Prashant S. Patole*,
Daniel Zecher*,
Rahul D. Pawar*,
Hermann-Josef Gröne,
Detlef Schlöndorff* and
Hans-Joachim Anders*
* Medical Policlinic, Ludwig-Maximilians-University Munich, Germany; and Division of Molecular and Cellular Pathology, German Cancer Research Center, Heidelberg, Germany
Address correspondence to: Dr. Hans-Joachim Anders, Medizinische Poliklinik der LMU, Pettenkoferstrasse 8a, 80336 Munich, Germany. Phone: +49-89-2180-75846; Fax: +49-89-2180-75860; hjanders{at}med.uni-muenchen.de
Received for publication June 27, 2005.
Accepted for publication August 1, 2005.
Whereas the role of immune complexes in mediating renal celland immune cell activation is well established, the contributionof sequence-specific immunomodulatory actions of the chromatinpart remains unclear. Toll-like receptor-9 (TLR-9) mediatesimmunostimulatory effects of unmethylated microbial CpG-DNA.It was hypothesized that hypomethylated CpG-DNA in vertebratesmay have similar effects and may contribute to disease progressionin lupus nephritis. A synthetic G-rich DNA, known to block CpG-DNAeffects, was used in this study. In macrophages, G-rich DNAsuppressed CpG-DNAbut not LPS-induced production of CCL5in a dose-dependent manner. Injections of G-rich DNA suppressedlymphoproliferation induced by CpG-DNA injections in mice. InMRLlpr/lpr mice with lupus nephritis, labeled G-rich DNA co-localizedto glomerular immune complexes and was taken up into endosomesof TLR-9positive infiltrating macrophages. Eleven-week-oldMRLlpr/lpr mice that received injections of either saline orG-rich DNA for 13 wk revealed decreased lymphoproliferationand less autoimmune tissue injury in lungs and kidneys as comparedwith saline-treated controls. G-rich DNA reduced the levelsof serum dsDNA-specific IgG2a as well as the renal immune complexdeposits. This was consistent with the blocking effect of G-richDNA on CpG-DNAinduced proliferation of B cells that wereisolated from MRLlpr/lpr mice. As oligodeoxyribonucleotide 2114treatedMRLlpr/lpr mice were not exposed to exogenous CpG-DNA, theseeffects should relate to a blockade of CpG motifs in endogenousDNA. It is concluded that adjuvant activity of self-DNA contributesto the pathogenesis of lupus nephritis. Modulating the CpG-DNATLR-9pathway may offer new opportunities for the understanding andtreatment of lupus.
The interaction of CpG-DNA and Toll-like receptor-9 (TLR-9)holds many promises for therapeutic intervention such as vaccination,anti-tumor immunity, asthma, and certain infectious diseases(1,2). However, repetitive injections of CpG-oligodeoxyribonucleotides(ODN) cause inappropriate lymphoproliferation in mice (3). Experimentalstudies with rodents suggest that synthetic CpG-ODN can exacerbateunderlying autoimmune tissue injury, e.g., glomerulonephritis,experimental encephalomyelitis, collagen-induced arthritis,or lupus nephritis (47). In lupus nephritis, the interactionof CpG-DNA with TLR-9 is of particular interest for the followingreasons: (1) Human lupus is paradigmatic for systemic autoimmunitywith polyclonal B cell proliferation; (2) CpG-DNA is a B cellmitogen that allows T cellindependent B cell proliferationand autoantibody production (8); (3) endogenous CpG-DNA mayhave similar effects, because immune complexes that are isolatedfrom patients with lupus activate dendritic cells to produceIFN-, an effect sensitive to DNAse digestion (9); and (4) CpG-DNAcan aggravate autoimmune tissue injury locally by activationof tissue macrophages (4). Experimental evidence for a pathogenicrole of CpG motifs in self-DNA for lupus is lacking. Methylationof CpG motif prevents their stimulatory effect on B cells (10),but CpG motifs in human DNA are methylated to only 70 to 80%(11), and genomic DNA released by dying cells can induce thematuration of antigen-presenting cells (12). It is interestingthat known inhibitors of DNA methylation can induce systemiclupus erythematosus (SLE) in humans (13). Furthermore, in vertebrates,G-rich inhibitory DNA sequence elements counterbalance the immunostimulatoryeffects of unmethylated CpG-DNA (14). Synthetic ODN with inhibitorymotifs have shown to block CpG-DNAinduced effects (1517).Thus, we intended to test whether inhibitory ODN given in excessto mice with experimental lupus could serve as an appropriatetool to block the effects of endogenous CpG-DNA in vivo. Weused the recently reported G-rich inhibitory ODN 2114 (16) inMRLlpr/lpr mice, a spontaneous model of autoimmune tissue injurywith striking similarities to human lupus nephritis. We foundthat that injections with G-rich DNA reduced lymphoproliferationand autoimmune tissue injury in MRLlpr/lpr mice. This can beattributed to a specific blocking effect of G-rich DNA on CpG-DNAinducedB cell proliferation and macrophage activation. As injectedG-rich DNA was found to localize to TLR-9positive macrophagesin the kidney, we conclude that injections of G-rich DNA caninterfere with local as well as systemic autoimmune diseasemechanisms in SLE. Thus, G-rich DNA can reduce autoimmunityin MRLlpr/lpr mice most likely involving TLR-9dependentrecognition of endogenous CpG-DNA.
