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Essential role and therapeutic targeting of the glomerular endothelial glycocalyx in lupus nephritis
Hiroyuki Kadoya, … , Chaim O. Jacob, János Peti-Peterdi
Hiroyuki Kadoya, … , Chaim O. Jacob, János Peti-Peterdi
Published September 1, 2020
Citation Information: JCI Insight. 2020;5(19):e131252. https://doi.org/10.1172/jci.insight.131252.
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Research Article Nephrology

Essential role and therapeutic targeting of the glomerular endothelial glycocalyx in lupus nephritis

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Abstract

Lupus nephritis (LN) is a major organ complication and cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). There is an unmet medical need for developing more efficient and specific, mechanism-based therapies, which depends on improved understanding of the underlying LN pathogenesis. Here we present direct visual evidence from high-power intravital imaging of the local kidney tissue microenvironment in mouse models showing that activated memory T cells originated in immune organs and the LN-specific robust accumulation of the glomerular endothelial glycocalyx played central roles in LN development. The glomerular homing of T cells was mediated via the direct binding of their CD44 to the hyaluronic acid (HA) component of the endothelial glycocalyx, and glycocalyx-degrading enzymes efficiently disrupted homing. Short-course treatment with either hyaluronidase or heparinase III provided long-term organ protection as evidenced by vastly improved albuminuria and survival rate. This glycocalyx/HA/memory T cell interaction is present in multiple SLE-affected organs and may be therapeutically targeted for SLE complications, including LN.

Authors

Hiroyuki Kadoya, Ning Yu, Ina Maria Schiessl, Anne Riquier-Brison, Georgina Gyarmati, Dorinne Desposito, Kengo Kidokoro, Matthew J. Butler, Chaim O. Jacob, János Peti-Peterdi

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Figure 5

Quantitative MPM imaging of the glomerular endothelial glycocalyx in different mouse models using iv-injected FITC-WGA lectin (shown in green).

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Quantitative MPM imaging of the glomerular endothelial glycocalyx in dif...
Intravascular space (plasma) was labeled with iv-injected albumin–Alexa Fluor 594 (red). (A) Representative image and calculation of endothelial surface FITC-WGA signal width on linear intensity profiles as an index of glycocalyx thickness. FITC-WGA fluorescence decreases as it meets the plasma (luminal end) and the endothelial cell (abluminal end). FITC-WGA signal width was measured as the distance between half maximal intensities as shown. Glycocalyx measurements relied on the selection of capillary segments where clear plasma and FITC-WGA peak signals could be seen. Only clear longitudinal or cross-sectioned (round) capillary profiles and the level at one-half the capillary depth (deduced from the Z-stack) were analyzed to ensure the glycocalyx was measured perpendicular to the endothelial membrane. (B) Summary of FITC-WGA signal width in various mouse groups as shown. (C–G) Representative images of FITC-WGA lectin labeling and intensity before and 1 hour after H treatment. (H) Summary and statistical analysis of FITC-WGA fluorescence intensity (ratio of glomerular labeling/proximal tubule autofluorescence). (B–H) Mice were 4–6 weeks old unless stated otherwise. Scale bar: 10 μm. n = 8 glomeruli from n = 4 mice each group. Values are expressed as means ± SEM, *P < 0.005, **P < 0.001, based on 1-way ANOVA followed by Tukey’s multiple-comparisons test (B–H). GC, glomerular capillary; ESL, endothelial surface layer; NOD, nonobese diabetic; H, hyaluronidase.

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