Modified Immune Cell (MIC) Therapy disrupts Tertiary Lymphoid Structures in Murine Lupus Nephritis

G. Ponath, C. Speer, Iris Arnold, A. Hidmark, Lei Wang, C. Kleist, A. Schmitt, V. Daniel, G. Opelz, P. Terness, M. Schmitt, M. Zeier, C. Morath, M. Schaier
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Abstract

Induction of tolerance can be achieved with Modified Immune Cells (MIC) by infusion of mononuclear cells challenged with mitomycin C (MMC). Although MIC treatment has been successful in several animal models for autoimmunity and in clinical studies of solid organ transplantation, the mechanism of immunosuppression is not fully elucidated. In lupus nephritis, the glomerular deposition of immune complexes is associated with accumulating immune cells in the kidney. The infiltrating immune cells frequently establish tertiary lymphoid structures (TLS) supporting adaptive autoimmune responses toward locally displayed antigens. Since TLS display a high persistence to peripheral B cell depletion, the destruction of TLS presents an essential treatment goal in lupus nephritis. In this study, we used lupus nephritis prone NZB/W F1 mice to show the destruction of TLS in the kidney after MIC treatment. Independent of treatment, >86% of animals displayed dense lymphocytic aggregates proximal to the pelvic wall of the medulla and the arcuate arteries within the cortex of kidneys. Cell type composition of TLS changed drastically after MIC treatment leading to diminished B-cells, a decreased B-cell/T-cell ratio, and a T cell dominated phenotype. Furthermore, a loss of organization of the TLS was observed after MIC treatment. The strict separation of B-cell and T-cell areas was abrogated, and germinal centers were disintegrated. However, regulatory T-cells remained unchanged indicative of a B-cell centric treatment mechanism. Our data provides a putative in vivomechanism how MIC treatment inhibits progression of active lupus nephritis by the destruction of tertiary lymphoid structures within the kidney. Commercial Support - TolerogenixX GmbH
改良免疫细胞(MIC)疗法破坏小鼠狼疮性肾炎的三级淋巴结构
经丝裂霉素C (MMC)刺激的单核细胞可通过修饰免疫细胞(MIC)诱导耐受。尽管MIC治疗在一些自身免疫动物模型和实体器官移植的临床研究中取得了成功,但免疫抑制的机制尚未完全阐明。在狼疮性肾炎中,免疫复合物的肾小球沉积与肾脏中积累的免疫细胞有关。浸润性免疫细胞经常建立三级淋巴样结构(TLS),支持对局部显示抗原的适应性自身免疫反应。由于TLS对外周B细胞耗竭具有高度持久性,因此破坏TLS是狼疮性肾炎的重要治疗目标。在本研究中,我们使用狼疮肾炎易发的NZB/W F1小鼠来显示MIC治疗后肾脏TLS的破坏。与治疗无关,bbbb86 %的动物在髓质骨盆壁近端和肾皮质弓形动脉内显示密集的淋巴细胞聚集。MIC处理后,TLS的细胞类型组成发生了巨大变化,导致b细胞减少,b细胞/T细胞比例降低,出现T细胞为主的表型。此外,MIC处理后观察到TLS的组织丢失。b细胞区和t细胞区的严格分离被废除,生发中心解体。然而,调节性t细胞保持不变,表明以b细胞为中心的治疗机制。我们的数据提供了一个假定的体内机制,MIC治疗如何通过破坏肾脏内的三级淋巴结构来抑制活动性狼疮性肾炎的进展。商务支持- TolerogenixX GmbH
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