Abstract
The strong association of anti-neutrophil cytoplasmic antibodies with various forms of systemic vasculitis suggests a role for these autoantibodies in the pathophysiology of systemic vasculitis. In the present study, we tested the hypothesis that release of neutrophil lysosomal enzymes in the presence of an anti-myeloperoxidase (anti-MPO) immune response may underlie the development of systemic vasculitis. Brown Norway rats were immunized with MPO in complete Freund's adjuvant or complete Freund's adjuvant alone. Two weeks after immunization, rats bad developed antibodies to human and rat MPO as measured by enzyme-linked immunosorbent assay. Next, rats were intravenously infused with 400 micrograms of a human neutrophil lysosomal extract containing 200 micrograms of MPO followed by 0.5 ml of a 1 mmol/L solution of H2O2 through a cannula inserted into the right jugular vein. Rats were sacrificed at 4 hours, 24 hours, 7 days, or 14 days, and several organs (lungs, heart, liver, spleen, gut, and kidneys) were examined for vasculitic lesions and inflammatory cell infiltrates. Macroscopically, patchy hemorrhagic spots were observed in the lungs and gut of MPO-immunized rats at days 7 and 14 after systemic infection of the neutrophil lysosomal extract and H2O2. Such changes were not observed at earlier time points or in control immunized rats. Histologically, the lungs of MPO-immunized rats sacrificed at days 7 and 14 showed patchy inflammatory cell infiltrates associated with vasculitis, granuloma formation, giant cells, and foci of hemorrhage. At 14 days, early signs of fibrosis were found with deposition of collagen and proliferation of fibroblasts. Furthermore, a prominent leukocytoclastic vasculitis was found in the small intestine of these rats characterized by fibrinoid necrosis and an extensive neutrophilic infiltrate. No inflammatory changes were found in the other organs studied (heart, liver, spleen, and kidneys). Control immunized rats, sacrificed at days 7 and 14 showed only some small foci of inflammatory infiltrates in the lungs whereas no inflammatory changes were found in the gastrointestinal tract. These studies show that release of products from activated neutrophils in the presence of anti-MPO autoantibodies may be relevant to the pathogenesis of anti-MPO-associated vasculitides.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ballieux B. E., Zondervan K. T., Kievit P., Hagen E. C., van Es L. A., van der Woude F. J., Daha M. R. Binding of proteinase 3 and myeloperoxidase to endothelial cells: ANCA-mediated endothelial damage through ADCC? Clin Exp Immunol. 1994 Jul;97(1):52–60. doi: 10.1111/j.1365-2249.1994.tb06579.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brooks C. J., King W. J., Radford D. J., Adu D., McGrath M., Savage C. O. IL-1 beta production by human polymorphonuclear leucocytes stimulated by anti-neutrophil cytoplasmic autoantibodies: relevance to systemic vasculitis. Clin Exp Immunol. 1996 Nov;106(2):273–279. doi: 10.1046/j.1365-2249.1996.d01-835.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brouwer E., Huitema M. G., Klok P. A., de Weerd H., Tervaert J. W., Weening J. J., Kallenberg C. G. Antimyeloperoxidase-associated proliferative glomerulonephritis: an animal model. J Exp Med. 1993 Apr 1;177(4):905–914. doi: 10.1084/jem.177.4.905. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brouwer E., Weening J. J., Klok P. A., Huitema M. G., Tervaert J. W., Kallenberg C. G. Induction of an humoral and cellular (auto) immune response to human and rat myeloperoxidase(MPO) in Brown-Norway(BN), Lewis and Wistar Kyoto(WKY) rat strains. Adv Exp Med Biol. 1993;336:139–142. doi: 10.1007/978-1-4757-9182-2_24. [DOI] [PubMed] [Google Scholar]
- Camilleri M., Pusey C. D., Chadwick V. S., Rees A. J. Gastrointestinal manifestations of systemic vasculitis. Q J Med. 1983 Spring;52(206):141–149. [PubMed] [Google Scholar]
- Casselman B. L., Kilgore K. S., Miller B. F., Warren J. S. Antibodies to neutrophil cytoplasmic antigens induce monocyte chemoattractant protein-1 secretion from human monocytes. J Lab Clin Med. 1995 Nov;126(5):495–502. [PubMed] [Google Scholar]
- Elson C. O., Sartor R. B., Tennyson G. S., Riddell R. H. Experimental models of inflammatory bowel disease. Gastroenterology. 1995 Oct;109(4):1344–1367. doi: 10.1016/0016-5085(95)90599-5. [DOI] [PubMed] [Google Scholar]
- Esnault V. L., Mathieson P. W., Thiru S., Oliveira D. B., Martin-Lockwood C. Autoantibodies to myeloperoxidase in brown Norway rats treated with mercuric chloride. Lab Invest. 1992 Jul;67(1):114–120. [PubMed] [Google Scholar]
- Ewert B. H., Jennette J. C., Falk R. J. Anti-myeloperoxidase antibodies stimulate neutrophils to damage human endothelial cells. Kidney Int. 1992 Feb;41(2):375–383. doi: 10.1038/ki.1992.52. [DOI] [PubMed] [Google Scholar]
