Abstract

In human lupus nephritis, tubulointerstitial inflammation (TII) is associated with in situ expansion of B cells expressing anti-vimentin antibodies (AVAs). The mechanism by which AVAs are selected is unclear. Herein, we demonstrate that AVA somatic hypermutation (SHM) and selection increase affinity for vimentin. Indeed, germline reversion of several antibodies demonstrated that higher affinity AVAs can be selected from both low affinity B cell germline clones and even those that are strongly reactive with other autoantigens. While we demonstrated affinity maturation, enzyme-linked immunosorbent assays (ELISAs) suggested that affinity maturation might be a consequence of increasing polyreactivity or even non-specific binding. Therefore, it was unclear if there was also selection for increased specificity. Subsequent multi-color confocal microscopy studies indicated that while TII AVAs often appeared polyreactive by ELISA, they bound selectively to vimentin fibrils in whole cells or inflamed renal tissue. Using a novel machine learning pipeline (CytoSkaler) to quantify the cellular distribution of antibody staining, we demonstrated that TII AVAs were selected for both enhanced binding and specificity in situ. Furthermore, reversion of single predicted amino acids in antibody variable regions indicated that we could use CytoSkaler to capture both negative and positive selection events. More broadly, our data suggest a new approach to assess and define antibody polyreactivity based on quantifying the distribution of binding to native and contextually relevant antigens.

Highlights

  • Nephritis is the most common severe manifestation of systemic lupus erythematosus (SLE)

  • In the LUNAR trial of Rituximab in lupus nephritis, high serum anti-vimentin antibodies (AVAs) at study entry predicted a poor outcome regardless of treatment arm [8]. These data suggest that AVAs are a feature of severe tubulointerstitial inflammation (TII) that predicts progressive lupus renal disease

  • When we used confocal microscopy and machine learning to quantify in situ binding, it was apparent that polyreactivity as measured by enzyme-linked immunosorbent assays (ELISAs), correlated with both increased binding and specificity for vimentin fibrils [18]. These results suggest that ELISA antibody reactivities do not predict in vivo binding specificity

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Summary

INTRODUCTION

Nephritis is the most common severe manifestation of systemic lupus erythematosus (SLE). In the LUNAR trial of Rituximab in lupus nephritis, high serum AVAs at study entry predicted a poor outcome regardless of treatment arm [8] These data suggest that AVAs are a feature of severe TII that predicts progressive lupus renal disease. Our studies suggest that in lupus nephritis, immune tolerance can be broken in situ to molecular patterns of inflammation and damage This is in contrast to typical lupus peripheral blood antibody specificities that target nucleotide-protein complexes [12]. In many cases, somatically hypermutated and selected autoantibodies, such as those that target dsDNA, are reactive to a broad range of antigens in vitro [16, 17] These studies suggest that in lupus, autoantibodies are selected for affinity but not necessarily for specificity. These results suggest that ELISA antibody reactivities do not predict in vivo binding specificity

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