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Department of Laboratory Medicine and Section of Immunobiology, Yale University School of Medicine, New Haven, CT 06520
| Abstract |
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| Introduction |
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Our results from these transgenic mice raised the question of the origin of the deleting Ag. IgG, the presumed tolerogen, can exist in soluble form in plasma, milk, and secretions and can be passed through the placenta and to neonates through the milk. It also can exist in membrane form on IgG-expressing B cells and as IgG bound to Fc receptors (FcR). Since we previously observed deletion of RF B cells in weanling mice, we speculated that maternally derived IgG could mediate deletion. To test this idea, in the present report we have exploited the allotype specificity of our RF transgenic system. Crosses in which the mother can or cannot donate tolerogenic IgG2aa were used to provide genetic evidence that maternal Ab mediates deletion in young mice. This conclusion, based on genetics, was corroborated by direct infusion experiments.
Since maternal IgG is a relevant tolerogen, this, in turn, raised the issue of whether autoimmunity would ensue once maternal IgG donation was ended by weaning. Therefore, we next studied the maintenance of tolerance with age and found that deletion in our transgenic mice is not stable; it remits several weeks after mice are weaned and in some mice is re-established later in life. Remarkably, the reversal of deletion occurs over a very brief time period. After induction, an "autoimmune" state in which the autoantibody is expressed at detectable levels can persist for months. Further evidence is presented suggesting that deletion is an interplay among Ag levels, B cell numbers, and autoantibody levels, all of which may modulate each other. The fluctuating nature of deletion and autoantibody expression in these mice may be an important model for the abrupt onset of expression of autoantibodies that occur in spontaneous autoimmunity (20, 21). The fact that the autoimmune state tends to be self-perpetuating has important implications for understanding the pathophysiology of chronic autoimmune disease, including whether apparent central tolerance defects are primary ones or occur secondarily to the clearance of tolerizing autoantigen by previously secreted autoantibodies.
| Materials and Methods |
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20.8.3 transgenic mice were constructed and bred as previously
described (17). For standard propagation, mice were backcrossed to
either BALB/c (Ig heavy chain allotype a (IgHa)) or
CB.17 (IgHb) with the male in each mating carrying the
transgenes. Various additional matings were set up as described in
Table I
. Mice were typed by PCR for
transgenes as described and for allotype by either PCR or Southern blot
as described below.
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A single pair of oligonucleotides was designed based on the
BALB/C
2a sequence: 5'-TGTCCTTGTCATTTCCAG-3' and
5'-TCTGGTCTAGTGACTTAC-3'. These oligos amplify a 179-bp fragment
for the IgHa allotype and a 201-bp fragment for the
IgHb allotype due to an insertion sequence polymorphism.
These fragments were resolved on a 3% Nusieve agarose gel (FMC,
Rockland, ME). Reaction conditions were as described with a 1.5 mM
final MgCl2 concentration. Cycling conditions were 95°C
for 5 min (one cycle); 95°C for 30 s, 48°C for 30 s, and
72°C for 45 s (10 cycles); 95°C for 30 s, 48°C for
30 s, and 72°C for 30 s (25 cycles); and 72°C for 5 min
(one cycle). Cycling was performed on an Omnigene Thermal Cycler
(Labnet, Woodbridge, NJ) using tube control.
FACS
FACS on spleen, blood, and bone marrow cells was performed as previously described (17, 18).
ELISA
Serum Ab level ELISA assays were determined as previously described (17, 18).
Serum infusion
C57Bl/6(B6)/lpr/IgHa mouse serum was
selected as a passive soluble IgG2aa source for infusion
into 20.8.3 transgenic mice, with B6/lpr/IgHb
serum serving as a negative control. B6/lpr/IgHa
and B6/lpr mice, 3 mo or older, were bled about once per
week, and sera from multiple bleeds were pooled. The IgG2b
concentration in serum was measured by ELISA using a monoclonal IgG2b
as a standard. An amount of pooled serum containing 1 mg of IgG2b was
used as one infusion dose in a 200-µl volume diluted in PBS. PBS
alone was used as an infusion control. In each set of experiments mice
received IgHa-derived serum, IgHb-derived
serum, or PBS. IgG2b measurement was used to standardize the doses, as
we did not have an assay available that would measure
IgG2aa and IgG2ab equivalently. Mice were
infused every other day, and PBL FACS and serum sampling for IgG2a and
RF assays were performed once after each three-dose infusion. Infusions
were continued for 3 or 4 wk, then the mice were killed and checked by
splenocyte FACS. In one experiment either IgG2aa
(23.3)
or IgG2ab
(15G5) protein G-purified mAbs obtained from
ascites raised in scid mice were used in lieu of serum at
the concentrations indicated in Results and figure
legends.
