The protease inhibitor E64d might attenuate the development of experimental anti-glomerular basement membrane disease through regulating the activation of Th1 cells

Background: Cathepsins have been recently identified as a regulator in the activation of Th1 and Th17 cells, which play an important role in the pathogenesis of anti-glomerular basement membrane (GBM) disease. Whether cathepsins contribute to the development of anti-GBM disease through regulating the activation of CD4⁺ T cell is still unclear.

Methods: Rats with experimental anti-GBM disease was established by immunization with the nephritogenic T cell epitope α3_127-148. E64d, a cysteine Cathepsin Inhibitor, was administered in vitro and vivo to evaluate the effect of cathepsins on regulating the activation of antigen specific T cells and the development of anti-GBM disease.

Results: In rats with experimental anti-GBM diseases, E64d treatment not only reduced the levels of proteinuria, serum creatinine and anti-GBM antibody, but also ameliorated the kidney injury with less glomerular IgG deposition, a lower percentage of crescents and less infiltration of CD4⁺ T cells, CD8⁺ T cells and macrophages, as well as a lower percentage of splenic Th1 cells. In vitro, E64d treatment could significantly reduce the production of IFN-γ in the supernatant which might be produced by the activation of Th1 cells after being recalled with the autoantigen α3_127-148. We also found the CD4⁺ T cells of rats with anti-GBM disease had an increased expression of Cathepsin L (Cts-L), and the percentage of CD4⁺ T cells with extracellular expression of Cts-L was obviously higher, indicating it as a potential key regulator.

Conclusions: E64d might attenuate the development of anti-GBM disease by participating in the activation of Th1 cells, indicating it as a potential drug for anti-GBM disease in the future.

CD4(+)T cell; E64d; Experimental anti-GBM disease; Th1 cell.