Phosphothioate ODN
The following ODN were used for in vitro or in vivo studies.ODN 2114 5'-TCC TGG AGG GGA AGT-3', CpG-ODN 1668 5'-TCG ATGACG TTC CTG ATG CT-3', and GpC-ODN 1720 5'-TCG ATG AGC TTC CTGATG CT-3' (TIB Molbiol, Berlin, Germany).
Animal Studies
Eight-week-old female 129Sv mice were obtained from Taconic(Ry, Denmark). Ten-week-old female MRLlpr/lpr mice were obtainedfrom Harlan Winkelmann (Borchen, Germany) and were kept in filter-topcages under a 12-h light/dark cycle. Autoclaved water and standardchow (Sniff, Soest, Germany) were available ad libitum. Forassessing the distribution of injected ODN 2114, 100 µg3'-rhodaminelabeled ODN 2114 was injected intraperitoneallyinto 16-wk-old MRLlpr/lpr mice. Tissues were collected 2 h afterinjection and subjected to further analysis as recently described(4). Different groups of mice were treated with either salineor ODN 2114 on alternate days from weeks 11 to 24 of age. Bloodand urine samples were collected from each animal at the endof the study, and urine protein/creatinine ratio, serum dsDNAautoantibody IgG isotype titers, and serum blood urea nitrogenlevels were determined as described previously (4). All experimentalprocedures were performed according to the German animal careand ethics legislation and had been approved by the local governmentauthorities.
Morphologic Analysis
Histologic studies were performed on paraffin-embedded sectionsas described (4). The severity of the renal lesions was gradedusing the indices for activity and chronicity of lupus nephritis(18). Peribronchial and pulmonary inflammation was graded from0 (no inflammation) to 3 (severe inflammation). The followingprimary antibodies were used for immunostaining: ER-HR3 (DPCBiermann, Bad Nauheim, Germany; 1:50) (19), anti-CD3 (BD Pharmingen,Heidelberg, Germany; 1:100), antismooth muscle actin(Dako, Carpinteria, CA; 1:100), antiKi-67 (DAKO, Hamburg,Germany; 1:25), antiTLR-9 (provided by Dr. Stefan Bauer,Technical University, Munich, Germany; 1:50 [7]). Negative controlsincluded incubation with a respective isotype antibody. Forquantitative analysis, glomerular cells were counted in 10 corticalglomeruli per section. Semiquantitative scoring of glomerularIgG deposits from 0 to 3+ was performed on 15 cortical glomerularsections as described (7).
Cell Culture Conditions
J774 mouse macrophages (American Type Culture Collection, Rockville,MD) were grown in RPMI 1640 that contained 1 mM HEPES, 10% heat-inactivatedbovine serum, 100 units/ml penicillin, and 100 µg/ml streptomycin(Biochrom KG, Berlin, Germany). B cells were isolated from spleensof female MRLlpr/lpr mice using B Cell Isolation Kit (Miltenyi,Bergisch Gladbach, Germany) following the manufacturersprotocol. Purity as determined by FACS analysis using CD45/B220-PEor rat IgG2a as an isotype (BD Biosciences, Hamburg, Germany)revealed 97% B cells after each isolation.