Statistics
Differences between various groups were determined using the Mann-Whitney unpaired U test as computed by StatView 4.5 for Macintosh (Abacus Concepts, Berkeley, CA). A value of p < 0.05 (two-tailed test) was considered significant.
| Results |
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Previously we demonstrated that 3- to 5-wk-old
IgHa 20.8.3 transgenic mice born to BALB/c
(IgHa) mothers manifested deletion of RF B cells (19). (Our
analysis of deletion in the BM of 20.8.3 mice showed that it actually
had features of receptor editing and developmental arrest; for
simplicity, we will refer to this process herein as deletion.) We
speculated that deletion was mediated by maternally derived Ig;
alternatively, endogenous IgG2a or circulating
IgG2aa-expressing B cells in the young transgenic progeny
could have provided sufficient Ag to mediate tolerance. Therefore, to
establish the origin(s) of deletion-mediating Ag, we set up crosses to
generate progeny of IgHa/b mothers that were endogenously
IgHb (b, baby; a, mother) or of IgHb mothers
that were endogenously IgHa/b (a, baby; b, mother; see
Table I
).
The deletion phenotype in these mice entirely segregates with the
IgHa maternal allotype. This is depicted in three ways, all
of which provide the same general conclusion. In the left
panel of Figure 1
, the percentage of
splenocytes that retain the RF specificity is shown, which demonstrates
a marked reduction in mice with IgHa mothers compared with
IgHb. Since this analysis could be confounded if IgG2a Ag
caused IgM receptor modulation or competed with the detecting reagent,
in the center panel we show
B220+/
+ cells (which are always >90% of
total B220+ cells). Again, the same picture is seen.
Finally in the right panel, the fraction of
B220+ cells that have the RF specificity is shown. This is
a good indicator of deletion, since B cells that no longer bind
IgG2aa because they have edited their receptors or
coexpress and endogenous Ig gene(s) are preserved, while B cells that
continue to express the RF specificity are deleted. By any of these
analyses, IgHb babies born to IgHa mothers
deleted RF B cells to the same extent as positive control mice entirely
of IgHa origin. As these progeny have no endogenous
capacity to produce IgG2aa, deletion in these mice is
entirely attributable to maternally derived IgG2aa.
Conversely, IgHa/b babies born to IgHb mothers
did not delete and had percentages (and numbers, not shown) of RF B
cells similar to those in control mice that were entirely of
IgHb origin. Thus, the endogenous capacity to express
IgG2aa is not required for deletion in these young mice and
is insufficient to mediate it. Similar data were obtained for a second
founder line (not shown). From these results we conclude that maternal
IgG can mediate deletion.
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The results of the above genetic crosses predicted that soluble IgG2aa should mediate deletion when injected into IgHb recipients. This prediction stems from the fact that the mothers that did (IgHa) and did not (IgHb) have progeny with deletion differed only at the IgH locus. Since the 20.8.3 RF that provided the V genes for the transgenic is specific for IgG2aa, and since the IgH locus represents the only known difference between BALB/c and CB.17, IgG2aa is almost certainly the active factor being transferred only by IgHa mothers. Further, since soluble IgG is known to be transferred across the placenta and in milk, soluble IgG2a is most likely the form of Ag mediating deletion in the crosses. To formally establish this point, we injected serum or IgG2a mAbs derived from IgHa or IgHb mice into young IgHb transgenics.
