A&R:亲环素D治疗抗中性粒细胞胞浆抗体相关性血管炎

2022-08-04 紫菀款冬 MedSci原创

研究亲环素D在抗中性粒细胞胞浆抗体相关性血管炎发病机制中的作用。

目的:抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAV)的病理特征是局灶性纤维蛋白样坏死,其中ANCA介导的中性粒细胞细胞胞外陷阱(NET)形成并随后发生内皮坏死。亲环素D(CypD)通过打开线粒体通透性转换孔(mPTP)在介导细胞坏死和炎症中发挥重要作用。该团队研究了CypD在AAV发病机制中的作用。

方法:在体外,通过免疫染色电子显微镜观察CypD在ANCA刺激的中性粒细胞中的作用和机制。对经ANCA处理的小鼠中性粒细胞进行了全面的RNA测序分析。为了研究CypD在体内的作用,在CypD敲除或野生型小鼠中诱导抗MPO IgG转移AAV模型或自发AAV模型小鼠。

结果:在体外,CypD的药理学和遗传学抑制通过抑制线粒体活性氧/细胞色素c的释放来抑制ANCA诱导的网络形成。对经ANCA处理的小鼠中性粒细胞的RNA测序分析表明,炎症反应参与其中,CypD缺乏减少了ANCA诱导的基因表达改变。

此外,上游调节因子分析揭示了细胞内钙离子(CypD激活剂)和环孢菌素(CypD抑制剂)在ANCA刺激中的相关性,表明CypD依赖的mPTP开放与ANCA诱导的中性粒细胞激活和坏死有关。在两种AAV模型中,CypD基因缺失通过抑制CypD依赖的中性粒细胞和内皮坏死而改善新月体肾炎。

结论:通过解决坏死性血管炎,CypD靶向治疗AAV是一种新的、特异的治疗策略

文献来源:

Kudo T, Nakazawa D, Watanabe-Kusunoki K, et al. Cyclophilin D regulates NETosis and inflammation in myeloperoxidase-antineutrophil cytoplasmic antibody-associated vasculitis [published online ahead of print, 2022 Jul 29]. Arthritis Rheumatol. 2022;10.1002/art.42314. doi:10.1002/art.42314

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