Publications

2021

Li, P., Jiang, M., Li, K., Li, H., Zhou, Y., Xiao, X., Xu, Y., Krishfield, S., Lipsky, P. E., Tsokos, G. C., & Zhang, X. (2021). Glutathione peroxidase 4-regulated neutrophil ferroptosis induces systemic autoimmunity. Nat Immunol, 22, Article 9. https://doi.org/10.1038/s41590-021-00993-310.1038/s41590-021-00993-3 [pii]
The linkage between neutrophil death and the development of autoimmunity has not been thoroughly explored. Here, we show that neutrophils from either lupus-prone mice or patients with systemic lupus erythematosus (SLE) undergo ferroptosis. Mechanistically, autoantibodies and interferon-alpha present in the serum induce neutrophil ferroptosis through enhanced binding of the transcriptional repressor CREMalpha to the glutathione peroxidase 4 (Gpx4, the key ferroptosis regulator) promoter, which leads to suppressed expression of Gpx4 and subsequent elevation of lipid-reactive oxygen species. Moreover, the findings that mice with neutrophil-specific Gpx4 haploinsufficiency recapitulate key clinical features of human SLE, including autoantibodies, neutropenia, skin lesions and proteinuria, and that the treatment with a specific ferroptosis inhibitor significantly ameliorates disease severity in lupus-prone mice reveal the role of neutrophil ferroptosis in lupus pathogenesis. Together, our data demonstrate that neutrophil ferroptosis is an important driver of neutropenia in SLE and heavily contributes to disease manifestations.
Li, X., Zhao, J., Naini, S. M., Sabiu, G., Tullius, S. G., Shin, S. R., Bromberg, J. S., Fiorina, P., Tsokos, G. C., Abdi, R., & Kasinath, V. (2021). Kidney-Draining Lymph Node Fibrosis Following Unilateral Ureteral Obstruction. Front Immunol, 12, 768412. https://doi.org/10.3389/fimmu.2021.768412768412
Although the primary organ has been the subject of intense investigation in the field of organ fibrosis over the past several decades, the presence of lymph node fibrosis due to persistent activation of the immune response in its partner organ remains largely unknown. Previously, we demonstrated that activation of the immune response following ischemia-reperfusion injury (IRI) and crescentic glomerulonephritis (CGN) in the kidney was associated with extracellular matrix (ECM) production by fibroblastic reticular cells (FRCs) of the kidney-draining lymph node (KLN). Here, we sought to determine whether FRCs in the KLN become similarly fibrogenic following unilateral ureteral obstruction (UUO) of the kidney. We subjected 6-8-week-old C57BL/6J mice to UUO for 2, 7, and 14 days. We examined the microarchitecture of the kidney and KLN by immunofluorescence staining at each timepoint, and we quantified immune cell populations in the KLN by flow cytometry. The contralateral kidney unaffected by UUO and its partner KLN were used as controls. We found through immunofluorescence staining that FRCs increased production of ECM fibers and remodeled the microarchitecture of the UUO KLN, contributing to fibrosis that mirrored the changes in the kidney. We also observed by flow cytometry that the populations of CD11b(+) antigen-presenting cells, CD11c(+) dendritic cells, and activated CD4(+) and CD8(+) T cells were significantly higher in the UUO KLN than the KLN draining the unaffected contralateral kidney. Expression of the TGFbeta/TGFbetaR signaling pathway was upregulated and colocalized with FRCs in the UUO KLNs, suggesting a possible mechanism behind the fibrosis. Both release of ureteral ligation at 2 days following UUO and depletion of FRCs at the time of injury onset halted the progression of fibrosis in both the kidney and the KLN. These findings for the first time highlight the association between fibrosis both in the kidney and the KLN during UUO, and they lay the groundwork for future studies that will investigate more deeply the mechanisms behind the connection between FRCs and KLN fibrosis.