In the first sets of experiments, serum isolated from either
IgHa (B6/lpr/IgHa) or
IgHb (B6/lpr) donors was infused into
IgHb transgenics in an attempt to cause deletion. The donor
mice were chosen because the hypergammaglobulinemia characteristic of
these strains provided an enriched source of IgG2a and so that this
preparation might mimic the situation of emerging RF B cells in an
autoimmune animal, which would have circulating immune complexes. In
addition, these congenic mice differ only in their IgH allotype; thus,
any differences in effects would be attributable to IgH gene products
and not to other factors in crude serum preparations. As shown in
Figure 2
A, this protocol
induced complete disappearance from the blood of detectable
RF-expressing lymphocytes within 1 wk (the first time point examined).
Deletion in PBL was essentially maintained for the 3-wk protocol
(p < 0.01 comparing IgHa-infused
mice to PBS- and IgHb-infused mice for wk 1, 2, and 4;
p = 0.07 for wk 3) and for an additional week
thereafter and was observed in spleen at the termination of the
experiment (Fig. 2
B). The average serum
IgG2aa level in recipients at this time was 84 µg/ml. We
consider this to be deletion, as demonstrated previously in intact
IgHa-expressing mice, since the percentages of total
B220+ cells in PBL were also significantly reduced in these
serum-infused mice (p < 0.01 comparing
IgHa-infused mice to combined other groups at wk 13). A
similar result for B220+ cells was seen in spleen at the 4
wk point.
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or the IgG2ab
type into
IgHb transgenics; these mAbs highly purified from tissue
culture would not contain immune complexes. Further, these mAbs both
have the same irrelevant specificity (anti-nitrophenyl hapten), the Ag
for which would not be expressed in the recipients. As with serum
injections, we observed deletion at both doses of IgG2aa
tested, but not with IgG2ab (Fig. 2Multiple independent mice show re-expression after weaning
Since maternally derived IgG2a can mediate B cell deletion in
20.8.3 transgenic mice, this raised the question of whether tolerance
would continue or autoimmunity would ensue postweaning. We therefore
determined the extent of deletion in spleen and PBL as mice aged.
Figure 3
shows the analysis of
splenocytes from two independent founder lines. Beginning about 5 to 6
wk of age and progressing through 7 to 8 wk of age, the percentages of
transgenic B cells in spleen and PBL were markedly increased, in
contrast with those in 3- to 4-wk-old mice (Fig. 3
A:
p < 0.01 comparing 3- to 4-wk-old mice to 6-, 7-, and
8-wk-old mice; Fig. 3
B: p < 0.05 comparing
3- to 4-wk-old mice to every other week). This pattern is identical in
both founder lines. At later ages in at least some of the mice,
expression of RF B cells continued, while in other mice, deletion was
re-established. In the Warren line (Fig. 3
B),
continued expression with age was somewhat more prevalent than that in
the Wendy line (Fig. 3
A).
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It was possible that in older mice the apparent lack of RF B cells
was due to a blockage of the RF receptor by IgG2a rather than to true
disappearance. This issue is further raised by the fact that some of
these mice have substantial percentages of B220+
cells. Receptor down-modulation could not explain our lack of RF B cell
detection, since there were no apparent differences in surface
levels in these residual B cells (data not shown). We assessed whether
receptor blockage was an alternative explanation as follows (Fig. 4
). Splenocytes from 10-wk-old
IgHa or IgHb mice were either incubated, or
not, with saturating (50 µg/ml) concentrations of
IgG2aa
, then washed and stained with anti-IgG2a
antiserum (FITC) and anti-IgMa (biotin). In this
scheme, additional circulating IgG2a should enhance, rather than block,
detection. The IgMa-expressing IgHb splenocytes
that were not incubated with IgG2aa were considered
negative or background; after incubation with IgG2aa,
however, these were revealed with anti-IgG2a, demonstrating our
ability to detect RF B cells by this staining technique (Fig. 4
A). A similar percentage of cells was detected by
our standard technique, using anti-IgMa and
biotinylated IgG2aa (Fig. 4
D). In two
different IgHa mice, different levels of deletion were seen
by this technique. In one animal, some of the B cells (32.6%) were
detected by this technique, but others failed to stain any more than
the IgHb-negative control. The percentage of B cells
detected matches closely the percentage detected in our standard
staining technique (45.4%; Fig. 4
E). A similar
picture was seen for the second animal, in which nearly all cells did
not display RF activity, as they were not stained even after incubation
with saturating IgG2a (only 1.5% positive; Fig. 4
C).
