<p>Patients with systemic lupus erythematosus (SLE) have elevated levels of interferon (IFN)-α in blood and IFN-α-producing cells in tissues. In the present thesis, we investigate the mechanisms behind the upregulated IFN-α-production in SLE and also show that the IFN-α system is activated in primary Sjögren’s syndrome (pSS), with IFN-α-producing cells in the major affected organ, the salivary glands. The IFN-α is a type I IFN, a family of cytokines counteracting especially viral infections, by acting directly on infected cells, and via many immunomodulatory effects. The latter may also contribute to autoimmune processes.</p><p>The type I IFNs are usually produced upon recognition of microbial structures. In SLE, however, DNA-containing immune complexes (ICs) that induce IFN-α production are found. Many autoantibodies in SLE and pSS are directed to nucleic acids or to DNA/RNA-binding proteins. We show that also RNA in complex with autoantibodies from SLE or pSS patients (RNA-IC) induces IFN-α-production. The RNA could be either in the form of RNA-containing material released from apoptotic or necrotic cells or as a pure RNA-containing autoantigen, the U1 small nuclear ribonucleoprotein particle. </p><p>The IFN-α-production induced by RNA-IC occurred in plasmacytoid dendritic cells (PDCs), also termed natural IFN-producing cells (NIPCs), via binding to Fcγ-receptor IIa, endocytosis and triggering of Toll-like receptors (TLRs), probably TLR7 and TLR9. The RNA-IC may also have other effects, and we found that they induce prostaglandin E2 (PGE2) production in monocytes and tumor necrosis factor (TNF)-α in both monocytes and NIPC/PDC. The PGE2 downregulated the IFN-α induction in NIPC/PDC, and the IFN-α induction was increased in monocyte-depleted cell cultures. </p><p>The findings presented in this thesis aids in the understanding of the mechanisms behind the activated IFN-α system in SLE and other autoimmune diseases, and shows that also pSS is one of these diseases.</p>

Patients with systemic lupus erythematosus (SLE) have elevated levels of interferon (IFN)-α in blood and IFN-α-producing cells in tissues. In the present thesis, we investigate the mechanisms behind the upregulated IFN-α-production in SLE and also show that the IFN-α system is activated in primary Sjögren’s syndrome (pSS), with IFN-α-producing cells in the major affected organ, the salivary glands. The IFN-α is a type I IFN, a family of cytokines counteracting especially viral infections, by acting directly on infected cells, and via many immunomodulatory effects. The latter may also contribute to autoimmune processes. The type I IFNs are usually produced upon recognition of microbial structures. In SLE, however, DNA-containing immune complexes (ICs) that induce IFN-α production are found. Many autoantibodies in SLE and pSS are directed to nucleic acids or to DNA/RNA-binding proteins. We show that also RNA in complex with autoantibodies from SLE or pSS patients (RNA-IC) induces IFN-α-production. The RNA could be either in the form of RNA-containing material released from apoptotic or necrotic cells or as a pure RNA-containing autoantigen, the U1 small nuclear ribonucleoprotein particle. The IFN-α-production induced by RNA-IC occurred in plasmacytoid dendritic cells (PDCs), also termed natural IFN-producing cells (NIPCs), via binding to Fcγ-receptor IIa, endocytosis and triggering of Toll-like receptors (TLRs), probably TLR7 and TLR9. The RNA-IC may also have other effects, and we found that they induce prostaglandin E2 (PGE2) production in monocytes and tumor necrosis factor (TNF)-α in both monocytes and NIPC/PDC. The PGE2 downregulated the IFN-α induction in NIPC/PDC, and the IFN-α induction was increased in monocyte-depleted cell cultures. The findings presented in this thesis aids in the understanding of the mechanisms behind the activated IFN-α system in SLE and other autoimmune diseases, and shows that also pSS is one of these diseases.

