhibition may represent a novel therapeutic target in GN.
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Affiliation(s)
- Lisa Scandiuzzi
- Institut National de la Santé et de la Recherche Médicale U699, Paris, France
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Abstract
Monocyte-derived tissue effector cells, macrophages, are present in large numbers in all forms of kidney disease with inflammation. Their roles in inflammation and the molecular effectors of macrophage function have been difficult to decipher. With the advent of modern genetic tools and mouse models of human disease, great insight into monocyte/macrophage biology has been forthcoming. This review places macrophage study in its historical context, defines immunologic diseases of the kidney, broadens its definition to encompass current thinking of the immune response to kidney injury, highlights key advances of the study of monocyte/macrophages in kidney diseases, and identifies new therapeutic pathways and targets that hinge around macrophage function. This article advances the case that targeting macrophage activation and phenotype is leading to new therapies in the treatment of many acute and chronic kidney diseases.
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Affiliation(s)
- Jeremy S Duffield
- Laboratory of Inflammation Research, Renal Division, Department of Medicine, Brigham & Women's Hospital, Boston, MA, USA.
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Peng M, Guo S, Yin N, Xue J, Shen L, Zhao Q, Zhang W. Ectodomain shedding of Fcalpha receptor is mediated by ADAM10 and ADAM17. Immunology 2010; 130:83-91. [PMID: 20059578 DOI: 10.1111/j.1365-2567.2009.03215.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
FcalphaR (CD89) plays important roles in immunoglobulin A (IgA)-mediated immune responses. Soluble forms of FcalphaR (sFcalphaR) are found in the culture supernatants of FcalphaR-expressing cells, in human serum and in the serum of FcalphaR transgenic mice, and have been suggested to be produced through a proteolytic process. However, little is known about the mechanism involved in the proteolytic release of sFcalphaR. In this study, we investigated the shedding mechanism of FcalphaR and determined the nature of the proteinase involved in FcalphaR shedding. In chemical inhibitor assays, shedding of FcalphaR was dramatically inhibited by EDTA, EGTA and a broad-spectrum metalloproteinase inhibitor, GM6001, suggesting that a metalloproteinase was responsible for FcalphaR shedding. Overexpression of dominant-negative mutants of ADAM (a disintegrin and metalloproteinase) 10 and ADAM17 markedly inhibited the production of sFcalphaR. Finally, knockdown of both endogenous ADAM10 and endogenous ADAM17 inhibited FcalphaR shedding, demonstrating that ADAM10 and ADAM17 were involved in the shedding of FcalphaR. The characterization of ADAM10 and ADAM17 as sFcalphaR-releasing enzymes provides a novel insight into the molecular mechanism of sFcalphaR production and will help in further elucidation of the physiological and pathological roles of sFcalphaR.
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Affiliation(s)
- Min Peng
- Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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Blank U, Launay P, Benhamou M, Monteiro RC. Inhibitory ITAMs as novel regulators of immunity. Immunol Rev 2009; 232:59-71. [DOI: 10.1111/j.1600-065x.2009.00832.x] [Citation(s) in RCA: 132] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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40
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Role of IgA and IgA fc receptors in inflammation. J Clin Immunol 2009; 30:1-9. [PMID: 19834792 DOI: 10.1007/s10875-009-9338-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Accepted: 09/24/2009] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Signals delivered by serum monomeric IgA (mIgA) are essential in controlling the immune system by preventing the development of autoimmunity and inflammation. However, IgA can also, when aggregated, be deleterious to the host, inducing inflammatory diseases. This Janus-like nature of IgA is mainly due to their heterogeneity in molecular forms and their interaction with IgA receptors. DISCUSSION While serum mIgA are mainly involved in FcalphaRI-mediated inhibition of immune responses, macromolecular serum IgA or circulating IgA immune complexes are often deleterious to the host by inducing sustained activation through IgA receptors including FcalphaRI and transferrin receptor. CONCLUSION FcalphaRI-mediated inhibitory function is able to suppress several inflammatory diseases in mice including asthma and glomerulonephritis. Intravenous mIgA (mIgAIV) and anti-FcalphaR monovalent antibodies represent thus promising tools for immunotherapy.