Again, the standard technique detected a similar percentage of cells
(1%; Fig. 4
F). Note also in Figure 4
, D
through F, that surface IgM levels did not appear modulated
in either nondeleting (D), partly deleting
(E), or fully deleting
(F) mice. From these analyses we confirm the
true absence of RF B cells in late deleting mice.
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The fact that at any age some of the mice failed to express RF B
cells could mean that some mice always remain tolerant or could reflect
the fact that these particular mice were assayed before the point at
which they would have expressed or after they had again down-regulated
expression. To distinguish these possibilities and to better define the
time course of the switch between deletion and expression in individual
mice, we performed weekly analysis of PBL by FACS on a cohort of 11
IgHa transgenic mice (Wendy line) starting at 4 wk of
age. Three patterns of expression emerged (Fig. 5
). Five of the 11 mice showed transient
and low level expression of B cells between 5 and 6 wk of age,
returning to a deletion phenotype by 7 wk. Three mice, however,
expressed large percentages (nearly as much as IgHb
controls) of RF B cells, and this expression persisted up to 25 wk of
age. A third pattern, seen in two mice, was high level expression,
followed by an eventual return to deletion by 25 wk. These results are
remarkable for several reasons. First, about half the mice never
expressed significant frequencies of RF B cells, supporting the idea of
heterogeneity among mice as opposed to sampling time variation in
explaining the data presented in Figure 3
. Second, the transition from
complete deletion to peak expression occurred in all mice over the
space of a single week. Finally, half the mice manifested persistent
expression, including three that expressed from wk 6 through 25,
indicating that at least for some mice, expression of RF autoantibody
is self-perpetuating. This corroborates the phenotypes shown in Figure 3
. As will be discussed in detail, these patterns of expression are
predicted by a positive feedback model with two metastable and
self-reinforcing states: deletion and expression.
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The most likely explanation for the late onset of expression of RF
B cells is the natural clearance of maternally derived serum
IgG2aa after weaning. If this were the case, one would
predict that artificial maintenance of serum IgG2aa levels
postweaning would abrogate the expression of RF B cells. To determine
whether this was, in fact, the case, we again turned to infusion of
passive IgG, although in this case with the aim of maintaining deletion
in IgHa mice rather than inducing deletion in
IgHb mice. At the start of the protocol, all 3-wk-old
IgHa recipient mice had few circulating RF B cells, as
expected (Fig. 6
, day 0). However, within
2 to 3 wk, mice receiving either PBS or IgHb-type serum had
low, but above background, levels of circulating RF B cells, the
expression of which became more prominent at 3 and 4 wk into the
experiment, also as expected. In contrast, mice that received
IgHa-derived serum never had significant numbers of
detectable RF B cells for the duration of the experiment
(p < 0.05 comparing IgHa
serum-infused group to PBS- and IgHb-infused groups at wk
2, 3, and 4). There were also significant differences in the
percentages of total B220+ cells (p
< 0.05) at all weeks except wk 2 (not shown).
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The results presented thus far demonstrate an interplay among
autoantigen, RF B cells, and possibly soluble IgM-RF secreted by RF B
cells. To better understand these interactions, we simultaneously
examined the serum IgG2a and RF levels in mice of various ages and
correlated these with the frequency of RF B cells in spleen. We
stratified these results by age, to focus on the transition period from
deletion to expression and thus to better understand the dynamic
process. These data are shown in Figure 7
. As expected, in young (3- to 5-wk-old)
mice, relatively high serum IgG2a levels were generally associated with
low levels of RF B cells as well as little serum RF. In particular,
very low RF B cell frequencies were associated with IgG2a
concentrations of 55 µg/ml or more. This suggests a rough estimate of
the concentration required to cause deletion in vivo.