In autoimmune diseases an individual’s immune system becomes targeted at the body’s own healthy cells. The aim of this thesis was to identify genetic risk factors for the two autoimmune diseases multiple sclerosis (MS) and systemic lupus erythematosus (SLE). In Study I, we found that genetic variation in the interferon regulatory factor 5 gene (IRF5), previously shown to be associated with SLE, rheumatoid arthritis and inflammatory bowel diseases, was associated also with MS. An insertion/deletion polymorphism in the first intron of IRF5 is as a good functional candidate for this association. IRF5, together with the signal transducer and activator of transcription 4 gene (STAT4), are the most important genetic risk factors for SLE, outside the HLA region. In Study II we showed using a family-based study design that genetic variation in STAT4 is associated with SLE also in the Finnish population. In Study III, we investigated a STAT4 risk allele for SLE for its association with cardiovascular disease in SLE patients. The risk allele of STAT4 proved to be strongly associated with ischemic cerebrovascular disease and anti-phospholipid antibodies in SLE patients. A possible mechanism for this association is that the risk allele leads to increased production of pro-thrombotic anti-phospholipid antibodies, which in turn increases the risk for stroke. Both IRF5 and STAT4 are involved in signalling of the type I interferon system. In Study IV, we investigated 78 additional genes in this system for their association with SLE in a Swedish cohort. The most promising results were followed up in additional patients and controls from Sweden and the US. Two novel SLE genes were identified. In Study V a large follow-up of a genome-wide association study was performed. Five new SLE loci were identified: TNIP1, PRDM1, JAZF1, UHRF1BP1 and IL10. A number of genes previously shown to be associated with other autoimmune diseases were also tested for association with SLE. This analysis identified the type I interferon system gene IFIH1 as a novel SLE risk locus. These studies confirms the central role of the type I interferon system in SLE and further suggests common genetic risk factors in autoimmunity.

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibody production, which can eventually lead to immune complex (IC)-mediated organ damage. Due to the stimulation of plasmacytoid dendritic cells (pDC) by nucleic acid-containing ICs (DNA- or RNA-IC), patients with SLE have an ongoing interferon (IFN)-α production. IFN-α induces a general activation of the immune system that may initiate or propagate an autoimmune process if not properly regulated. Previous studies have shown that natural killer (NK) cells potently enhance the IFN-α production by pDCs. In study I, the mechanisms behind the NK cell-mediated increased IFN-α production by RNA-IC-stimulated pDCs were investigated. ICs triggered CD56dim NK cells via FcγRIIIA to the secretion of cytokines (e.g. MIP-1β) that promoted IFN-α production. Additionally, an LFA-1-dependent cell-cell interaction between pDCs and NK cells strongly contributed to the increased production of IFN-α. In study II, the RNA-IC-induced regulation of surface molecules on pDCs and NK cells was investigated. The expression of CD319 and CD229, which are two SLAM family receptors genetically associated with SLE, was induced on pDCs and NK cells by RNA-IC. IFN-α-producing pDCs displayed an increased expression of CD319 and CD229, whereas pDCs from patients with SLE had a decreased expression of CD319. In study III, we serendipitously identified an SLE patient harboring autoantibodies to the NK cell receptor CD94/NKG2A. In study IV, sera from 203 patients with SLE were analyzed for autoantibodies to the CD94/NKG2A, CD94/NKG2C and NKG2D receptors. Seven patients harbored anti-CD94/NKG2A autoantibodies, and two of these patient’s autoantibodies also reacted with CD94/NKG2C. Anti-CD94/NKG2A and anti-CD94/NKG2C autoantibodies both interfered with the HLA-E-mediated regulation of NK cell cytotoxicity, and facilitated the elimination of target cells expressing these receptors. Furthermore, these autoantibodies were found in a group of severely diseased SLE patients and their titers closely followed disease activity. In conclusion, this thesis provides insights to molecular mechanisms whereby NK cells regulate the IFN-α production, it further links the SLAM receptors to SLE, and it describes novel autoantibodies to receptors regulating NK cell cytotoxicity. Together these findings strengthen the assumption that NK cells are involved in the pathogenesis of SLE.