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Abstract
The gut mucosa is exposed to a large community of commensal bacteria that are required for the processing of nutrients and the education of the local immune system. Conversely, the gut immune system generates innate and adaptive responses that shape the composition of the local microbiota. One striking feature of intestinal adaptive immunity is its ability to generate massive amounts of noninflammatory immunoglobulin A (IgA) antibodies through multiple follicular and extrafollicular pathways that operate in the presence or absence of cognate T-B cell interactions. Here we discuss the role of intestinal IgA in host-commensal mutualism, immune protection, and tolerance and summarize recent advances on the role of innate immune cells in intestinal IgA production.
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Affiliation(s)
- Andrea Cerutti
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, and Weill Graduate School of Medical Sciences of Cornell University, 1300 York Avenue, New York, NY 10065, USA.
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Tsuboi N, Asano K, Lauterbach M, Mayadas TN. Human neutrophil Fcgamma receptors initiate and play specialized nonredundant roles in antibody-mediated inflammatory diseases. Immunity 2008; 28:833-46. [PMID: 18538590 PMCID: PMC2577844 DOI: 10.1016/j.immuni.2008.04.013] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2007] [Revised: 02/22/2008] [Accepted: 04/01/2008] [Indexed: 01/13/2023]
Abstract
Inflammation mediated by antibody-antigen complexes contributes to autoimmune diseases. Mice deficient in the common Fcgamma-chain are protected from IgG-mediated glomerulonephritis and the reverse passive Arthus (RPA) reaction and FcR-bearing macrophages, and mast cells have been assigned primary roles in these processes. Here we demonstrate that neutrophil-selective transgenic expression of the two uniquely human neutrophil Fc gamma receptors (FcgammaRs), FcgammaRIIA and FcgammaRIIIB, in Fcgamma-chain-deficient mice restored susceptibility to progressive glomerulonephritis and the cutaneous RPA reaction. FcgammaRIIIB and FcgammaRIIA mediated neutrophil accumulation, whereas FcgammaRIIA alone promoted organ injury. In a model of soluble immune complexes deposited within the vasculature, FcgammaRIIIB was responsible for neutrophil slow rolling and adhesion whereas in the cremaster RPA, induced by both vascular and tissue soluble immune complexes, FcgammaRIIA predominated. Thus, human FcgammaRs on neutrophils serve as molecular links between antibody and immunological disease, with FcgammaRIIA promoting tissue injury and FcgammaRIIIB and FcgammaRIIA displaying specialized context-dependent functions in neutrophil recruitment.
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Affiliation(s)
- Naotake Tsuboi
- Center of Excellence in Vascular Biology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
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Kanamaru Y, Pfirsch S, Aloulou M, Vrtovsnik F, Essig M, Loirat C, Deschênes G, Guérin-Marchand C, Blank U, Monteiro RC. Inhibitory ITAM signaling by Fc alpha RI-FcR gamma chain controls multiple activating responses and prevents renal inflammation. THE JOURNAL OF IMMUNOLOGY 2008; 180:2669-78. [PMID: 18250479 DOI: 10.4049/jimmunol.180.4.2669] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Inhibitory signaling is an emerging function of ITAM-bearing immunoreceptors in the maintenance of homeostasis. Monovalent targeting of the IgA Fc receptor (FcalphaRI or CD89) by anti-FcalphaRI Fab triggers potent inhibitory ITAM (ITAM(i)) signaling through the associated FcRgamma chain (FcalphaRI-FcRgamma ITAM(i)) that prevents IgG phagocytosis and IgE-mediated asthma. It is not known whether FcalphaRI-FcRgamma ITAM(i) signaling controls receptors that do not function through an ITAM and whether this inhibition requires Src homology protein 1 phosphatase. We show in this study that FcalphaRI-Fcgamma ITAM(i) signals depend on Src homology protein 1 phosphatase to target multiple non-ITAM-bearing receptors such as chemotactic receptors, cytokine receptors, and TLRs. We found that anti-FcalphaRI Fab treatment in vivo reduced kidney inflammation in models of immune-mediated glomerulonephritis and nonimmune obstructive nephropathy by a mechanism that involved decreased inflammatory cell infiltration and fibrosis development. This treatment also prevented ex vivo LPS activation of monocytes from patients with lupus nephritis or vasculitis, as well as receptor activation through serum IgA complexes from IgA nephropathy patients. These findings point to a crucial role of FcalphaRI-FcRgamma ITAM(i) signaling in the control of multiple heterologous or autologous inflammatory responses. They also identify anti-FcalphaRI Fab as a new potential therapeutic tool for preventing progression of renal inflammatory diseases.