Psarras, A., Antanaviciute, A., Alase, A., Carr, I., Wittmann, M., Emery, P., Tsokos, G. C., & Vital, E. M. (2021). TNF-alpha Regulates Human Plasmacytoid Dendritic Cells by Suppressing IFN-alpha Production and Enhancing T Cell Activation. J Immunol, 206, Article 4. https://doi.org/10.4049/jimmunol.1901358jimmunol.1901358 [pii]ji_1901358 [pii]
Human plasmacytoid dendritic cells (pDCs) play a vital role in modulating immune responses. They can produce massive amounts of type I IFNs in response to nucleic acids via TLRs, but they are also known to possess weak Ag-presenting properties inducing CD4(+) T cell activation. Previous studies showed a cross-regulation between TNF-alpha and IFN-alpha, but many questions remain about the effect of TNF-alpha in regulating human pDCs. In this study, we showed that TNF-alpha significantly inhibited the secretion of IFN-alpha and TNF-alpha of TLR-stimulated pDCs. Instead, exogenous TNF-alpha promoted pDC maturation by upregulating costimulatory molecules and chemokine receptors such as CD80, CD86, HLA-DR, and CCR7. Additionally, RNA sequencing analysis showed that TNF-alpha inhibited IFN-alpha and TNF-alpha production by downregulating IRF7 and NF-kappaB pathways, while it promoted Ag processing and presentation pathways as well as T cell activation and differentiation. Indeed, TNF-alpha-treated pDCs induced in vitro higher CD4(+) T cell proliferation and activation, enhancing the production of Th1 and Th17 cytokines. In conclusion, TNF-alpha favors pDC maturation by switching their main role as IFN-alpha-producing cells to a more conventional dendritic cell phenotype. The functional status of pDCs might therefore be strongly influenced by their overall inflammatory environment, and TNF-alpha might regulate IFN-alpha-mediated aspects of a range of autoimmune and inflammatory diseases.
Pan, W., Nagpal, K., Suarez-Fueyo, A., Ferretti, A., Yoshida, N., Tsokos, M. G., & Tsokos, G. C. (2021). The Regulatory Subunit PPP2R2A of PP2A Enhances Th1 and Th17 Differentiation through Activation of the GEF-H1/RhoA/ROCK Signaling Pathway. J Immunol, 206, Article 8. https://doi.org/10.4049/jimmunol.2001266jimmunol.2001266 [pii]
Protein phosphatase 2A (PP2A) composed of a scaffold subunit, a catalytic subunit, and multiple regulatory subunits is a ubiquitously expressed serine/threonine phosphatase. We have previously shown that the PP2A catalytic subunit is increased in T cells from patients with systemic lupus erythematosus and promotes IL-17 production by enhancing the activity of Rho-associated kinase (ROCK) in T cells. However, the molecular mechanism whereby PP2A regulates ROCK activity is unknown. In this study, we show that the PP2A regulatory subunit PPP2R2A is increased in T cells from people with systemic lupus erythematosus and binds to, dephosphorylates, and activates the guanine nucleotide exchange factor GEF-H1 at Ser(885), which in turn increases the levels of RhoA-GTP and the activity of ROCK in T cells. Genetic PPP2R2A deficiency in murine T cells reduced Th1 and Th17, but not regulatory T cell differentiation and mice with T cell-specific PPP2R2A deficiency displayed less autoimmunity when immunized with myelin oligodendrocyte glycoprotein peptide. Our studies indicate that PPP2R2A is the regulatory subunit that dictates the PP2A-directed enhanced Th1 and Th17 differentiation, and therefore, it represents a therapeutic target for pathologies linked to Th1 and Th17 cell expansion.
Scherlinger, M., & Tsokos, G. C. (2021). Shortage of aspartate in mitochondria fuels arthritis. Nat Immunol, 22, Article 12. https://doi.org/10.1038/s41590-021-01069-y10.1038/s41590-021-01069-y [pii]
In patients with rheumatoid arthritis, a short supply of aspartate in the mitochondria can force the endoplasmic reticulum of T cells to generate transmembrane TNF, which in turn contributes to synovial inflammation.
Satyam, A., Tsokos, M. G., Brook, O. R., Hecht, J. L., Moulton, V. R., & Tsokos, G. C. (2021). Activation of classical and alternative complement pathways in the pathogenesis of lung injury in COVID-19. Clin Immunol, 226, 108716. https://doi.org/S1521-6616(21)00053-X [pii]10.1016/j.clim.2021.108716108716 [pii]
Lung inflammation and damage is prominent in people infected with SARS-Cov-2 and a major determinant of morbidity and mortality. We report the deposition of complement components in the lungs of people who succumbed to COVID-19 consistent with the activation of the classical and the alternative pathways. Our study provides strong rationale for the expansion of trials involving the use of complement inhibitors to treat patients with COVID-19.