L’immunité innée est notre premier mécanisme de défense contre l’invasion des pathogènes. Cette défense est basée sur la reconnaissance d’éléments invariables des pathogènes par des récepteurs encodés dans les lignées germinales. Dans la réponse anti-virale, le facteur de transcription Interferon Regulatory Factor 3 (IRF3) joue un rôle clé dans la réponse interféron de type I, combattant ainsi la réplication virale et conférant un état anti-viral aux cellules infectées ainsi qu’aux cellules avoisinantes. IRF3 est une protéine dont l’activation et la phosphorylation sont régulées par les kinases TBK1 et IKKi. Nous proposons ici que l’acétylation est une modification post-traductionnelle importante dans la régulation de l’activité d’IRF3. Nous avons observé par immunobuvardage qu’IRF3 est acétylé de façon basale et que cette acétylation est induite par la présence du co-facteur CBP et est inhibée par la présence de la kinase TBK1. Par spectrométrie de masse, nous avons ensuite identifié huit lysines sujettes à l’acétylation sur IRF3. Aussi, par mutagénèse dirigée, nous avons muté de façon ponctuelle chacun de ces sites et avons déterminé que la mutation de la lysine 87 inhibe la capacité d’IRF3 à s’attacher à l’ADN en EMSA et à transactiver son élément de réponse en essai luciférase. Aussi, nous proposons que l’acétylation masque la charge positive de la lysine 87 et contrôle de façon négative l’activité du facteur de transcription IRF3. Notre groupe démontre ainsi pour la première fois l’acétylation du facteur de transcription dans un modèle cellulaire et propose que ce processus joue un rôle inhibiteur dans la régulation de la protéine. / Innate immunity is our first line of defense against invading pathogens. This process is based on the recognition of invariable molecular patterns present on different pathogens by germ-line encoded receptors. In the innate immune response against invading viruses, the transcription factor Interferon Regulatory Factor 3 (IRF3) plays a major role in the regulation of type I interferons, priming the defense of infected and surrounding cells against viral infection. The phosphorylation and activation of IRF3 is regulated by the kinases TBK1 and IKKi. Here we suggest that acetylation is also an important post-translational modification in the regulation of this transcription factor. We have observed by immunoblot analysis a basal acetylation of IRF3, which is increased in the presence of its co-factor CBP and inhibited in the presence of its kinase TBK1. Also, we have identified on IRF3 eight different lysine residues subjected to acetylation using mass spectrometry and we have mutated these sites using sitedirected mutagenesis. We found that the K87R mutation inhibits IRF3-DNA binding in EMSA and leads to the transactivation of its promoter in luciferase assays. We also suggest that by masking the positive charge of the lysine 87 residue, acetylation negatively controls the activity of IRF3. Our group thus demonstrates for the first time the acetylation of IRF3 in a cellular model and suggests that this modification plays a role in the inhibition of the IRF3 transcription factor.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

L'action ubiquitaire de l'interféron de type I (IFN- alpha/beta , ici IFN) dans la physiologie et la pathologie est aujourd'hui certaine. Une réponse dérégulée à l'IFN peut entraîner des interféronopathies ou des maladies auto-immunes. Dans mon travail de thèse j'ai étudié trois éléments de la voie de signalisation de l'IFN afin de comprendre comment une dérégulation peut se produire. TYK2 est une tyrosine kinase de la famille Janus impliquée dans la signalisation de cytokines immunorégulatrices (IFN de type I, IL-10, IL-12, IL-23). Selon le récepteur, TYK2 est co-activé avec JAK1 ou JAK2. L'interaction moléculaire entre les deux kinases juxtaposées est peu connue. J'ai caractérisé deux variants de TYK2 associés à des maladies auto-immunes, TYK2 I684S et TYK2 P1104A. J'ai démontré que ces deux variants ont un défaut catalytique, mais soutiennent la réponse à l'IFN. Mes résultats suggèrent un modèle d'activation réciproque des deux kinases. Par des études de signalisation dans les cellules EBV-B j'ai montré que l'homozygotie TYK2 P1104A a un impact différent selon la cytokine étudiée. L'analyse de deux autres polymorphismes de TYK2 associés à des maladies auto-immunes (rs12720270, rs2304256) a montré un impact sur la rétention de l'Exon 8, ce qui augmente l'expression de TYK2. J'ai aussi contribué à la dissection du mécanisme moléculaire contrôlant la réponse à l'IFN dans les cellules de patients déficients pour USP18 ou ISG15 et souffrant d'interféronopathies. Ces travaux ont démontré le rôle essentiel d'USP18 pour restreindre la réponse à l'IFN et ont mis en évidence ISG15 comme un nouvel inhibiteur de l'IFN chez l'humain mais pas chez la souris. / Today, the pervasive action of type I IFN (IFN-alpha/beta, here IFN) in human physiology and pathology has become evident. Dysregulated IFN response can lead to interferonopathies and auto-immune diseases (AID). My thesis work has focused on the study of three elements of the IFN response pathway, aiming to understand how dysregulation occurs. TYK2 belongs to the Janus tyrosine kinase family and is involved in signaling of several immunoregulatory cytokines, such as type I IFN, IL-10, IL-12 and IL-23. Depending on the receptor complex, TYK2 is co-activated with either JAK1 or JAK2. A detailed molecular characterization of the interplay between the two juxtaposed enzymes is missing. In my study, I characterized two rare AID-associated human variants TYK2 I684S and TYK2 P1104A. I found that both variants are catalytically impaired but rescue signaling in response to IFN in fibroblasts. My results support a model of reciprocal activation of Janus kinases. Through signaling studies I showed that TYK2 P1104A homozygosity has a cytokine-specific impact in EBV-B cells. My studies of two other AID-associated TYK2 SNPs (rs12720270 and rs2304256) suggest that they promote Exon 8 retention and increase TYK2 expression. In the second part of my thesis work, I contributed to dissecting the molecular mechanism that tunes down IFN response in cells from rare USP18- and ISG15-deficient patients that suffered of interferonopathies. This work substantiated the essential role of USP18 in downregulating the IFN response and highlighted ISG15 as a novel IFN inhibitor in humans, but not in mice.