B Cell Proliferation Assay
Proliferation of B cells was assessed using CellTiter 96 ProliferationAssay (Promega, Mannheim, Germany). In brief, B cells (1 x 105)were incubated in 96-well plates in 100 µl RPMI mediumthat contained 10% FCS, 100 units/ml penicillin, and 100 µg/mlstreptomycin (Biochrom KG) with 1 µM CpG-ODN 1668, 1 µg/mlLPS, or various concentrations of ODN 2114 for a period of 72h. To each well, 20 µl of CellTiter 96 Aqueous One Solution(Promega) was added and incubated at 37°C for 4 h. The O.D.was measured at 292 nm.
Cytokine and Nitric Oxide Analysis
Cytokine levels in mice sera or cell culture supernatants weredetermined using commercial ELISA kits: Mouse TNF- (Biolegend,San Diego, CA), CCL5 (R&D, Wiesbaden-Nordenstadt, Germany),and IFN- (Perbioscience, Bonn, Germany). The Griess ReagentSystem (Promega) was used for the determination of nitrite incell supernatants as a marker of nitric oxide production.
Statistical Analyses
Data were expressed as mean ± SEM. Cell culture datawere analyzed using ANOVA, and post hoc Bonferroni correctionwas used for multiple comparisons. Comparison of groups of micewas performed using unpaired two-tailed t test. P < 0.05was considered to indicate statistical significance.
ODN 2114 Blocks Stimulatory Activity of CpG-ODN In Vitro
ODN 2114 have been reported to block CpG-ODNinduced NF-Bactivation in mouse B cells (16). We first aimed to confirmthis blocking effect in murine macrophages. ODN 2114 blockedCpG-ODNinduced CCL5 (Figure 1A) and nitric oxide (Figure 1B)production in J774 monocytes in a dose-dependent manner.At equimolar concentrations of CpG-DNA and ODN 2114, the blockingeffect of ODN 2114 on nitrite production was 100%. By contrast,ODN 2114 did not affect CCL5 or TNF- production induced by LPS(Figure 1, C and D). These data suggest that ODN 2114 can actas a specific antagonist for CpG-ODNinduced activationof mouse monocytes in vitro.
Figure 1. Oligodeoxyribonucleotides (ODN) 2114 block CpG-DNAinduced effects in vitro. Cultured J774 macrophages were incubated with CpG-ODN, CpG-ODN with different concentrations of ODN 2114, or standard medium without supplements for 24 h as indicated. (A) CCL5 was measured in supernatants by ELISA. (B) Nitrite was determined by the Griess reaction. (C and D) J774 macrophages were incubated with either LPS alone or LPS with different concentrations of ODN 2114 or standard medium without supplements for 24 h as indicated. CCL5 and TNF- levels were measured in supernatants by ELISA. Results shown are means ± SEM from one of two comparable experiments, each performed in duplicate.
ODN 2114 Blocks Stimulatory Activity of CpG-ODN In Vivo
Next we assessed the potential of ODN 2114 to block the reportedCpG-ODNinduced toxicity after repeated injection in mice(3). We treated 129Sv mice with daily intraperitoneal injectionsof saline or either 60 µg CpG-ODN, GpC-ODN, ODN 2114,or CpG-ODN plus ODN 2114 or saline for 12 d (n = 5 in each group).As previously reported, CpG-ODN induced splenomegaly and lymphadenopathyas compared with saline-injected mice (3). In spleens and lymphnodes, total cellularity was increased and follicles were replacedby disorganized collections of activated macrophages (Figure 2).All CpG-ODNtreated mice showed hemorrhagic ascites,as compared with saline and ODN 2114treated controls,whereas ODN 2114 completely blocked CpG-ODNinduced ascitesproduction. Livers of these mice revealed multifocal portalinflammatory cell infiltrates associated with large areas ofnecrotic and apoptotic hepatocytes (Figure 2). By contrast,all mice that received ODN 2114 injections together with CpG-ODNdid not show major signs of CpG-ODN toxicity. ODN 2114 alsosignificantly reduced CpG-ODNinduced alterations of themicroarchitecture in spleens and lymph nodes (Figure 2). Micethat received injections with either ODN 2114 or GpC-ODN alonedid not show any histopathologic abnormalities as compared withsaline-injected mice (data not shown), the latter excludingunspecific competition of CpG-DNA. These data implicate thatODN 2114 can block CpG-ODNinduced effects in vivo inmice.
