Recombinant thrombomodulin ameliorates autoimmune vasculitis via immune response regulation and tissue injury protection.

Abstract:

:Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is characterized by necrotizing vasculitis with the presence of pathogenic ANCA. ANCA can potentially cause neutrophil activation and induce neutrophil extracellular traps (NETs), resulting in endothelial damage as well as activation of autoreactive B cells and alternative complement pathway. Recombinant thrombomodulin (rTM) protects the endothelium from vascular injury during disseminated intravascular coagulation, thus we hypothesized that rTM ameliorates necrotizing vasculitis in AAV. In this study, rTM was administered in an experimental AAV rat model. Treatment of experimental AAV rats with rTM improved pulmonary hemorrhage and glomerulonephritis, with a suppression of ANCA production and NETs formation. In addition, in vitro experiments showed that rTM bound to neutrophils via Mac-1 (macrophage-1 antigen) and inhibited ANCA-induced NETs formation accompanied by a suppression of histone citrullination, leading to a protection of the endothelium from NETs toxicity. Additionally, rTM affected lymphocytes leading to the inhibition of pro-inflammatory cytokine/chemokin in PBMC during the antibody production process, which might indirectly be involved in the reduction of pathogenic ANCA. Our data revealed that the rTM could ameliorate autoimmune vasculitis through a combination of different biological mechanisms.

journal_name

J Autoimmun

journal_title

Journal of autoimmunity

authors

Watanabe-Kusunoki K,Nakazawa D,Kusunoki Y,Kudo T,Hattanda F,Nishio S,Masuda S,Tomaru U,Kondo T,Atsumi T,Ishizu A

doi

10.1016/j.jaut.2019.102390

subject

Has Abstract

pub_date

2020-03-01 00:00:00

pages

102390

eissn

0896-8411

issn

1095-9157

pii

S0896-8411(19)30746-2

journal_volume

108

pub_type

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