Stalesen, R. | Search bioRxiv

bioRxiv2025

Anti-MDA5 monoclonal antibodies from patients with dermatomyositis - B cell characteristics and differential targeting of the helicase domains

ObjectivesAutoantibodies targeting melanoma differentiation associated protein 5 (MDA5) are strongly associated with dermatomyositis (DM) and may contribute to its pathogenesis. Here we aimed to investigate MDA5+ B cells, their phenotype and generate MDA5 monoclonal antibodies to assess their epitope specificity. MethodsMDA5-reactive B cells were captured from peripheral blood of patients with anti-MDA5+ DM (n=3) using an MDA5-fluorescent probe. B cell receptor (BCR) sequences were analysed from single-sorted B cells (n=240). Selected clones were re-expressed as IgG1 monoclonal antibodies (mAbs, n=23). Reactivity was assessed using recombinant MDA5 protein constructs, peptide epitope mapping, ELISA, western blot and a commercial line blot assay. ResultsOf 240 anti-MDA5+ sorted B cells, 23 BCRs were re-expressed as mAbs, two of which showed high reactivity and specificity for MDA5. These antibody sequences originated from one CD19+IgD-CD27-CD38+ and one CD19+IgD-CD27+CD38+ IgG+ B cell with low somatic hypermutation (SHM). Both mAbs had nanomolar apparent affinity and bound to sites within the helicase domains of the MDA5 protein but with distinct epitope recognition. Serology screening confirmed targeting of a linear epitope identified in the mAb studies. ConclusionOur results show that anti-MDA5+ B cells recognize the helicase domains, which are the enzymatically active domains of the protein. These results have implications for understanding the etiopathology of anti-MDA5+ DM and development of new antigen-specific therapies.

immunology↗

bioRxiv2022

Divergent and dominant anti-inflammatory effects of patient-derived anti-citrullinated protein antibodies (ACPA) in arthritis development

About two thirds of rheumatoid arthritis (RA) patients develop anti-citrullinated protein antibodies (ACPA), which are a characteristic of the disease and sparsely observed in other clinical settings or in the healthy population. ACPA are used as a diagnostic criterion and often develop prior to diagnosis. Therefore, ACPA titers are important in the identification of individuals at risk of developing RA. Interestingly, the titers and target cross-reactivity of ACPA increase by time of diagnosis, suggesting a causality between anti-citrulline reactivity and the development of RA. However, only 50% of ACPA-positive at-risk individuals will progress to a clinical RA diagnosis. This observation suggests that there are different types of ACPA and that their relationship with RA development is more complex than presently assumed. To address the biological effect of ACPA in the establishment and development of inflammatory arthritis, we made use of the collagen antibody-induced arthritis (CAIA) model of passive arthritis. Using seven unique patient derived monoclonal ACPA, we observed that ACPA are predominantly anti-inflammatory, with some clones (C03 and BVCA1) completely inhibiting disease development. We have also identified a clone (C04) as having a disease-prone effect, by increasing and sustaining disease prevalence. This clone had previously been reported as being pro-inflammatory in a different model of joint inflammation. The anti-inflammatory effects of C03 were dependent on Fc{gamma}R, since neither F(ab)2 or a mutated Fc-null GRLR-C03 clone could mediate disease protection. Most importantly, mice receiving polyclonal ACPA enriched from RA sera were also partially protected from disease. Looking at the cell and tissue of origin of the ACPA clones, their V(D)J sequences, Fc glycosylation pattern and fine-specificities, we could not identify a common feature between anti-inflammatory ACPA distinguishing them from those without the properties. Together, our data demonstrates that circulating ACPA in RA patients are predominantly anti-inflammatory, emphasizing the need to study ACPA repertoires in order to determine their influence on the clinical outcome of the patient or at-risk individual.

immunology↗