REDD1/autophagy pathway promotes thromboinflammation and fibrosis in human systemic lupus erythematosus (SLE) through NETs decorated with tissue factor (TF) and interleukin-17A (IL-17A).


Journal

Annals of the rheumatic diseases
ISSN: 1468-2060
Titre abrégé: Ann Rheum Dis
Pays: England
ID NLM: 0372355

Informations de publication

Date de publication:
02 2019
Historique:
received: 04 02 2018
revised: 28 10 2018
accepted: 01 11 2018
pubmed: 20 12 2018
medline: 29 10 2019
entrez: 20 12 2018
Statut: ppublish

Résumé

The release of neutrophil extracellular traps (NETs) represents a novel neutrophil effector function in systemic lupus erythematosus (SLE) pathogenesis. However, the molecular mechanism underlying NET release and how NETs mediate end-organ injury in SLE remain elusive. NET formation and NET-related proteins were assessed in the peripheral blood and biopsies from discoid lupus and proliferative nephritis, using immunofluorescence, immunoblotting, quantitative PCR and ELISA. Autophagy was assessed by immunofluorescence and immunoblotting. The functional effects of NETs in vitro were assessed in a primary fibroblast culture. Neutrophils from patients with active SLE exhibited increased basal autophagy levels leading to enhanced NET release, which was inhibited in vitro by hydroxychloroquine. NETosis in SLE neutrophils correlated with increased expression of the stress-response protein REDD1. Endothelin-1 (ET-1) and hypoxia-inducible factor-1α (HIF-1α) were key mediators of REDD1-driven NETs as demonstrated by their inhibition with bosentan and L-ascorbic acid, respectively. SLE NETs were decorated with tissue factor (TF) and interleukin-17A (IL-17A), which promoted thrombin generation and the fibrotic potential of cultured skin fibroblasts. Notably, TF-bearing and IL-17A-bearing NETs were abundant in discoid skin lesions and in the glomerular and tubulointerstitial compartment of proliferative nephritis biopsy specimens. Our data suggest the involvement of REDD1/autophagy/NET axis in end-organ injury and fibrosis in SLE, a likely candidate for repositioning of existing drugs for SLE therapy. Autophagy-mediated release of TF-bearing and IL-17A-bearing NETs provides a link between thromboinflammation and fibrosis in SLE and may account for the salutary effects of hydroxychloroquine.

Identifiants

pubmed: 30563869
pii: annrheumdis-2018-213181
doi: 10.1136/annrheumdis-2018-213181
pmc: PMC6352428
doi:

Substances chimiques

DDIT4 protein, human 0
IL17A protein, human 0
Interleukin-17 0
Transcription Factors 0
Thromboplastin 9035-58-9

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

238-248

Informations de copyright

© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Eleni Frangou (E)

Laboratory of Immune Regulation and Tolerance, Autoimmunity and Inflammation, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.
Department of Internal Medicine, Medical School, University of Cyprus, Nicosia, Cyprus.
Department of Nephrology and Transplantation, Nicosia General Hospital, Nicosia, Cyprus.

Akrivi Chrysanthopoulou (A)

Department of Internal Medicine, Laboratory of Molecular Hematology, Democritus University of Thrace, Alexandroupolis, Greece.

Alexandros Mitsios (A)

Department of Internal Medicine, Laboratory of Molecular Hematology, Democritus University of Thrace, Alexandroupolis, Greece.

Konstantinos Kambas (K)

Department of Internal Medicine, Laboratory of Molecular Hematology, Democritus University of Thrace, Alexandroupolis, Greece.

Stella Arelaki (S)

Department of Pathology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.

Iliana Angelidou (I)

Department of Internal Medicine, Laboratory of Molecular Hematology, Democritus University of Thrace, Alexandroupolis, Greece.

Athanasios Arampatzioglou (A)

Department of Internal Medicine, Laboratory of Molecular Hematology, Democritus University of Thrace, Alexandroupolis, Greece.

Hariklia Gakiopoulou (H)

1st Department of Pathology, National and Kapodistrian University of Athens Medical School, Athens, Greece.

George K Bertsias (GK)

Rheumatology, Clinical Immunology and Allergy, University of Crete School of Medicine, Heraklion, Greece.

Panayotis Verginis (P)

Laboratory of Immune Regulation and Tolerance, Autoimmunity and Inflammation, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.

Konstantinos Ritis (K)

Department of Internal Medicine, Laboratory of Molecular Hematology, Democritus University of Thrace, Alexandroupolis, Greece.
First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.

Dimitrios T Boumpas (DT)

Laboratory of Immune Regulation and Tolerance, Autoimmunity and Inflammation, Biomedical Research Foundation of the Academy of Athens, Athens, Greece boumpasd@uoc.gr.
Department of Internal Medicine, Medical School, University of Cyprus, Nicosia, Cyprus.
4th Department of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, Athens, Greece.

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