The pathogenesis of systemic lupus erythematosus (SLE) is caused by a complex mix of genetic factors that lead to dysregulation of the immune response. Mild susceptibility or resistance factors can tilt the scale towards or against pathology. Here, we present evidence for the Irf8 gene as a lupus protective factor in conditions of haploinsufficiency or mosaicism. We targeted Irf8 expression in mice deficient in Fcgr2b, a well characterized mouse model of SLE. As is the case in human SLE, hyperresponsive B cells and dendritic cells (DCs) are causal factors at various stages of disease in Fcgr2b-deficient mice (R2-/-). Since Irf8 is essential for the generation of cDC1s, we used conditional deletion with various known DC-targeting Cre systems to delete Irf8. All conditional systems tested to delete Irf8 reduced the titer of antinuclear antibodies and abrogated kidney pathology in R2-/- mice. In addition to the expected effect of Irf8 deletion in cDC1s, we unexpectedly found that mosaic deletion of Irf8 also occurred in B cells and other immune cells. Using mixed bone marrow chimeras we determined that the aborted disease in Irf8f/fCD11c-Cre+R2-/- and Irf8f/fItgax-Cre+R2-/- mice could be attributed to the inability of B cells with partial reduction of IRF8 to produce autoantibodies. Therefore, these results reveal IRF8 as a susceptibility factor of SLE even in cases of mild changes of expression levels and mosaic somatic deletion of the gene in B cells.

Autoantibodies (AAbs) contribute to various immune-mediated diseases and are valuable biomarkers for diagnosis, classification, and disease activity. Here, we present a protocol for the affinity enrichment of AAbs from human plasma samples. We describe steps to generate a human cell line lysate, which is immobilized on Sepharose beads for affinity enrichment of AAbs. We then detail the quality-control procedure of verifying autoreactivity of AAb fractions. This protocol has potential application in functional and proteomic analyses of AAbs. For complete details on the use and execution of this protocol, please refer to Hagadorn et al.1.

Renal injury often occurs as a complication in autoimmune diseases such as systemic lupus erythematosus (SLE). It is estimated that a minimum of 20% SLE patients develop lupus nephritis, a condition that can be fatal when the pathology progresses to end-stage renal disease. Studies in animal models showed that incidence of immune cell infiltrates in the kidney was linked to pathological injury and correlated with severe lupus nephritis. Thus, preventing immune cell infiltration into the kidney is a potential approach to impede the progression to an end-stage disease. A requirement to investigate the role of kidney-infiltrating leukocytes is the development of reproducible and efficient protocols for purification and characterization of immune cells in kidney samples. This chapter describes a detailed methodology that discriminates tissue-resident leukocytes from blood-circulating cells that are found in kidney. Our protocol was designed to maximize cell viability and to reduce variability among samples, with a combination of intravascular staining and magnetic bead separation for leukocyte enrichment. Experiments included as example were performed with FcγRIIb[KO] mice, a well-characterized murine model of SLE. We identified T cells and macrophages as the primary leukocyte subsets infiltrating into the kidney during severe nephritis, and we extensively characterized them phenotypically by flow cytometry.

Many infections, including malaria, are associated with an increase in autoantibodies (AAbs). Prior studies have reported an association between genetic markers of susceptibility to autoimmune disease and resistance to malaria, but the underlying mechanisms are unclear. Here, we performed a longitudinal study of children and adults (n = 602) in Mali and found that high levels of plasma AAbs before the malaria season independently predicted a reduced risk of clinical malaria in children during the ensuing malaria season. Baseline AAb seroprevalence increased with age and asymptomatic Plasmodium falciparum infection. We found that AAbs purified from the plasma of protected individuals inhibit the growth of blood-stage parasites and bind P. falciparum proteins that mediate parasite invasion. Protected individuals had higher plasma immunoglobulin G (IgG) reactivity against 33 of the 123 antigens assessed in an autoantigen microarray. This study provides evidence in support of the hypothesis that a propensity toward autoimmunity offers a survival advantage against malaria.

