Dominant protection from HLA-linked autoimmunity by antigen-specific regulatory T cells

  • Nature. 2017 May 11;545(7653):243-247. doi: 10.1038/nature22329.
Joshua D Ooi  1 Jan Petersen  2  3 Yu H Tan  2 Megan Huynh  1 Zoe J Willett  1 Sri H Ramarathinam  2 Peter J Eggenhuizen  1 Khai L Loh  2 Katherine A Watson  4 Poh Y Gan  1 Maliha A Alikhan  1 Nadine L Dudek  2 Andreas Handel  5 Billy G Hudson  6 Lars Fugger  7 David A Power  8  9 Stephen G Holt  9  10 P Toby Coates  11 Jon W Gregersen  12 Anthony W Purcell  2 Stephen R Holdsworth  1  13 Nicole L La Gruta  2  4 Hugh H Reid  2  3 Jamie Rossjohn  2  3  14 A Richard Kitching  1  13  15  16
Affiliations
  • 1. Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Clayton, Victoria 3168, Australia.
  • 2. Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria 3800, Australia.
  • 3. Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria 3800, Australia.
  • 4. Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria 3010, Australia.
  • 5. Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia 30602, USA.
  • 6. Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA.
  • 7. Oxford Centre for Neuroinflammation, Nuffield Department of Clinical Neurosciences, and MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DS, UK.
  • 8. Department of Nephrology, Austin Health, Heidelberg, Victoria 3084, Australia.
  • 9. Department of Medicine, University of Melbourne, Melbourne, Victoria 3010, Australia.
  • 10. Department of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria 3050, Australia.
  • 11. Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia.
  • 12. Department of Medicine, Viborg Regional Hospital, Viborg 8800, Denmark.
  • 13. Department of Nephrology, Monash Health, Clayton, Victoria 3168, Australia.
  • 14. Institute of Infection and Immunity, Cardiff University School of Medicine, Heath Park, Cardiff CF14 4XN, UK.
  • 15. NHMRC Centre for Personalised Immunology, Monash University, Clayton, Victoria 3168, Australia.
  • 16. Department of Pediatric Nephrology, Monash Health, Victoria 3168, Australia.
Abstract

Susceptibility and protection against human autoimmune diseases, including type I diabetes, multiple sclerosis, and Goodpasture disease, is associated with particular human leukocyte antigen (HLA) alleles. However, the mechanisms underpinning such HLA-mediated effects on self-tolerance remain unclear. Here we investigate the molecular mechanism of Goodpasture disease, an HLA-linked autoimmune renal disorder characterized by an immunodominant CD4+ T-cell self-epitope derived from the α3 chain of type IV Collagen (α3135-145). While HLA-DR15 confers a markedly increased disease risk, the protective HLA-DR1 allele is dominantly protective in trans with HLA-DR15 (ref. 2). We show that autoreactive α3135-145-specific T cells expand in patients with Goodpasture disease and, in α3135-145-immunized HLA-DR15 transgenic mice, α3135-145-specific T cells infiltrate the kidney and mice develop Goodpasture disease. HLA-DR15 and HLA-DR1 exhibit distinct peptide repertoires and binding preferences and present the α3135-145 epitope in different binding registers. HLA-DR15-α3135-145 tetramer+ T cells in HLA-DR15 transgenic mice exhibit a conventional T-cell phenotype (Tconv) that secretes pro-inflammatory cytokines. In contrast, HLA-DR1-α3135-145 tetramer+ T cells in HLA-DR1 and HLA-DR15/DR1 transgenic mice are predominantly CD4+Foxp3+ regulatory T cells (Treg cells) expressing tolerogenic cytokines. HLA-DR1-induced Treg cells confer resistance to disease in HLA-DR15/DR1 transgenic mice. HLA-DR15+ and HLA-DR1+ healthy human donors display altered α3135-145-specific T-cell antigen receptor usage, HLA-DR15-α3135-145 tetramer+ Foxp3- Tconv and HLA-DR1-α3135-145 tetramer+ Foxp3+CD25hiCD127lo Treg dominant phenotypes. Moreover, patients with Goodpasture disease display a clonally expanded α3135-145-specific CD4+ T-cell repertoire. Accordingly, we provide a mechanistic basis for the dominantly protective effect of HLA in autoimmune disease, whereby HLA polymorphism shapes the relative abundance of self-epitope specific Treg cells that leads to protection or causation of autoimmunity.