Short term administration of costimulatory blockade and cyclophosphamide induces remission of systemic lupus erythematosus nephritis in NZB/W F1 mice by a mechanism downstream of renal immune complex deposition.
NZB/W F(1) mice with established nephritis were treated with a single dose of cyclophosphamide with or without a 2-wk course of murine CTLA4Ig, either alone or in combination with anti-CD154. Sixty to 80% of treated mice entered remission, and remission could be reinduced following relapse. A decrease in the frequency of anti-DNA-producing B cells and activated T cells was observed in treated mice, but this effect lasted only 3-6 wk, while remissions were sustained for up to 20 wk. Light microscopy of the kidneys of mice in remission revealed less glomerular inflammation, less tubular damage, and less infiltration of inflammatory cells. By immunofluorescence, however, IgG and C3 staining of glomeruli was no different in treated mice vs controls. Since chemokines and their receptors play an important role in inflammatory cell infiltration of affected organs in autoimmune diseases, we examined chemokine expression in the kidneys. Decreases in the expression of inflammatory cytokines and chemokines were evident in mice in the early stages of remission, but these differences were no longer present in late remission. Increased expression of CXCL13 was detected in the inflammatory infiltrates of the control NZB/NZW mice. Strikingly, we could not detect any CXCL13 in the kidneys of the treated group even in late remission. These findings suggest that costimulatory blockade together with cyclophosphamide influence the activation state of renal CD11c-positive cells and therefore lead to less B and T cell infiltration and nephritis.
Schiffer
Lena
L
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Sinha
Jayashree
J
Wang
Xiaobo
X
Huang
Weiqing
W
von Gersdorff
Gero
G
Schiffer
Mario
M
Madaio
Michael P
MP
Davidson
Anne
A
Von Gonsdorff
Gero
G
D000069594:Abatacept; D000818:Animals; D000936:Antigen-Antibody Complex / Q000378:metabolism*; D015703:Antigens, CD; D000943:Antigens, Differentiation / Q000276:immunology; D001324:Autoantigens / Q000276:immunology; D016175:B-Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D060908:CTLA-4 Antigen; D002465:Cell Movement / Q000276:immunology; D003433:Crosses, Genetic; D003520:Cyclophosphamide / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005822:Genetic Vectors; D018796:Immunoconjugates / Q000008:administration & dosage / Q000235:genetics; D007274:Injections, Intraperitoneal; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000276:immunology / Q000473:pathology / Q000517:prevention & control; D008181:Lupus Nephritis / Q000188:drug therapy* / Q000276:immunology* / Q000473:pathology / Q000517:prevention & control; D008213:Lymphocyte Activation / Q000187:drug effects* / Q000276:immunology*; D016131:Lymphocyte Subsets / Q000276:immunology / Q000473:pathology; D051379:Mice; D008814:Mice, Inbred NZB; D016513:Mice, SCID; D012074:Remission Induction; D013154:Spleen / Q000166:cytology / Q000276:immunology
D000936:Antigen-Antibody Complex; D015703:Antigens, CD; D000943:Antigens, Differentiation; D001324:Autoantigens; D060908:CTLA-4 Antigen; C556707:Ctla4 protein, mouse; D018796:Immunoconjugates; D000069594:Abatacept; D003520:Cyclophosphamide