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Affiliation(s)
- Yutaka Kanamaru
- INSERM Unité 699, Universite Paris 7-Denis Diderot, Faculte de Medecine, Site Xavier Bichat, 16 rue Henri Huchard, Paris, France
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Moura IC, Benhamou M, Launay P, Vrtovsnik F, Blank U, Monteiro RC. The glomerular response to IgA deposition in IgA nephropathy. Semin Nephrol 2008; 28:88-95. [PMID: 18222350 DOI: 10.1016/j.semnephrol.2007.10.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Compelling evidence points to a role for IgA receptors in the pathogenesis of IgA nephropathy. The soluble form of the type I IgA receptor (FcalphaRI or CD89) forms complexes with IgA that can be found in patients' serum and that initiate the disease in CD89 transgenic mice. A nonclassic IgA receptor, identified as the transferrin receptor (TfR), is highly expressed in patients' mesangium and colocalizes with IgA deposits. TfR preferentially binds polymeric IgA1 complexes, but not monomeric IgA1 or IgA2. The TfR-IgA1 interaction is dependent on carbohydrate moieties because hypoglycosylated IgA1 has superior binding to TfR than normally glycosylated IgA1. Polymeric IgA1 binding enhances mesangial cell TfR expression and results in cell proliferation and inflammatory and profibrogenic cytokine and chemokine production, suggesting a pivotal role in mesangial cell proliferation, matrix expansion, and recruitment of inflammatory cells. We propose that, as a second event, activation of the classic, FcRgamma-associated transmembrane FcalphaRI expressed on circulating myeloid leukocytes takes place. FcalphaRI/gamma2 cross-linking in human FcalphaRI transgenic animals promotes disease progression by enhancing leukocyte chemotaxis and cytokine production, and IgA immune complexes from IgA nephropathy patients induce FcalphaRI-dependent cell activation. This review therefore details the functional consequences of IgA/receptor interactions and discusses proposed mechanisms to explain the development and chronicity of the disease.
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Abstract
Inflammatory kidney disease involves a complex network of interactions between resident kidney and infiltrating hematopoietic cells. Mast cells (MCs) are constitutively found in kidneys in small numbers but increase considerably in various renal diseases. While this increase is usually interpreted as a sign of pathological involvement, recent data using MC-deficient animals show their ability to restore kidney homeostasis. In anti-glomerular basement membrane antibody-induced glomerulonephritis, MCs are protective by initiating repair and remodeling functions counteracting the devastating effects of glomerular injury. Protection may also include immunoregulatory capacities to limit autoreactive T-cell responses. MCs also control tubulointerstitial fibrosis by activating tissue remodeling and neutralizing fibrotic factors. Release of mediators by MCs during inflammation, however, could also promote unwanted responses that ultimately lead to destruction of kidney structure, as exemplified by data showing either protection or aggravation in related renal disease models. Similarly, while the action of proteases may initially be beneficial, the generation of fibrosis-promoting angiotensin II by chymase also shows the limits of adaptive responses to achieve homeostasis. Thus, it is likely the physiological context involving the interaction with other cells and inflammatory mediators that determines the final action of MCs in the development of kidney disease.
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Affiliation(s)
- Ulrich Blank
- Inserm U699, Immunopathologie Rénale, Récepteurs et Inflammation, Univesité Paris 7, Paris, France.
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