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Autoantibodies Against the Complement Regulator Factor H in the Serum of Patients With Neuromyelitis Optica Spectrum Disorder

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disease of the central nervous system (CNS), characterized by pathogenic, complement-activating autoantibodies against the main water channel in the CNS, aquaporin 4 (AQP4). NMOSD is frequently associated with additional au...

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Autores principales: Uzonyi, Barbara, Szabó, Zsóka, Trojnár, Eszter, Hyvärinen, Satu, Uray, Katalin, Nielsen, Helle H., Erdei, Anna, Jokiranta, T. Sakari, Prohászka, Zoltán, Illes, Zsolt, Józsi, Mihály
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111293/
https://www.ncbi.nlm.nih.gov/pubmed/33986750
http://dx.doi.org/10.3389/fimmu.2021.660382
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author Uzonyi, Barbara
Szabó, Zsóka
Trojnár, Eszter
Hyvärinen, Satu
Uray, Katalin
Nielsen, Helle H.
Erdei, Anna
Jokiranta, T. Sakari
Prohászka, Zoltán
Illes, Zsolt
Józsi, Mihály
author_facet Uzonyi, Barbara
Szabó, Zsóka
Trojnár, Eszter
Hyvärinen, Satu
Uray, Katalin
Nielsen, Helle H.
Erdei, Anna
Jokiranta, T. Sakari
Prohászka, Zoltán
Illes, Zsolt
Józsi, Mihály
author_sort Uzonyi, Barbara
collection PubMed
description Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disease of the central nervous system (CNS), characterized by pathogenic, complement-activating autoantibodies against the main water channel in the CNS, aquaporin 4 (AQP4). NMOSD is frequently associated with additional autoantibodies and antibody-mediated diseases. Because the alternative pathway amplifies complement activation, our aim was to evaluate the presence of autoantibodies against the alternative pathway C3 convertase, its components C3b and factor B, and the complement regulator factor H (FH) in NMOSD. Four out of 45 AQP4-seropositive NMOSD patients (~9%) had FH autoantibodies in serum and none had antibodies to C3b, factor B and C3bBb. The FH autoantibody titers were low in three and high in one of the patients, and the avidity indexes were low. FH-IgG complexes were detected in the purified IgG fractions by Western blot. The autoantibodies bound to FH domains 19-20, and also recognized the homologous FH-related protein 1 (FHR-1), similar to FH autoantibodies associated with atypical hemolytic uremic syndrome (aHUS). However, in contrast to the majority of autoantibody-positive aHUS patients, these four NMOSD patients did not lack FHR-1. Analysis of autoantibody binding to FH19-20 mutants and linear synthetic peptides of the C-terminal FH and FHR-1 domains, as well as reduced FH, revealed differences in the exact binding sites of the autoantibodies. Importantly, all four autoantibodies inhibited C3b binding to FH. In conclusion, our results demonstrate that FH autoantibodies are not uncommon in NMOSD and suggest that generation of antibodies against complement regulating factors among other autoantibodies may contribute to the complement-mediated damage in NMOSD.
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spelling pubmed-81112932021-05-12 Autoantibodies Against the Complement Regulator Factor H in the Serum of Patients With Neuromyelitis Optica Spectrum Disorder Uzonyi, Barbara Szabó, Zsóka Trojnár, Eszter Hyvärinen, Satu Uray, Katalin Nielsen, Helle H. Erdei, Anna Jokiranta, T. Sakari Prohászka, Zoltán Illes, Zsolt Józsi, Mihály Front Immunol Immunology Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disease of the central nervous system (CNS), characterized by pathogenic, complement-activating autoantibodies against the main water channel in the CNS, aquaporin 4 (AQP4). NMOSD is frequently associated with additional autoantibodies and antibody-mediated diseases. Because the alternative pathway amplifies complement activation, our aim was to evaluate the presence of autoantibodies against the alternative pathway C3 convertase, its components C3b and factor B, and the complement regulator factor H (FH) in NMOSD. Four out of 45 AQP4-seropositive NMOSD patients (~9%) had FH autoantibodies in serum and none had antibodies to C3b, factor B and C3bBb. The FH autoantibody titers were low in three and high in one of the patients, and the avidity indexes were low. FH-IgG complexes were detected in the purified IgG fractions by Western blot. The autoantibodies bound to FH domains 19-20, and also recognized the homologous FH-related protein 1 (FHR-1), similar to FH autoantibodies associated with atypical hemolytic uremic syndrome (aHUS). However, in contrast to the majority of autoantibody-positive aHUS patients, these four NMOSD patients did not lack FHR-1. Analysis of autoantibody binding to FH19-20 mutants and linear synthetic peptides of the C-terminal FH and FHR-1 domains, as well as reduced FH, revealed differences in the exact binding sites of the autoantibodies. Importantly, all four autoantibodies inhibited C3b binding to FH. In conclusion, our results demonstrate that FH autoantibodies are not uncommon in NMOSD and suggest that generation of antibodies against complement regulating factors among other autoantibodies may contribute to the complement-mediated damage in NMOSD. Frontiers Media S.A. 2021-04-27 /pmc/articles/PMC8111293/ /pubmed/33986750 http://dx.doi.org/10.3389/fimmu.2021.660382 Text en Copyright © 2021 Uzonyi, Szabó, Trojnár, Hyvärinen, Uray, Nielsen, Erdei, Jokiranta, Prohászka, Illes and Józsi https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Uzonyi, Barbara
Szabó, Zsóka
Trojnár, Eszter
Hyvärinen, Satu
Uray, Katalin
Nielsen, Helle H.
Erdei, Anna
Jokiranta, T. Sakari
Prohászka, Zoltán
Illes, Zsolt
Józsi, Mihály
Autoantibodies Against the Complement Regulator Factor H in the Serum of Patients With Neuromyelitis Optica Spectrum Disorder
title Autoantibodies Against the Complement Regulator Factor H in the Serum of Patients With Neuromyelitis Optica Spectrum Disorder
title_full Autoantibodies Against the Complement Regulator Factor H in the Serum of Patients With Neuromyelitis Optica Spectrum Disorder
title_fullStr Autoantibodies Against the Complement Regulator Factor H in the Serum of Patients With Neuromyelitis Optica Spectrum Disorder
title_full_unstemmed Autoantibodies Against the Complement Regulator Factor H in the Serum of Patients With Neuromyelitis Optica Spectrum Disorder
title_short Autoantibodies Against the Complement Regulator Factor H in the Serum of Patients With Neuromyelitis Optica Spectrum Disorder
title_sort autoantibodies against the complement regulator factor h in the serum of patients with neuromyelitis optica spectrum disorder
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111293/
https://www.ncbi.nlm.nih.gov/pubmed/33986750
http://dx.doi.org/10.3389/fimmu.2021.660382
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