In rheumatoid arthritis (RA), immunological triggers at mucosal sites, such as the gut microbiota, may promote autoimmunity that affects joints. Here, we used discovery-based proteomics to detect HLA-DR-presented peptides in synovia or peripheral blood mononuclear cells and identified 2 autoantigens, N-acetylglucosamine-6-sulfatase (GNS) and filamin A (FLNA), as targets of T and B cell responses in 52% and 56% of RA patients, respectively. Both GNS and FLNA were highly expressed in synovia. GNS appeared to be citrullinated, and GNS antibody values correlated with anti-citrullinated protein antibody (ACPA) levels. FLNA did not show the same results. The HLA-DR-presented GNS peptide has marked sequence homology with epitopes from sulfatase proteins of the Prevotella sp. and Parabacteroides sp., whereas the HLA-DR-presented FLNA peptide has homology with epitopes from proteins of the Prevotella sp. and Butyricimonas sp., another gut commensal. Patients with T cell reactivity with each self-peptide also had responses to the corresponding microbial peptides, and the levels were directly correlated. Furthermore, HLA-DR molecules encoded by shared-epitope (SE) alleles were predicted to bind these self- and microbial peptides strongly, and these responses were more common in RA patients with SE alleles. Thus, sequence homology between T cell epitopes of 2 self-proteins and a related order of gut microbes may provide a link between mucosal and joint immunity in patients with RA.

译文

在类风湿关节炎(RA)中,粘膜部位(如肠道菌群)的免疫触发可能会促进影响关节的自身免疫。在这里,我们使用基于发现的蛋白质组学来检测滑膜或外周血单核细胞中HLA-DR呈递的肽,并鉴定了2种自身抗原N-乙酰氨基葡萄糖-6-硫酸酯酶(GNS)和纤维蛋白A(FLNA)作为T和T的靶标B细胞反应分别在52%和56%的RA患者中发生。 GNS和FLNA在滑膜中均高表达。 GNS似乎是瓜氨酸化的,并且GNS抗体值与抗瓜氨酸化的蛋白抗体(ACPA)的水平相关。 FLNA没有显示相同的结果。 HLA-DR呈递的GNS肽与Prevotella sp的硫酸酯酶蛋白的表位具有明显的序列同源性。 HLA-DR呈递的FLNA肽与Prevotella sp。蛋白的表位具有同源性。和Butyricimonas sp。,另一个肠胃奖。与每种自身肽具有T细胞反应性的患者也对相应的微生物肽有反应,并且其水平直接相关。此外,预计由共享表位(SE)等位基因编码的HLA-DR分子会强烈结合这些自身和微生物肽,这些反应在SE等位基因的RA患者中更为常见。因此,两种自身蛋白的T细胞表位与肠道微生物相关顺序之间的序列同源性可能为RA患者的粘膜免疫和关节免疫之间提供了联系。

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