Numerous mechanisms of action have been proposed for intravenous Ig (IVIG). In this study, we used IgG passive transfer murine models of bullous pemphigoid (BP), pemphigus foliaceus (PF), and pemphigus vulgaris (PV) to test the hypothesis that the effect of IVIG in autoantibody-mediated cutaneous bullous diseases is to accelerate the degradation of pathogenic IgG by saturation of the MHC-like Fc receptor neonatal Fc receptor (FcRn). BP, PF, and PV are organ-specific antibody-mediated diseases in which autoantibodies target the hemidesmosomal antigen BP180 and desmosomal antigens Dsg1 and Dsg3, respectively. Antibodies against BP180, Dsg1, and Dsg3, when injected into neonatal mice, induce the BP, PF, and PV disease phenotypes, respectively. We found that FcRn-deficient mice were resistant to experimental BP, PF, and PV. Circulating levels of pathogenic IgG in FcRn-deficient mice were significantly reduced compared with those in WT mice. Administration of high-dose human IgG (HDIG) to WT mice also drastically reduced circulating pathogenic IgG levels and prevented blistering. In FcRn-deficient mice, no additional protective effect with HDIG was realized. These data demonstrate that the therapeutic efficacy of HDIG treatment in the pemphigus and pemphigoid models is dependent on FcRn. Thus, FcRn is a promising therapeutic target for treating such IgG-mediated autoimmune diseases.

译文

:已经提出了多种作用机制用于静脉注射Ig(IVIG)。在这项研究中,我们使用了大疱性天疱疮(BP),天疱疮天疱疮(PF)和寻常型天疱疮(PV)的IgG被动转移小鼠模型来检验IVIG在自身抗体介导的皮肤大疱性疾病中的作用是加速免疫球蛋白MHC样Fc受体新生Fc受体(FcRn)饱和引起的致病性IgG降解。 BP,PF和PV是器官特异性抗体介导的疾病,其中自身抗体分别靶向半桥粒抗原BP180和桥粒抗原Dsg1和Dsg3。当将抗BP180,Dsg1和Dsg3的抗体注射入新生小鼠后,它们分别诱导BP,PF和PV疾病表型。我们发现,FcRn缺陷型小鼠对实验性BP,PF和PV具有抗性。与WT小鼠相比,FcRn缺陷型小鼠的致病性IgG循环水平显着降低。向野生型小鼠施用大剂量人IgG(HDIG)还可以大大降低循环中的致病性IgG水平并防止起泡。在FcRn缺陷型小鼠中,没有实现HDIG的其他保护作用。这些数据证明,HDIG在天疱疮和天疱疮模型中的治疗功效取决于FcRn。因此,FcRn是用于治疗这种IgG介导的自身免疫疾病的有希望的治疗靶标。

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