Figure 2. ODN 2114 block CpG-DNAinduced effects in vivo. 129Sv mice received intraperitoneal injections of saline or 60 µg of GpC-ODN, CpG-ODN, or CpG-ODN + ODN 2114 or saline daily for 14 d (n = 5 in each group; saline not shown). Respective organs were stained with periodic acid-Schiff (PAS). Magnification, x400.
Distribution of Labeled ODN 2114 and CpG-ODN of Autoimmune MRLlpr/lpr Mice
In view of our previous findings that exogenous CpG-DNA is takenup by intrarenal macrophages (7), we questioned whether injectedODN 2114 localizes likewise in nephritic kidneys of MRLlpr/lprmice. Thus, we studied the distribution of rhodamine-labeledODN 2114 in nephritic kidneys of 16-wk-old MRLlpr/lpr mice.After intravenous injection, ODN 2114 were detected in a glomerularmesangial and capillary staining pattern (Figure 3A). Co-stainingwith an anti-mouse IgG antibody showed co-localization of labeledODN 2114 with glomerular IgG deposits (Figure 3B). In some areas,ODN 2114positive granules were negative for IgG (Figure 3C).Co-staining with an EH-HR3 antibody identified these granulesto be endosomes of glomerular macrophages but IgGODN2114 double-positive endosomes were also observed (Figure 3D).Co-staining with a TLR-9 antibody confirmed co-localizationof ODN 2114 with TLR-9 (Figure 3E). Nephritic MRLlpr/lpr micethat received an injection of rhodamine only or healthy MRLwild-type mice that received an injection of labeled ODN 2114did not show any glomerular deposits (data not shown). Thesefindings show that injected ODN 2114 localize to glomerularmesangium and capillaries and are taken up into TLR-9positiveintracellular endosomes of glomerular macrophages.
Figure 3. Localization of ODN 2114 in kidneys of MRLlpr/lpr mice after intravenous injection. Rhodamine-labeled ODN 2114 were injected intravenously into 16-wk-old MRLlpr/lpr mice, and renal tissue was harvested 2 h later. (A) Fluorescence imaging of frozen sections showed uptake of labeled ODN 2114 in glomeruli in a mesangial and capillary staining pattern. (B) At higher magnification, the granular deposits of ODN 2114 co-localize with IgG deposits in glomerular capillaries upon double staining. (C) In some areas, ODN 2114positive but IgG-negative granula are noted. (D) Co-staining with an EHRH-3 antibody identified these granula to be localized within macrophages. (E) Co-staining with a Toll-like receptor-9 (TLR-9) antibody showed co-localization of ODN 2114 and TLR-9 to an intracellular compartment. Magnification, x400 in A; x630 in B; x1000 in C through E.
ODN 2114 Protect MRLlpr/lpr Mice from Autoimmune Tissue Injury
On the basis of these data, we hypothesized that ODN 2114 mightmodulate macrophage function in experimental lupus. We treatedMRLlpr/lpr mice from week 11 to week 24 of age with intraperitonealinjections of ODN 2114 on alternate-day intervals and comparedmarkers of disease activity with saline-treated MRLlpr/lpr miceat the end of the study. We observed that ODN 2114 reduced spleenweight in MRLlpr/lpr mice as compared with saline-treated controls(Table 1). Morphometric analysis revealed less tissue injuryin kidneys and lungs of ODN 2114treated mice (Table 1).Lungs of ODN 2114treated mice showed less peribronchiolarand perivascular inflammatory cell infiltrates compared withsaline-treated controls (Figure 4). In kidneys of MRLlpr/lprmice, ODN 2114 significantly reduced the number of interstitialER-HR3 macrophages, CD3 lymphocytes, and Ki-67positiveproliferating cells in glomeruli and the tubular compartment(Table 1, Figure 5A). Proteinuria as a marker of glomerularinjury was also reduced, although the altogether low glomerularER-HR3 macrophage and CD3 T cell counts were similar in bothgroups (Table 1).
