Neutralization and clearance of GM-CSF by autoantibodies in pulmonary alveolar proteinosis.

Neutralization and clearance of GM-CSF by autoantibodies in pulmonary alveolar proteinosis.
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DOI:
10.1038/ncomms8375
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发表时间:
2015-06-16
影响因子:
16.6
通讯作者:
Lanzavecchia, Antonio
Lanzavecchia, Antonio
中科院分区:
综合性期刊1区
文献类型:
--
作者:
Piccoli, Luca;Campo, Ilaria;Fregni, Chiara Silacci;Rodriguez, Blanca Maria Fernandez;Minola, Andrea;Sallusto, Federica;Luisetti, Maurizio;Corti, Davide;Lanzavecchia, Antonio

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肺泡蛋白沉积症(PAP)是一种严重的自身免疫性疾病,由中和GM-CSF的自身抗体引起,导致肺泡巨噬细胞功能受损。在这项研究中,我们的特点21 GM-CSF自身抗体PAP患者,发现体细胞突变决定了他们的特异性自身抗原。使用体外生物测定,单个抗体仅部分中和GM-CSF活性,这取决于实验条件,而当与人GM-CSF一起注射到小鼠中时,它们导致大量循环GM-CSF的积累,其保持部分生物可利用性。相比之下,三种非交叉竞争抗体的组合通过在高分子量复合物中螯合细胞因子在体外完全中和GM-CSF活性,并且在体内以Fc依赖性方式促进含有GM-CSF的免疫复合物的快速降解。总之,这些发现为PAP患者的严重表型和基于单一抗GM-CSF单克隆抗体的治疗的安全性提供了合理的解释。 自身免疫性肺泡蛋白沉积症是由GM-CSF自身抗体引起的。在这里,作者表明,单个自身抗体仅部分中和GM-CSF,并且需要针对至少三种不同表位的抗体来阻断GM-CSF的生物利用度。
Pulmonary alveolar proteinosis (PAP) is a severe autoimmune disease caused by autoantibodies that neutralize GM-CSF resulting in impaired function of alveolar macrophages. In this study, we characterize 21 GM-CSF autoantibodies from PAP patients and find that somatic mutations critically determine their specificity for the self-antigen. Individual antibodies only partially neutralize GM-CSF activity using an in vitro bioassay, depending on the experimental conditions, while, when injected in mice together with human GM-CSF, they lead to the accumulation of a large pool of circulating GM-CSF that remains partially bioavailable. In contrast, a combination of three non-cross-competing antibodies completely neutralizes GM-CSF activity in vitro by sequestering the cytokine in high-molecular-weight complexes, and in vivo promotes the rapid degradation of GM-CSF-containing immune complexes in an Fc-dependent manner. Taken together, these findings provide a plausible explanation for the severe phenotype of PAP patients and for the safety of treatments based on single anti-GM-CSF monoclonal antibodies. Autoimmune pulmonary alveolar proteinosis is caused by autoantibodies to GM-CSF. Here the authors show that the individual autoantibodies only partially neutralize GM-CSF and that antibodies to at least three different epitopes are required to block GM-CSF bioavailability.
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