Two rheumatoid arthritis-specific autoantigens correlate microbial immunity with autoimmune responses in joints

J Clin Invest. 2017 Aug 1;127(8):2946-2956. doi: 10.1172/JCI93450. Epub 2017 Jun 26.

Abstract

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.

MeSH terms

  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / immunology*
  • Autoantigens / immunology*
  • Autoimmunity / immunology*
  • Enzyme-Linked Immunosorbent Assay
  • Epitopes / immunology
  • Filamins / immunology
  • Gastrointestinal Microbiome*
  • HLA-DR Antigens / immunology
  • Humans
  • Immunoglobulin A / immunology
  • Immunoglobulin G / immunology
  • Joints / immunology*
  • Joints / pathology
  • Leukocytes, Mononuclear / cytology
  • Leukocytes, Mononuclear / immunology*
  • Leukocytes, Mononuclear / metabolism
  • Sulfatases / immunology
  • Synovial Membrane / metabolism

Substances

  • Antirheumatic Agents
  • Autoantigens
  • Epitopes
  • Filamins
  • HLA-DR Antigens
  • Immunoglobulin A
  • Immunoglobulin G
  • Sulfatases
  • N-acetylglucosamine-6-sulfatase