Activated B cells experience metabolic changes that require mitochondrial remodeling, in a process incompletely defined. In this study, we report that mitochondrial antiviral signaling protein (MAVS) is involved in BCR-initiated cellular proliferation and prolonged survival. MAVS is well known as a mitochondrial-tethered signaling adaptor with a central role in viral RNA-sensing pathways that induce type I IFN. The role of MAVS downstream of BCR stimulation was recognized in absence of IFN, indicative of a path for MAVS activation that is independent of viral infection. Mitochondria of BCR-activated MAVS-deficient mouse B cells exhibited a damaged phenotype including disrupted mitochondrial morphology, excess mitophagy, and the temporal progressive blunting of mitochondrial oxidative capacity with mitochondrial hyperpolarization and cell death. Costimulation of MAVS-deficient B cells with anti-CD40, in addition to BCR stimulation, partially corrected the mitochondrial structural defects and functionality. Our data reveal a (to our knowledge) previously unrecognized role of MAVS in controlling the metabolic fitness of B cells, most noticeable in the absence of costimulatory help.

The host response against infection with Plasmodium commonly raises self-reactivity as a side effect, and antibody deposition in kidney has been cited as a possible cause of kidney injury during severe malaria. In contrast, animal models show that infection with the parasite confers long-term protection from lethal lupus nephritis initiated by autoantibody deposition in kidney. We have limited knowledge of the factors that make parasite infection more likely to induce kidney damage in humans, or the mechanisms underlying protection from autoimmune nephritis in animal models. Our experiments with the autoimmune-prone FcγR2B[KO] mice have shown that a prior infection with P. yoelii 17XNL protects from end-stage nephritis for a year, even when overall autoreactivity and systemic inflammation are maintained at high levels. In this report we evaluate post-infection alterations, such as hemozoin accumulation and compensatory changes in immune cells, and their potential role in the kidney-specific protective effect by Plasmodium. We ruled out the role of pigment accumulation with the use of a hemozoin-restricted P. berghei ANKA parasite, which induced a self-resolved infection that protected from autoimmune nephritis with the same mechanism as parasitic infections that accumulated normal levels of hemozoin. In contrast, adoptive transfer experiments revealed that bone marrow cells were altered by the infection and could transmit the kidney protective effect to a new host. While changes in the frequency of bone marrow cell populations after infection were variable and unique to a particular parasite strain, we detected a sustained bias in cytokine/chemokine expression that suggested lower fibrotic potential and higher Th1 bias likely affecting multiple cell populations. Sustained changes in bone marrow cell activation profile could have repercussions in immune responses long after the infection was cleared.

A protective role of malaria infection in SLE was proposed to explain the relatively low prevalence of SLE in West Africa compared to populations of similar genetic background living in the West. Various reports showed an increase of autoantibodies in plasma of West African populations, suggesting that parasite infections were inducing systemic autoreactivity while protecting from tissue pathology. Our own studies from a large longitudinal study in a malaria endemic region confirm the high penetrance of elevated titers of anti-nuclear antibodies in plasma of Plasmodium PCR-positive individuals. In mouse models of malaria, murine Plasmodium infection increases systemic autoreactivity but does not trigger any type of immune-complex induced inflammatory disease. To further investigate the mechanism of kidney protection by Plasmodium, we set up experiments using a malaria parasite in the well characterized SLE mouse model FcγRIIb[KO]. This model system allowed for evaluation of the effect of malaria on autoantibodies, systemic vasculitis and kidney specific pathology, while also assessing the role of parasite-mediated bone marrow alterations, or parasite-produced hemozoin. We found that infection with Plasmodium protects SLE by modifying bone marrow cells and impairing leukocyte infiltration in the kidney, without altering systemic autoimmunity, vasculitis, all independent of the expression of hemozoin. Our results point to a protection of late-stage kidney disease by malaria that targets a step beyond immune complex deposition, hypoxia or innate responses and release of cytokines (IFN, TNF, IL1).