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A last issue in the dynamic process of RF deletion and expression is
the cause of late deletion (see Figs. 3
A and 5 at time
points beyond 8 wk). Late deletion does not always occur (it is less
prominent in the Warren than in the Wendy line; Fig. 3
), and its timing
is variable (Figs. 3
and 5
). We hypothesized that late deletion
reflects activation of endogenous IgG2a production, which, in turn,
could rely on environmental exposure. To examine this possibility, we
determined IgG2a levels in older mice and, in fact, found very high
levels in many older deleting mice (Fig. 6
, bottom
panels). In addition, several IgHb transgenics
that were born to IgHa/b mothers, which uniformly
experience early deletion (Fig. 1
), were examined at later time points.
As expected from their inability to produce endogenous
IgG2aa, late deletion in these mice was not observed (not
shown). These data are consistent with the idea that late deletion
results from re-emergence of serum IgG2aa.
| Discussion |
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Using a series of reciprocal genetic crosses, we have established that maternally derived IgG plays a critical role in neonatal tolerance of high affinity RF B cells. Mice without maternal IgG2aa but with the endogenous capacity to express IgG2aa still do not delete, whereas in the converse situation, mice with maternal IgG2aa but without the endogenous capacity to express do, in fact, delete. These results provide evidence for the role of maternal Ag in censoring the neonatal B cell repertoire of cells that would react with a developmentally expressed Ag.
Examples of this phenomenon as it relates to B cells and Ags other than IgG are rare in the literature. This could mean that RF is a special case. However, in principle one would expect maternal donation of other developmentally expressed Ags through either the placenta or milk to cause B cell tolerance. Therefore, we believe that the lack of similar data in the literature may reflect a lack of suitable systems for detecting and distinguishing B cell tolerance.
T cells, on the other hand, are known to be susceptible to transplacental Ag-mediated tolerance, as has been elegantly shown in an HBVe-Ag transgenic model (22, 23, 24) as well as for mouse mammary tumor virus (25, 26, 27). Similarly, Geiger et al. demonstrated that tissue-specific expression of transgenic SV40 T Ag led to tolerance if this expression began early in ontogeny but led to autoimmunity if it began later (28, 29, 30). If early expression of some Ags is indeed important to establish tolerance, then maternal transfer of adult developmental Ags, such as IgG, may be one means to prevent autoimmunity of both T and B cells. Further work on this and similar systems would be needed to address the general relevance of this mechanism.
Initial establishment of tolerance via maternally derived IgG may be an important factor in the prevention of RF production in nontransgenic mice and in humans. In this regard, literature from the 1960s regarding serum normal agglutinins is reminiscent of the situation in 20.8.3 transgenic mice (31, 32). These workers found that neonatal humans did not make RF-like Abs to maternal allotypes at 6 mo of age or younger, but often did so at older ages. They speculated that this related to initial self-tolerance, followed by an immunization by the maternal IgG as the neonate aged. Our 20.8.3 data are consistent with this phenomenon. In contrast to 20.8.3, in the case of humans, the roles of B cell vs T cell tolerance could not be discerned.
One implication of the role of the maternal IgH allotype in causing deletion is that soluble IgG is mediates deletion. The alternative, that maternal surface IgG2a-positive B cells are being passed to the fetus, seems unlikely. In this regard, two other groups have investigated the negative regulatory effects of IgG. Weigle and colleagues, in classic tolerance experiments, injected high doses of soluble human deaggregated IgG and found both B and T cell tolerance (33). These results differ from ours in that the Ag was actually foreign, deaggregated IgG had a unique effect (whereas our autoimmune serum with immune complexes also did), and the mechanism of tolerance was not shown. More recently, Tighe et al. have demonstrated deletion after injection of soluble, deaggregated human IgG into mice that were expressing a transgenic, high affinity human RF. In this case, the deletion resembled activation-induced cell death (34). The idea that soluble Ag mediates deletion is further supported by our experiments in which soluble injected IgG either caused deletion in mice that had been expressing or maintained deletion in weanlings. It has been suggested that soluble Ags or Ags with low valency would cause anergy, whereas membrane-bound or highly multivalent Ags would cause deletion (35, 36, 37, 38). The dominant role of valency has been emphasized, since even very low affinity reactions have caused deletion when the Ag is membrane bound, whereas the interaction of soluble lysozyme with a transgenic B cell Ag receptor causes anergy even though it is of high affinity. Up to now, the only precedent for a soluble endogenous Ag causing deletion is DNA (39, 40). Soluble DNA, however, may be more akin to a membrane-bound Ag, since it is highly polymeric. One problem in interpreting our finding is that IgG can bind to FcRs and could mediate deletion in this form as a membrane-bound Ag. Experiments are in progress to distinguish the direct role of soluble IgG in mediating deletion from indirect effects. In any case, we doubt that the effects are exclusively due to either immune complexes or the V region specificity, since a purified mAb specific for an irrelevant hapten readily caused deletion.