Figure 4. Autoimmune lung injury in MRLlpr/lpr mice. Lung sections that were taken from 24-wk-old MRLlpr/lpr mice were stained with PAS. Note that ODN 2114treated MRLlpr/lpr mice show less peribronchiolar and perivascular inflammatory cell infiltrates as compared with saline-injected MRLlpr/lpr mice. Magnification, x200.
Figure 5. Lupus nephritis in MRLlpr/lpr mice. (A) Renal sections were stained with PAS, EHRH-3, and CD3 as indicated. Images are representative of 10 mice in each group. Note that ODN 2114treated MRLlpr/lpr mice show less periglomerular and interstitial inflammatory cell infiltrates as compared with saline-treated MRLlpr/lpr mice. (B) Serum IFN- levels in 24-wk-old female saline- or ODN 2114treated MRLlpr/lpr mice were determined by ELISA (n = 8 in each group). *P < 0.05 as compared with saline. Magnification, x400 in A.
IFN- is an important mediator of CpG-DNAmediated autoimmunity(20) and a marker of disease activity in lupus erythematosus(21). Therefore, we determined serum IFN- levels in saline andODN 2114treated MRLlpr/lpr mice. ODN 2114 treatment significantlyreduced serum IFN- levels in ODN 2114treated MRLlpr/lprmice (Figure 5B). Thus, injections of ODN 2114 that inhibitthe biologic effects of CpG-DNA reduce the serum levels of IFN-and prevent autoimmune tissue injury in MRLlpr/lpr mice.
ODN 2114 Block B CellDependent Autoimmunity in MRLlpr/lpr Mice
Autoantibody production and immune complex deposition causetissue injury in lupus. Thus, we assessed the effect of ODN2114 on DNA autoantibody production and renal immune complexdeposits in MRLlpr/lpr mice. At 24 wk, ODN 2114treatedMRLlpr/lpr mice revealed reduced serum levels of dsDNA-specificIgG2a antibodies as compared with saline-treated MRLlpr/lprmice (Figure 6A). This was consistent with the observation thatODN 2114 markedly reduced glomerular IgG2a deposits in MRLlpr/lprmice (Figure 6B, Table 1). Glomerular IgG1 deposits were notreduced, indicating that the effect of ODN 2114 on serum IgG1levels relates to their specificity for dsDNA. These findingsare suggestive of an inhibitory effect of ODN 2114 on CpG-DNAinducedB cell proliferation in MRLlpr/lpr mice. Therefore, we isolatedB cells from MRLlpr/lpr mice and studied the effects of ODN2114 on either CpG-DNAor LPS-induced B cell proliferationin vitro. ODN 2114 blocked B cell proliferation in a dose-dependentmanner when cells were exposed to CpG-DNA (Figure 7A). By contrast,ODN 2114 had no effect on LPS-induced B cell proliferation (Figure 7B).These data suggest that ODN 2114 specifically block CpG-ODNinducedB cell proliferation as well as subsequent DNA autoantibodyproduction and renal immune complex deposits in MRLlpr/lpr mice.
Figure 6. Serum dsDNA autoantibody levels and glomerular immune complex deposits in MRLlpr/lpr mice. Serum dsDNA autoantibody IgG1 (A) and IgG2a (B) levels were determined by ELISA (n = 8 to 10). Data are means ± SEM. *P < 0.05 versus saline. (C) Renal sections were stained for IgG1 and IgG2a, as indicated. Note less glomerular IgG1 and IgG2a deposits in ODN 2114treated MRLlpr/lpr mice. Images are representative of 10 mice in each group. Magnification, x400 in C.
Figure 7. B cell activation in MRLlpr/lpr mice. (A) B cells were isolated from MRLlpr/lpr mice as described in Materials and Methods. B cells were incubated with CpG-ODN, CpG-ODN plus different concentrations of ODN 2114, or standard medium without supplements for 72 h as indicated. B cell proliferation was assessed by CellTiter 96 proliferation assay. (B) B cells were isolated as before and incubated with LPS alone or LPS with different concentrations of ODN 2114 or standard medium without supplements for 72 h as indicated. Results are means ± SEM from one of two comparable experiments, each performed in duplicate.