Lupus nephritis is a severe organ manifestation in systemic lupus erythematosus leading to kidney failure in a subset of patients. In lupus-prone mice, controlled infection with Plasmodium parasites protects against the progression of autoimmune pathology including lethal glomerulonephritis. Here, we demonstrate that parasite-induced protection was not due to a systemic effect of infection on autoimmunity as previously assumed, but rather to specific alterations in immune cell infiltrates into kidneys and renal draining lymph nodes. Infection of lupus-prone mice with a Plasmodium parasite did not reduce the levels or specificities of autoreactive antibodies, vasculitis, immune complex-induced innate activation, or hypoxia. Instead, infection uniquely reduced kidney-infiltrating CCL17-producing bone marrow-derived type 2 inflammatory dendritic cells (iDC2s). Bone marrow reconstitution experiments revealed that infection with Plasmodium caused alterations in bone marrow cells that hindered the ability of DC2s to infiltrate the kidneys. The essential role for CCL17 in lupus nephritis was confirmed by in vivo depletion with a blocking antibody, which reduced kidney pathology and immune infiltrates, while bypassing the need for parasitic infection. Therefore, infiltration into the kidneys of iDC2s, with the potential to prime local adaptive responses, is an essential regulated event in the transition from manageable glomerulonephritis to lethal tubular injury.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the presence of autoantibodies in serum and multi-organ inflammation. Immune complex deposition in kidney can lead to lupus nephritis, which is a major risk factor for morbidity and mortality in SLE. Using FcγRIIB−/− mice as a lupus animal model, we performed a detailed time course analysis of the extent of the spontaneous leukocyte activation and expansion in spleen and in renal, inguinal, mesenteric lymph nodes. We then correlated the data with the onset of pathology and leukocyte infiltration in the kidney. In the FcγRIIB−/− mouse model, effector-memory CD4 cells and germinal centers appeared first in the spleen and renal lymph nodes, but not in other immune organs such as inguinal or mesenteric lymph nodes. As the disease progresses in these mice, lymphocytes undergo an extensive expansion that involves all immune organs in a systemic manner. At the same moment we can detect the first signs of kidney pathology, measured by histopathology and by the levels of creatinine and albumin in urine. In FcγRIIB−/− mice, the onset of kidney pathology correlates with leukocyte infiltration in kidney, detected both by parenchyma-restricted flow cytometry and histopathology. Macrophages, CD4 and CD8 cells are found both in glomerular and interstitial spaces with the exclusion of B cells, most likely suggesting a role for T cells and/or macrophage specific chemokine signals in lupus nephritic kidney.

Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by increased production of autoantibodies, which commonly target nuclear antigens, and concomitant deposition of immune complexes that cause inflammation in tissues. SLE is often associated with increased systemic expression of type I interferons, in some cases due to dysregulation in nucleic acid-sensing innate pathways. There is strong genetic evidence for a link between cytoplasmic RNA sensing pathways (RIG-I/MDA5) and SLE, both in human patients and murine models, however questions still remain regarding pathway initiation, cell types involved and downstream effects. Here we show that MAVS, an essential adaptor for RIG-I/MDA5 signaling, is necessary for all symptoms of autoimmune disease that develop spontaneously in the lupus model FcγRIIB-/- mice. This effect was independent of type I interferon signaling, TLR7 expression or STING, all three factors that have been connected to autoimmunity. Mixed bone marrow reconstitution experiments showed reduced occurrence in autoimmune germinal centers and diminished autoantibody production by MAVS-deficient B cells. Thus, MAVS plays a B cell intrinsic role in autoreactive B cell activation that is independent of its anti-viral functions and independent of elevated type I interferon expression.

Pathogenic infections are important environmental modifiers of autoimmune disease as they can alter the immune system in a way that either promotes or reduces autoimmune responses. We tested the effect of infection with vesicular stomatitis virus (VSV) on the FcγR2B−/− (R2) mouse strain that spontaneously develops lupus disease. Infecting FcγR2B−/− mice with live VSV reduces autoantibody levels and inflammatory pathology and prolongs survival. We showed that VSV-mediated protection can be transferred in a CD8 cell adoptive transfer experiment. After further testing the transfer of various CD8 T cell subsets, we have identified CD8+CD122+NKG2D+ cells as mediator in VSV-induced Lupus amelioration. RNA Sequencing data for gene expression profiles among various CD8 subsets, indicate that the protective cells express higher level of genes linked to memory phenotype. Our working hypothesis is that the viral infection may induce the expansion of long lived CD8 populations that regulate the antibody response. In support of the idea we initiated to identify the target of the VSV-primed CD8 T cells in vivo. We examined the effect of VSV-primed CD8 T cells on the immune phenotypes of recipient R2 mice at the initial stages, e.g. after 1, 2 or 3 weeks of transfer. Interestingly, we found that Tfh and germinal center B cells are significantly reduced after three weeks of VSV-CD8 transfer. Thus, the protective CD8 T cells from VSV-infected mice might target autoreactive germinal center to regulate the antibody response. How VSV-CD8 T cells might control germinal center & why it takes about 3 weeks for controlling is under investigation.