Scherlinger, M., & Tsokos, G. C. (2021). Reactive oxygen species: The Yin and Yang in (auto-)immunity. Autoimmun Rev, 20, Article 8. https://doi.org/S1568-9972(21)00142-7 [pii]10.1016/j.autrev.2021.102869
Reactive oxygen species (ROS) are produced by immune cells in response to antigens. They are produced mostly in the mitochondria and their levels are tightly controlled by a series of metabolic processes. ROS are necessary for the development of the immune response but the role of ROS in the development of autoimmune disease needs further clarification. Early clinical information points to the beneficial role of supplementation of antioxidant agents or the reduction of ROS production. We review recent information in the field in an effort to identify areas more studies are needed.
Umeda, M., Yoshida, N., Hisada, R., Burbano, C., Orite, S. Y. K., Kono, M., Kyttaris, V. C., Krishfield, S., Owen, C. A., & Tsokos, G. C. (2021). ADAM9 enhances Th17 cell differentiation and autoimmunity by activating TGF-beta1. Proc Natl Acad Sci U S A, 118, Article 18. https://doi.org/10.1073/pnas.2023230118e20232301182023230118 [pii]202023230 [pii]
The a disintegrin and metalloproteinase (ADAM) family of proteinases alter the extracellular environment and are involved in the development of T cells and autoimmunity. The role of ADAM family members in Th17 cell differentiation is unknown. We identified ADAM9 to be specifically expressed and to promote Th17 differentiation. Mechanistically, we found that ADAM9 cleaved the latency-associated peptide to produce bioactive transforming growth factor beta1, which promoted SMAD2/3 phosphorylation and activation. A transcription factor inducible cAMP early repressor was found to bind directly to the ADAM9 promoter and to promote its transcription. Adam9-deficient mice displayed mitigated experimental autoimmune encephalomyelitis, and transfer of Adam9-deficient myelin oligodendrocyte globulin-specific T cells into Rag1(-/-) mice failed to induce disease. At the translational level, an increased abundance of ADAM9 levels was observed in CD4(+) T cells from patients with systemic lupus erythematosus, and ADAM9 gene deletion in lupus primary CD4(+) T cells clearly attenuated their ability to differentiate into Th17 cells. These findings revealed that ADAM9 as a proteinase provides Th17 cells with an ability to activate transforming growth factor beta1 and accelerates its differentiation, resulting in aberrant autoimmunity.
Wu, X., Liu, Y., Jin, S., Wang, M., Jiao, Y., Yang, B., Lu, X., Ji, X., Fei, Y., Yang, H., Zhao, L., Chen, H., Zhang, Y., Li, H., Lipsky, P. E., Tsokos, G. C., Bai, F., & Zhang, X. (2021). Single-cell sequencing of immune cells from anticitrullinated peptide antibody positive and negative rheumatoid arthritis. Nat Commun, 12, Article 1. https://doi.org/10.1038/s41467-021-25246-7497710.1038/s41467-021-25246-7 [pii]25246 [pii]
The presence or absence of anti-citrullinated peptide antibodies (ACPA) and associated disparities in patients with rheumatoid arthritis (RA) implies disease heterogeneity with unknown diverse immunopathological mechanisms. Here we profile CD45(+) hematopoietic cells from peripheral blood or synovial tissues from both ACPA+ and ACPA- RA patients by single-cell RNA sequencing and identify subsets of immune cells that contribute to the pathogenesis of RA subtypes. We find several synovial immune cell abnormalities, including up-regulation of CCL13, CCL18 and MMP3 in myeloid cell subsets of ACPA- RA compared with ACPA+ RA. Also evident is a lack of HLA-DRB5 expression and lower expression of cytotoxic and exhaustion related genes in the synovial tissues of patients with ACPA- RA. Furthermore, the HLA-DR15 haplotype (DRB1/DRB5) conveys an increased risk of developing active disease in ACPA+ RA in a large cohort of patients with treatment-naive RA. Immunohistochemical staining shows increased infiltration of CCL13 and CCL18-expressing immune cells in synovial tissues of ACPA- RA. Collectively, our data provide evidence of the differential involvement of cellular and molecular pathways involved in the pathogenesis of seropositive and seronegative RA subtypes and reveal the importance of precision therapy based on ACPA status.