In our view, the most striking feature of the 20.8.3 transgenics is the
dynamic nature of the B cell tolerance. After an initial phase of
deletion that is caused by maternal IgG, a second phase ensues during
which deletion fails or is incomplete. The onset of this second phase
is due to the decay of maternal Ig after weaning, and it can be delayed
by providing passive IgG2a at this point (Fig. 6
). This second phase is
then perpetuated, for weeks to months, by the subsequent suppression of
serum IgG2a by the autoreactive RF. The low levels of serum IgG2a and
high levels of serum RF during this time (Fig. 7
) are also consistent
with this interpretation. Whether B cells are specifically activated
during this interval or whether serum levels reflect tonic secretion of
IgM by naive B cells remains to be determined.
The appearance of self-specific RF B cells at 6 to 7 wk of age is quite
sudden, taking less than a week to reach its peak (Fig. 5
). Since in
the absence of RF, the half-life of IgG2a is about 3 wk, the abrupt
onset suggests a steep threshold effect for tolerance and/or a positive
feedback loop that accelerates the process. Positive feedback, at
least, seems likely, since we have recently shown that RF, when
present, does contribute to decreased serum IgG2a levels in vivo (19).
Thus, one could envision that as the serum IgG2a level falls to a
threshold level of around 55 µg/ml, a fraction of B cells that would
have been tolerized at higher IgG2a levels escapes and contributes to
serum RF. This RF, in turn, accelerates the disappearance of serum
IgG2a, leading to an increased rate of tolerance escape and completing
the positive feedback loop. The kinetics of RF expression are
consistent with this. Serum IgG2a levels are on the order of 100
µg/ml at weaning age. Assuming a normal 3-wk half-life of IgG2a
(since RF is not present at weaning), one would predict the initiation
of RF expression, when serum levels drop below 55 µg/ml, to be at
about 6 wk of age. The observed onset is, in fact, 6 to 7 wk of
age.
The sudden appearance of particular autoantibodies is also a characteristic feature of both murine and human lupus (20, 21, 41, 42). Why this occurs is unknown. However, it is interesting to speculate that a positive feedback mechanism similar to that demonstrated here is operating, particularly in the chronic phase of the disease. Such a positive feedback mechanism would also account for why, once tolerance is broken for a particular Ag, it may be hard to re-establish. This mechanism may, in fact, apply more to autoantigens present in low concentrations, such as DNA and chromatin or ribonucleoproteins, than to a high concentration Ag such as RF. However, it may apply to RF as well, since the tolerance threshold for disease-related RFs, such as the RF transgenic AM14 (18), must be quite high (e.g., >100 µg/ml); thus, even reductions in effective concentrations of highly expressed Ags could result in an alteration in the population of B cells that escape tolerance in the BM.
Autoantibodies are known to evolve both specificity and affinity; the pattern of autoantibody specificities progressively spreads within a particle (43, 44), and the affinities of these tend to increase (45, 46). Both of these could be affected by a putative positive feedback circuit. Regarding the spreading of autoantibody specificities, there could be several explanations for why loss of tolerance to one epitope on a particle subsequently leads to loss at other epitopes. It could in part be due to the enhanced immunogenicity of the particle or to the loss of T cell tolerance, leading to the activation of nontolerant B cells. However, in view of our results, we propose that autoantibodies themselves may mediate cross-talk between B cell clones by clearing or blocking autoantigens, thus preventing them from mediating tolerance of newly emerging B cell clones in the bone marrow. This would provide an additional mechanism for how, once autoantibodies to one particular epitope on an autoantigen appear, they are often accompanied or followed by autoantibodies to multiple epitopes.