Infections can alter the prevalence of autoimmune diseases such as SLE. Epidemiological studies have showed a relative absence SLE in West Africa (areas of endemic malaria), even though SLE is highly prevalent in populations of African descent living outside of Africa. We hypothesize that malaria infections might reduce the incidence of autoimmune lupus. In the present work, we assess the effect of the non-lethal Plasmodium yoelii 17XNL in a well-characterized animal model of SLE (FcγRIIB−/−). Mice deficient in the inhibitory Fc receptor for IgG (FcγRIIB) develop spontaneous disease driven by the production of anti-nuclear autoantibodies, a broad immune activation, splenomegaly, anemia and lethal glomerulonephritis with a pathology similar to human SLE. We infected FcγRIIB−/− mice at 2 months of age with P.yoelii and followed the progression of autoimmune disease for 5 months. Infection with P. yoelii increased the titer of a broad range of autoantibodies, with concomitant immune-complex deposition and complement fixation in the kidney. While lupus-prone mice succumbed from renal disease detected by protein in urine and serum urea nitrogen, malaria-infected lupus-prone mice did not develop proteinuria or lethal disease. Infection with the parasite did not alter tolerance mechanisms leading to lupus but instead prevented end-point tissue pathology. P. yoelii infection seems to inhibit pathogenic leukocyte infiltration without affecting the autoimmune inflammation of glomeruli. These results indicate a possible route for lupus protection that specifically targets renal function, which remains a cause of the substantial morbidity and mortality in SLE patients.

Pathogenic infections are important environmental modifiers of autoimmune disease as they can alter the immune system in a way that either promotes or reduces autoimmune responses. We tested the effect of infection with vesicular stomatitis virus (VSV) on the FcγR2B−/− (R2) mouse strain that spontaneously develops lupus disease. Infecting FcγR2B−/− mice with live VSV reduces autoantibody levels and inflammatory pathology, and prolongs survival. We showed that VSV-mediated protection can be transferred in a CD8 cell adoptive transfer experiment. Legend screening for surface markers on CD8 T cells indicated that CD8 T cells from VSV infected mice express high level of markers linked to exhausted and regulatory phenotypes. After testing the transfer of various CD8 T cell subsets, we have identified CD8+CD122+NKG2D+ cells as mediator in VSV-induced Lupus amelioration. Preliminary analysis of RNA Sequencing data for gene expression profiles among various CD8 subsets, indicate that the protective cells express higher level of genes linked to memory phenotype. Our working hypothesis is that the viral infection may induce the expansion of long lived CD8 populations that regulate the humoral response.

There is evidence that autoimmune disease might be induced by deficient regulation of innate immune pathways that normally induce type I interferon in response to pathogen-derived nucleic acids. To investigate a potential role for nucleic acid sensing pathways with cytosolic localization and more ubiquitous expression, we tested the requirement for MAVS (dsRNA-sensing) or STING (dsDNA-sensing) in the lupus autoimmune disease developed by FcγRIIB-KO (R2−/−) mice. These experiments revealed that STING was mildly protective, while MAVS was an essential factor for autoimmune disease in R2−/− mice. We found that MAVS deficiency, but not type I IFN receptor deficiency, completely eliminated autoantibodies and autoimmune pathology in R2−/− mice. MAVS deficiency also eliminated spontaneous activation of B and T cells, germinal center formation and follicular helper T cell development. Using mixed bone marrow reconstitution experiments, we determined that MAVS was required for autoreactivity in a B cell intrinsic manner, with a profound effect on B cell survival in the germinal center. MAVS deficiency did not alter BCR-proximal signaling, but resulted in diminished long term proliferative capacity of B cells, with lower cyclin D2 and Bcl-xL expression 24 hours after anti-IgM stimulation. MAVS deficiency also resulted in B cell developmental defects, fewer total B cells but a skewing toward marginal zone and against the follicular B cell program. Overall MAVS seems to provide its costimulatory effect independent of type I IFN, by enhancing the activation of NFκB in situations where T cell help or other modes of costimulation are not present and most importantly, by providing survival stimulus for autoreactive B cells.

