Regulation of autoantibody activity by the IL-23–TH17 axis determines the onset of autoimmune disease

R Pfeifle, T Rothe, N Ipseiz, HU Scherer… - Nature …, 2017 - nature.com
R Pfeifle, T Rothe, N Ipseiz, HU Scherer, S Culemann, U Harre, JA Ackermann, M Seefried…
Nature immunology, 2017nature.com
The checkpoints and mechanisms that contribute to autoantibody-driven disease are as yet
incompletely understood. Here we identified the axis of interleukin 23 (IL-23) and the TH17
subset of helper T cells as a decisive factor that controlled the intrinsic inflammatory activity
of autoantibodies and triggered the clinical onset of autoimmune arthritis. By instructing B
cells in an IL-22-and IL-21-dependent manner, TH17 cells regulated the expression of β-
galactoside α2, 6-sialyltransferase 1 in newly differentiating antibody-producing cells and …
Abstract
The checkpoints and mechanisms that contribute to autoantibody-driven disease are as yet incompletely understood. Here we identified the axis of interleukin 23 (IL-23) and the TH17 subset of helper T cells as a decisive factor that controlled the intrinsic inflammatory activity of autoantibodies and triggered the clinical onset of autoimmune arthritis. By instructing B cells in an IL-22- and IL-21-dependent manner, TH17 cells regulated the expression of β-galactoside α2,6-sialyltransferase 1 in newly differentiating antibody-producing cells and determined the glycosylation profile and activity of immunoglobulin G (IgG) produced by the plasma cells that subsequently emerged. Asymptomatic humans with rheumatoid arthritis (RA)-specific autoantibodies showed identical changes in the activity and glycosylation of autoreactive IgG antibodies before shifting to the inflammatory phase of RA; thus, our results identify an IL-23–TH17 cell–dependent pathway that controls autoantibody activity and unmasks a preexisting breach in immunotolerance.
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