When MRLlpr/lpr mice are exposed to bacterial or synthetic CpG-DNA,ligation of TLR-9 on immune cells leads to enhanced dsDNA autoantibodyproduction and aggravation of lupus nephritis (7). Similarly,insufficient clearance of nuclear particles in lupus may alsoprovide a permanent source of hypomethylated CpG motifs fromself DNA (22). This mechanism may contribute to a continuousactivation of B cells and dendritic cells and perpetuate systemiclupus in humans (10,23,24). In this study, we addressed thishypothetical pathway by blocking potential CpG-DNAinducedimmunity both in vitro and in vivo with a specific antagonist,G-rich DNA. We further argued that if endogenous CpG-DNA wereto contribute to the progression of lupus nephritis, then injectionsof G-rich DNA should prevent disease progression in MRLlpr/lprmice with experimental lupus.
Synthetic G-Rich ODN Neutralizes CpG-DNA
CpG-DNA is a strong activator of plasmacytoid dendritic cells,macrophages, and B cells in mice (10,25). CpG-DNA stimulatestheir antigen presentation and proinflammatory cytokine productionthat drive subsequent Th1-type responses (25). Lenert et al.(16) first used the ODN 2114 to block CpG-ODNinducedeffects on murine B cells. Here we confirm that this antagonisticeffect is specific, as the G-rich ODN 2114, which totally preventedCpG-DNAinduced B cell proliferation or CCL5 and TNF-production by macrophages, did not modulate LPS-related effects.This antagonism occurs proximal to NF-B activation (16), butthe specific site of interaction is yet unknown. Competitionfor intracellular uptake of CpG-DNA was shown to be independentof G-rich motifs and far too weak to explain the 100% antagonismat equimolar concentrations of G-rich- and CpG-DNA (14,15).Alternatively, G-rich ODN may either compete with CpG-DNA forthe CG binding site at TLR-9 (26) or modify the nanoparticlestructure of nucleosomes by direct interaction with endogenousCpG-DNA (26,27). The latter would require co-localization ofinjected G-rich DNA chromatin particles. This may occur in vivobecause we observed co-localization of injected ODN 2114 withglomerular IgG deposits that are complexed with chromatin-particlesin nephritic MRLlpr/lpr mice. However, as our study was notdesigned to address this question, the interaction of CpG-DNAwith TLR-9 on a molecular level remains to be determined. Nevertheless,G-rich ODN represents a specific antagonist for CpG-DNAinducedB cell and monocyte activation in mice. This was also confirmedin vivo by our experiments in Sv129 mice. G-rich ODN 2114 blockedCpG-ODNinduced lymphoproliferation, an effect shown tobe mediated through TLR-9 on marginal zone B cells and monocytes(3) Together, G-rich ODN 2114 specifically block the effectsof CpG-DNA in vitro and in vivo, which renders ODN 2114 a valuabletool to address the question, whether endogenous CpG-DNA canmodulate lupus erythematosus.
G-Rich DNA Modulates Systemic Autoimmunity in MRLlpr/lpr Mice
Systemic lupus is associated with polyclonal B cell proliferationand DNA autoantibody production in humans. In MRLlpr/lpr mice,lymphoproliferation and dsDNA autoantibody production progresswith age. Injections with G-rich ODN 2114 reduced spleen weightas a marker of lymphoproliferation as well as serum dsDNA autoantibodyconcentrations as compared with saline-injected MRLlpr/lpr mice.As the MRLlpr/lpr mice were not exposed to exogenous CpG-DNA,the observation may be attributed to a blockade of immunostimulatoryeffects of endogenous CpG-DNA on B cells. This is consistentwith a study published by Leadbetter et al. (8) showing thatself chromatin-containing immune complexes stimulate B cellsisolated from MRLlpr/lpr mice via TLR-9. It is noteworthy thatsuppressive ODN as well as DNAse treatment of the immune complexesabrogated this effect, supporting the role for the endogenousCpG-DNA in this context (8). In our study, the blocking effectof G-rich DNA on B cell proliferation was specific for CpG-DNA,because ODN 2114 did not modulate LPS-induced B cell proliferation.