FcγRIIB-deficient mice represent a well-characterized animal model of systemic lupus erythematosus. They develop spontaneous anti-nuclear antibodies (ANA) and fatal glomerulonephritis when on the C57BL/6 (B6) background while the same mutation on the BALB/c background is phenotypically benign, indicating differences in lupus susceptibility between the BALB/c and B6 strains. We mapped the BALB/c derived protection to a 151KB genomic fragment on chromosome 12. Insertion of this fragment in transgenic form (A12Tg) results in protection from lupus disease. Mixed bone marrow reconstitution experiments pointed to a T cell intrinsic effect of the protective gene in the BALB/c A12 interval. This region contains a single gene, Rrm1, which encodes for a subunit of the ribonucleotide reductase responsible for the synthesis of deoxiribonucleotides. We hypothesize that reduced levels of this enzyme affect the ability of T cell to expand upon activation and that is why allelic differences in Rrm2 expression can alter tolerance in mouse models of lupus.

Several mouse models of SLE, including FcgRIIB-KO and TLR7tg mice, develop an expansion of an atypical NK cell subset with functional similarity to cells referred as IKDCs or pre-mNKs in other systems and identified as NK1.1+CD11c+CD122+MHC-II+. These cells belong to the NK cell lineage because they depend on IL15 and express E4BP4. Functionally they are cytotoxic, produce type I and type II interferons upon activation and they are efficient antigen presenting cells both through MHC-II expression and in cross-presentation to CD8s. These atypical NK cells are responsive to TLR stimulation and thus are most abundant in mice with high copy number of the Tlr7 gene. They are highly proliferative as assessed by in vivo BrdU incorporation. Transferring 4 million atypical NKs purified from spleens of SLE-prone mice into WT induces a 2-week-long wave of inflammatory cytokines in the serum, a sustained increase in T cell activation and follicular helper cells for the following months, and a progressive expansion of dendritic cells, monocytes and granulocytes. Furthermore IL15 deficiency, which impedes development of NK cells, ameliorates the autoimmune pathology of TLR7tg mice. These results suggest that cells of the NK lineage can develop into cytokine producing/antigen-presenting cells that affect the priming and progression of systemic autoimmune disease.

Several mouse models of systemic lupus erythematosus, including FcγRIIB-KO and TLR7tg mice, develop an expansion of an atypical NK cell subset with functional similarity to cells referred as IFN-producing killer DCs or pre-mature NKs in other systems. In this study, we show that atypical NKs purified from spleens of systemic lupus erythematosus-prone mice, and identified as NK1.1(+)CD11c(+)CD122(+)MHC-II(+), induce persistent autoimmune disease in an IFN-I- and CD40L-dependent manner when transferred to wild-type mice. A single transfer of 4 × 10(6) NK1.1(+) cells from TLR7tg into wild-type induces a 2-wk-long wave of inflammatory cytokines in the serum; a sustained increase in T cell activation and follicular helper cells for the following months; and a progressive expansion of dendritic cells, monocytes, and granulocytes. Furthermore, IL-15 deficiency, which impedes development of NK cells, ameliorates the autoimmune pathology of TLR7tg mice. These results suggest that cells of the NK lineage can develop into cytokine-producing/APCs that affect the priming and progression of systemic autoimmune disease.

FcγRIIB knock-out mice in B6 background develop a lupus like autoimmune disease. With the addition of the yaa (Y-chromosome autoimmune accelerator) gene, pathogenecity in these male mice is significantly enhanced and autoantibodies switch from nuclear to nucleolar specificity. High titer of λ-light chains immunoglobulin, and anti-RNA antibodies were found in R2-/-yaa serum. Also, R2-/-yaa serum selectively bound 5 major nuclear proteins compared to R2-/- serum. To characterize the autoantibodies produced by R2-/-yaa mice and the nucleolar antigens that react with these antibodies, we have produced hybridomas. Hybridoma H526 produced anti-nucleolar IgG2c-λ antibodies. The antibody binds RNA, a synthetic polyribonucleotide poly (GC)20 and a RNA-associated nucleolar protein, nucleolin. R2-/-yaa serum also found to cross-react with poly (GC)20, nucleolin and also with poly ADP-ribose (PAR). Simultaneous presence of nucleolin and PAR autoantibodies has been found to be associated with lupus. Further characterization of nucleolin modification and lupus development is in progress.