No description available.

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On a récemment mis en évidence l'existence d'une étroite interconnexion entre la perception d'éléments d'origine microbienne (qui se fait à travers les récepteurs de l’immunité innée tels que les TLRs) et l'homéostasie du réticulum endoplasmique. En situation de stress, une grande quantité de protéines mal repliées s'accumule dans le réticulum, déclenchant une série de réponses cellulaires connues sous le nom de "Unfolded Protein Response" (UPR). On a découvert que l'activation de l'UPR contribue à la réponse inflammatoire, en particulier chez les cellules dendritiques. GADD34/PP1 est un complexe protéique qui dé-phosphoryle eIF2α et participe à la restauration de la synthèse protéique. On a démontré que GADD34 a aussi un rôle dans le contrôle de l’expression des cytokines pro-inflammatoires, en particulier l'interféron de type I. Le but de cette thèse est de clarifier comment la voie de signalisation des TLRs et le UPR s'intercroisent et comment est-ce qu'on peut exploiter cette interaction dans des cas pathologiques J’ai pu démontrer, à l'aide de cellules dendritiques d’origine humaine et murine, que le guanabenz (GBZ), un inhibiteur du complexe GADD34/PP1, est capable de bloquer l'activation des récepteurs TLRs endosomaux. Cet inhibiteur est également capable de bloquer le choc septique dépendent de TLR9 et de baisser le niveau d’autoanticorps dans un modèle lupique. En conclusion, j'ai pu démontrer, aussi bien in vitro que in vivo, que le guanabenz est capable d'inhiber les TLRs endosomaux à travers un nouveau mécanisme d’inhibition sur CH25H, une enzyme du métabolisme du cholestérol, qui a été récemment découvert comme faisant partie de l'immunité innée. / Sustained immune reaction is strictly interconnected to pathogenic situations. For this reason, the activation of immune cells is controlled by multiple pathways. A cross-talk between microbial sensing and Endoplasmic Reticulum (ER) homeostasis has been discovered. Abnormal accumulation of proteins in the ER is a sign of cellular malfunction and triggers emergency rescue pathways, collectively known as the Unfolded Protein Response (UPR). UPR induction triggers or amplifies inflammatory signals by dendritic cells (DCs). GADD34/PP1 is a holophosphatase complex that dephosphorylates eIF2α and participates in the UPR feedback loop, by restoring protein translation. It has been shown that GADD34 plays an important role in controlling the expression of pro-inflammatory cytokines, especially type I interferon. In dendritic cells (DCs), pathogens are sensed by Pathogen Recognition Receptors (PRRs); the better characterised class of PRRs being the Toll-Like Receptors (TLRs). Thus, the aim of my thesis is to investigate how TLRs and ER-signalling pathways intersect and how this can be used to control pathogenic states, with particular attention for the GADD34/PP1 complex. Using both human and mouse DCs, we show that guanabenz (GBZ), an inhibitor of the GADD34/PP1 complex, blocks endosomal TLRs activation. The same inhibitor rescues mice viability in a TLR-dependent septic shock model and controls the circulating autoantibodies in a lupus model. Our studies show that TLR9 is particularly sensitive to GBZ. We show also that GBZ has a previously unidentified effect on CH25H, an enzyme that hydroxylates the cholesterol in 25-hydroxycholesterol, recently linked to TLRs signaling.