Serum IFN- levels depict the activation of IFN-producing plasmacytoiddendritic cells, which represents another marker for diseaseactivity in lupus (28). Nuclear particles released from dyingcells and complexed with lupus patient IgG are potent inducersof IFN- production in plasmacytoid dendritic cells, an effectthat is sensitive to DNAse digestion (29). In a recent study,immune complexes were isolated from sera of patients with variousrheumatic diseases (16). It was found that only DNA-containingimmune complexes that were isolated from lupus patients stimulatedplasmacytoid dendritic cells to produce cytokines and chemokinesvia a cooperative interaction between TLR-9 and FcRIIa (CD32).CD32 shuttles DNA-containing immune complexes into a subcellularcompartment that contains TLR-9 (9). Only CD32-positive plasmacytoiddendritic cells internalized DNA-immune complexes and producedlarge amounts of IFN-. Our finding that MRLlpr/lpr mice thatreceived injections with G-rich DNA show lower serum IFN- levelsas compared with saline-injected MRLlpr/lpr mice is in favorof a blocking effect of G-rich DNA on IFN-producing plasmacytoiddendritic cells. Thus, G-rich DNA can block B cell proliferation,dsDNA autoantibody production, and IFN- release in MRLlpr/lprmice, which all have established etiopathogenic roles in thesystemic autoimmunity of lupus erythematosus.
G-Rich DNA Prevents Tissue Injury in MRLlpr/lpr Mice
MRLlpr/lpr mice that received injections of G-rich DNA had markedlyreduced renal and pulmonary autoimmune tissue injury as comparedwith saline-injected mice. In part this may relate to the reducedanti-dsDNA antibody production and immune complex deposition,as demonstrated for the kidney. However, injected G-rich ODN2114 could also interact locally with immune complexes and TLR-9positiveimmune cells. We addressed this issue by injecting fluorescentlylabeled ODN 2114 into nephritic MRLlpr/lpr mice. In fact, ODN2114 localized to glomerular immune complex deposits and tointracellular compartments of infiltrating glomerular macrophages.This cellular distribution was comparable to that of TLR-9 immunostainingin kidneys of MRLlpr/lpr mice. Thus, ODN 2114 could interferewith CpG-DNArich chromatin-immune complexes in the endosomesof intrarenal macrophages in vivo. This could reduce a proinflammatoryeffect of the immune complexes on macrophages and possibly dendriticcells in kidneys of MRLlpr/lprmice. We showed previously thatexogenous bacterial DNA or CpG-DNA markedly stimulate renalmacrophages in lupus nephritis of MRLlpr/lpr mice and antigen-inducedimmune complex glomerulonephritis (4,7). CpG-DNA stimulatesmacrophages to produce multiple proinflammatory mediators thatcontribute to the progression of renal disease. Similarly, exogenousCpG-DNA can cause macrophage-dependent arthritis or lung injury,which both can be blocked with G-rich DNA (17,30). However,in this study, MRLlpr/lpr mice were not exposed to exogenousCpG-DNA, so the beneficial effect of G-rich DNA is compatiblewith the influence with endogenous CpG-DNAmediated effects.Our data support the hypothesis that endogenous CpG-DNArichchromatin activates TLR-9positive immune cells, specificallyB cells, macrophages, and dendritic cells, and thus contributeto the pathogenesis of lupus. Apart from the experimental datain mice, this concept is also supported by the therapeutic propertiesof chloroquine, an unspecific blocker of endosomal TLR activation,in the treatment of human lupus (31). Our observation that administrationof G-rich DNA attenuates the course of the lupus-like diseasein MRLlpr/lpr mice also argues in favor of endogenous CpG-DNAfragments as pathophysiologic contributors to the murine diseaseand indicates G-rich DNA as a potential therapeutic pathwayfor the treatment of SLE.
Acknowledgments
The work was supported by grants from the Deutsche Forschungsgemeinschaft(AN372/4-1, GRK 1201) to H.J.A. and a grant (BA2137/1-1) toD.S. H.J.A. and D.S. were supported by a grant from the EU Networkof Excellence "MAIN" (FP6-502935). H.J.A. was also funded bythe Fritz Thyssen Foundation.
Parts of this project were prepared as a doctoral thesis atthe Faculty of Medicine, University of Munich, by P.S.P.
Footnotes
Published online ahead of print. Publication date availableat www.jasn.org.
See related editorial, "More Targeted Treatments for Lupus Nephritis:Is the Future (Nearly) Here?," on pages 31463148.
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Received for publication June 27, 2005.
Accepted for publication August 1, 2005.
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