Secretory IgA mediates retrotranscytosis of intact gliadin peptides via the transferrin receptor in celiac disease

Celiac disease (CD) is an enteropathy resulting from an abnormal immune response to gluten-derived peptides in genetically susceptible individuals. This immune response is initiated by intestinal transport of intact peptide 31-49 (p31-49) and 33-mer gliadin peptides through an unknown mechanism. We show that the transferrin receptor CD71 is responsible for apical to basal retrotranscytosis of gliadin peptides, a process during which p31-49 and 33-mer peptides are protected from degradation. In patients with active CD, CD71 is overexpressed in the intestinal epithelium and colocalizes with immunoglobulin (Ig) A. Intestinal transport of intact p31-49 and 33-mer peptides was blocked by polymeric and secretory IgA (SIgA) and by soluble CD71 receptors, pointing to a role of SIgA–gliadin complexes in this abnormal intestinal transport. This retrotranscytosis of SIgA–gliadin complexes may promote the entry of harmful gliadin peptides into the intestinal mucosa, thereby triggering an immune response and perpetuating intestinal inflammation. Our findings strongly implicate CD71 in the pathogenesis of CD

Mecanismos de permeabilidade glomerular no modelo de inibição cronica do oxido nitrico

Orientador: Roberto ZatzDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: A inibição crônica do óxido nítrico (NO) leva ao desenvolvimento de hipertensão arterial, lesão renal isquêmica e glomeruloesderose. A administração concomitante de Uma dieta hipersódica leva ao desenvolvimento de albuminúria maciça. Nós investigamos os mecanismos responsáveis por esse aumento de permeabilidade glomerular a macromoléculas.Ratos Munich Wistar machos e adultos receberam dietas padrão (NS) ou hipersódica (HS) e associado ou não à administração de um inibido r específico da síntese de óxido nítrico, o Nw Nitro-L-Arginina-Metil Ester (L-NAME), via oral a 70 mgjKgj dia. Após 15 e 30 dias medimos: a °albuminúria (UalbV, mgj min), a pressão arterial média (P AM, mmHg), o clearance de inulina (Ci, mIj min), o de dextran (Cd, mIj min) e o clearance fracional de dextran (8=Ci/Cd). Investigamos também a densidade de cargas aniônicas da membrana basal glomerular (MBG), perfundindo o rim com uma solução contendo ferritina catiônica e quantificando a porcentagem de depósitos de ferritina em micrografias eletrônica de glomérulos. N ossos resultados sugerem que a inibiç'ão crônica do NO quando associada a sobrecarga salina aumenta a permeabilidade glomerular através de: (1) um defeito na restrição por tamanho à filtração de macromoléculas; (2) perda da barreira eletrostática glomerular. Observamos também que 30 dias após interrupção dos tratamentos ocorre reversão dessas alteraçõesAbstract: We have previously described that chronic nitric oxide (NO) inhibition leads to progressive systemic hypertension and renal structural injury. Concomitant dietary salt overload and NO blockade lead to the development of massive albuminuria. Here we investigated the mechanism whereby these treatments increase the glomerular permeability to macromolecules. Adult male Munich Wistar rats were given standard-salt (55, 0.5% Na) or high salt (H5, 3.12% Na) diet and received either no treatment or the NO inhibitor Nco-L-nitroarginine metilester (NAME), 70 mg/kgl day in drinking water. At 15 and 30 days albuminuria (UalbV, mg/min), inulin clearance (Cin, mI/min), mean arterial pressure (MAP, mmHg), neutral dextran clearance (Cd, mIl min) and the fractional neutral dextran clearance (8= Cinl Cd) were measure,d. The density of fixed anionic sites at glomerular basement membrane (GBM) was also estimated by a point-counting technique, after renal perfusion with a solution containing cationic ferritin. The results suggest that chronic NO inhibition combined with H5 enhances the permeability of the glomerulus by : (1) impairing its size selectivity (by direct wall injury); (2) impairing especialIy its charge selectivity. We also observed that 30 days after the interruption of treatments all these alterations were reverted.MestradoFarmacologiaMestre em Ciência

Pathogénie de la maladie de Berger : Implication des immunoglobulines A et de leurs récepteurs

La néphropathie à immunoglobulines A (IgA) ou maladie de Berger est la plus fréquente des glomérulonéphrites primitives et une des premières causes d’insuffisance rénale terminale. Elle se caractérise par des dépôts mésangiaux de complexes d’IgA1 polymériques. Alors que l’épidémiologie et l’évolution clinique sont bien établies, les causes et mécanismes de cette affection restent inconnus. Les études biochimiques et moléculaires chez les patients ont montré une augmentation des concentrations sériques d’IgA polymériques et anormalement glycosylées. Ces modifications quantitatives et structurales des IgA jouent un rôle clé dans la genèse de la maladie en induisant des anomalies fonctionnelles des différents récepteurs des IgA: le RFcα (CD89) exprimé par les cellules sanguines circulantes et le récepteur de la transferrine (CD71) présent sur les cellules mésangiales. Les IgA anormales induisent la libération de CD89 soluble qui participe à la formation des complexes circulants contenant des IgA. Ces complexes se déposent secondairement dans le mésangium probablement par la fixation à un second récepteur, le CD71, surexprimé sur les cellules mésangiales des patients.Immunoglobulin A (IgA) nephropathy or Berger’s disease is the most common form of primary glomerulonephritis in the world and one of the first cause of end-stage renal failure. IgA nephropathy is characterized by the accumulation in mesangial areas of immune complexes containing polymeric IgA1. While epidemiology and clinical studies of IgA nephropathy are well established, the mechanism(s) underlying disease development is poorly understood. The pathogenesis of this disease involves the deposition of polymeric and undergalactosylated IgA1 in the mesangium. Quantitative and structural changes of IgA1 play a key role in the development of the disease due to functional abnormalities of two IgA receptors: The FcαR (CD89) expressed by blood myeloid cells and the transferrin receptor (CD71) on mesangial cells. Abnormal IgA induce the release of soluble CD89 which is responsible for the formation of circulating IgA complexes. These complexes may be trapped by CD71 that is overexpressed on mesangial cells in IgA nephropathy patients allowing pathogenic IgA complex formation