Affinity maturation, the second major feature of autoimmune
progression, could also be accounted for in two ways, each of which
could be influenced by positive feedback. First, it is clear that
somatic hypermutation and Ag-driven selection operate on established,
activated B cell clones to yield higher affinity mutants (4, 45, 46, 47, 48).
While selection on mutants is manifest, it is puzzling to explain how
competition-driven Ag selection would operate for self-Ags that are at
high concentration, such as IgG. Feedback by pre-existing
autoantibodies could drive competition, however, by causing clearance
or epitope blocking of high concentration Ags. A second possible
mechanism for affinity maturation is the effect of autoantigen
clearance on B cell deletion, as indicated by our results. In
particular, the prolonged presence of autoreactive high affinity RF B
cells that occurs for several weeks after the initial period of
deletion is accompanied by relatively high autoantibody levels as well
as low autoantigen levels. During this interval, newly emerging B cells
from the BM are not tolerized (not shown) but instead develop, thus
maintaining the peripheral pool for a period of weeks or more (Fig. 3
).
By analogy, we propose that in lupus, initial autoantibodies will cause
clearance or blockage of autoantigen. Concurrently, more avid B cells
that would have been deleted at higher (i.e., normal) autoantigen
levels will instead mature and will then become activated in the
periphery. This predicts that as autoimmunity progresses, even
unmutated autoantibodies will begin to appear that have high affinity
and lupus-specific characteristics, such as the ability to bind dsDNA.
In fact, such Abs have been found in both human and murine lupus (46, 49, 50, 51, 52, 53, 54) and have otherwise been difficult to fit into a model that
requires affinity maturation of lower affinity, nontolerized B cells.
Indeed, two groups have produced evidence in humans that receptor
editing of particular V
genes that are prone to encode anti-DNA
appears defective in lupus patients, particularly those with nephritis
(55, 56). Given the above scenario, such data need not indicate a
primary defect in central tolerance but, instead, may reflect a
secondary defect.
The work of Eisenberg and colleagues (42) and of Maini and colleagues (57) may have revealed a similar mechanism in the regulation of anti-Sm responses in autoimmune disease-prone mice. These laboratories found that a few injections of anti-Sm Ab into preautoimmune (anti-Sm seronegative) mice led to an increased frequency and pace of endogenous anti-Sm seroconversion. While several possible explanations were originally advanced, the current RF model argues in favor of a transient reduction in Sm Ag caused by the exogenous anti-Sm, in turn leading to a loss of B cell tolerance, with the subsequent activation of mature anti-Sm B cells. In this regard it is of interest that in these studies, the resultant anti-Sm response was heterogeneous and could target multiple subunits of the Sm particle. This fulfills the prediction of a model in which the mechanism of autoimmunity depends on the clearance of the whole particle.
It will be interesting in the future to further investigate the hypothesized mechanisms of cross-talk between B cell clones, as this could be a major means by which autoimmunity spreads and exacerbates.
| Acknowledgments |
|---|
| Footnotes |
|---|
2 Address correspondence and reprint requests to Dr. Mark J. Shlomchik, Department of Laboratory Medicine, Room CB465, Yale University School of Medicine, 333 Cedar St., Box 208035, New Haven, CT 06520-8035. E-mail address: ![]()
3 Abbreviations used in this paper: RF, rheumatoid factor; BM, bone marrow; FcR, Fc receptors; IgHa, immunoglobulin heavy chain allotype a; Sm, Smith autoantigen. ![]()
Received for publication June 23, 1997. Accepted for publication November 18, 1997.
| References |
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gene rearrangements. EMBO J. 13:2951.[Medline]
gene encoding cationic anti-DNA antibody and role of receptor editing for development of the autoantibody in patients with systemic lupus erythematosus. J. Clin. Invest. 98:1843.[Medline]
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