- Falk R. J., Jennette J. C. Anti-neutrophil cytoplasmic autoantibodies with specificity for myeloperoxidase in patients with systemic vasculitis and idiopathic necrotizing and crescentic glomerulonephritis. N Engl J Med. 1988 Jun 23;318(25):1651–1657. doi: 10.1056/NEJM198806233182504. [DOI] [PubMed] [Google Scholar]
- Falk R. J., Terrell R. S., Charles L. A., Jennette J. C. Anti-neutrophil cytoplasmic autoantibodies induce neutrophils to degranulate and produce oxygen radicals in vitro. Proc Natl Acad Sci U S A. 1990 Jun;87(11):4115–4119. doi: 10.1073/pnas.87.11.4115. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Goldschmeding R., van der Schoot C. E., ten Bokkel Huinink D., Hack C. E., van den Ende M. E., Kallenberg C. G., von dem Borne A. E. Wegener's granulomatosis autoantibodies identify a novel diisopropylfluorophosphate-binding protein in the lysosomes of normal human neutrophils. J Clin Invest. 1989 Nov;84(5):1577–1587. doi: 10.1172/JCI114335. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Haworth S. J., Pusey C. D. Severe intestinal involvement in Wegener's granulomatosis. Gut. 1984 Nov;25(11):1296–1300. doi: 10.1136/gut.25.11.1296. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Heeringa P., Brouwer E., Klok P. A., Huitema M. G., van den Born J., Weening J. J., Kallenberg C. G. Autoantibodies to myeloperoxidase aggravate mild anti-glomerular-basement-membrane-mediated glomerular injury in the rat. Am J Pathol. 1996 Nov;149(5):1695–1706. [PMC free article] [PubMed] [Google Scholar]
- Hodgson H. J., Potter B. J., Skinner J., Jewell D. P. Immune-complex mediated colitis in rabbits. An experimental model. Gut. 1978 Mar;19(3):225–232. doi: 10.1136/gut.19.3.225. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hudson M., Piasecki C., Wakefield A. J., Sankey E. A., Dhillon A. P., Osborne M., Sim R., Pounder R. E. A vascular hypersensitivity model of acute multifocal gastrointestinal infarction. Dig Dis Sci. 1994 Mar;39(3):534–539. doi: 10.1007/BF02088338. [DOI] [PubMed] [Google Scholar]
- Hünig T., Wallny H. J., Hartley J. K., Lawetzky A., Tiefenthaler G. A monoclonal antibody to a constant determinant of the rat T cell antigen receptor that induces T cell activation. Differential reactivity with subsets of immature and mature T lymphocytes. J Exp Med. 1989 Jan 1;169(1):73–86. doi: 10.1084/jem.169.1.73. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kallenberg C. G., Brouwer E., Weening J. J., Tervaert J. W. Anti-neutrophil cytoplasmic antibodies: current diagnostic and pathophysiological potential. Kidney Int. 1994 Jul;46(1):1–15. doi: 10.1038/ki.1994.239. [DOI] [PubMed] [Google Scholar]
- Lüdemann J., Utecht B., Gross W. L. Anti-neutrophil cytoplasm antibodies in Wegener's granulomatosis recognize an elastinolytic enzyme. J Exp Med. 1990 Jan 1;171(1):357–362. doi: 10.1084/jem.171.1.357. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mathieson P. W., Thiru S., Oliveira D. B. Mercuric chloride-treated brown Norway rats develop widespread tissue injury including necrotizing vasculitis. Lab Invest. 1992 Jul;67(1):121–129. [PubMed] [Google Scholar]
- Mulder A. H., Heeringa P., Brouwer E., Limburg P. C., Kallenberg C. G. Activation of granulocytes by anti-neutrophil cytoplasmic antibodies (ANCA): a Fc gamma RII-dependent process. Clin Exp Immunol. 1994 Nov;98(2):270–278. doi: 10.1111/j.1365-2249.1994.tb06137.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Niles J. L., McCluskey R. T., Ahmad M. F., Arnaout M. A. Wegener's granulomatosis autoantigen is a novel neutrophil serine proteinase. Blood. 1989 Nov 1;74(6):1888–1893. [PubMed] [Google Scholar]
- Noble B., Milgrom M., Van Liew J. B., Brentjens J. R. Chronic serum sickness in the rat: influence of antigen dose, route of antigen administration and strain of rat on the development of disease. Clin Exp Immunol. 1981 Dec;46(3):499–507. [PMC free article] [PubMed] [Google Scholar]
- Porges A. J., Redecha P. B., Kimberly W. T., Csernok E., Gross W. L., Kimberly R. P. Anti-neutrophil cytoplasmic antibodies engage and activate human neutrophils via Fc gamma RIIa. J Immunol. 1994 Aug 1;153(3):1271–1280. [PubMed] [Google Scholar]
- Qasim F. J., Mathieson P. W., Sendo F., Thiru S., Oliveira D. B. Role of neutrophils in the pathogenesis of experimental vasculitis. Am J Pathol. 1996 Jul;149(1):81–89. [PMC free article] [PubMed] [Google Scholar]
- Savage C. O., Pottinger B. E., Gaskin G., Pusey C. D., Pearson J. D. Autoantibodies developing to myeloperoxidase and proteinase 3 in systemic vasculitis stimulate neutrophil cytotoxicity toward cultured endothelial cells. Am J Pathol. 1992 Aug;141(2):335–342. [PMC free article] [PubMed] [Google Scholar]
- Vargunam M., Adu D., Taylor C. M., Michael J., Richards N., Neuberger J., Thompson R. A. Endothelium myeloperoxidase-antimyeloperoxidase interaction in vasculitis. Nephrol Dial Transplant. 1992;7(11):1077–1081. [PubMed] [Google Scholar]