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Mitochondrial dysfunction drives natural killer cell dysfunction in systemic lupus erythematosus
Natalia Fluder, Morgane Humbel, Emeline Recazens, Alexis A. Jourdain, Camillo Ribi, George Tsokos, Denis Comte
Natalia Fluder, Morgane Humbel, Emeline Recazens, Alexis A. Jourdain, Camillo Ribi, George Tsokos, Denis Comte
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Research Article Immunology

Mitochondrial dysfunction drives natural killer cell dysfunction in systemic lupus erythematosus

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Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by immune dysregulation and widespread inflammation. NK cells display marked functional impairment in SLE, including defective cytotoxicity and cytokine production, but the underlying mechanisms remain poorly defined. Here, we show that mitochondrial dysfunction and impaired mitophagy are key contributors to NK cell abnormalities in SLE. Using complementary structural, metabolic, and proteomic analyses, we found that SLE NK cells accumulate enlarged and dysfunctional mitochondria, exhibit impaired lysosomal acidification, and release mitochondrial DNA into the cytosol — features consistent with defective mitochondrial quality control. Transcriptional and proteomic profiling revealed downregulation of key mitophagy-related genes and pathways. These abnormalities correlated with reduced NK cell degranulation and cytokine production. We then tested whether enhancing mitochondrial quality control could restore NK cell function. The mitophagy activator Urolithin A improved mitochondrial and lysosomal parameters and rescued NK cell effector responses in vitro. Hydroxychloroquine partially restored mitochondrial recycling and reduced cytosolic mtDNA. These findings suggest that defective mitophagy and mitochondrial dysfunction are major contributors to NK cell impairment in SLE and that targeting mitochondrial quality control may represent a promising strategy for restoring immune balance in this disease.

Authors

Natalia Fluder, Morgane Humbel, Emeline Recazens, Alexis A. Jourdain, Camillo Ribi, George Tsokos, Denis Comte

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Figure 1

NK cells from patients with SLE accumulate enlarged dysfunctional mitochondria.

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NK cells from patients with SLE accumulate enlarged dysfunctional mitoch...
(A–C) Mitochondrial mass, membrane potential, and relative mitochondrial labeling (MTR/MTG ratio) in NK cells from patients with SLE and HC, assessed at baseline by flow cytometry. (D) Mitochondrial mass and relative labeling stratified by disease activity score (SLEDAI). (E) Representative TEM images of NK cells from HC (n = 5) and patients with SLE (n = 5). Red arrows indicate enlarged mitochondria. Low-magnification images (left panels) show whole cells (scale bar: 500 nm); high-magnification images (right panels) show subcellular details (scale bar: 200 nm). (F) Quantification of mitochondrial area per NK cell (10 images per individual). Each symbol represents 1 NK cell. (G) Total mtDNA content quantified by qPCR (n = 12 per group). A log2 fold change > 0.5 or < –0.5 was considered significant; *P < 0.05, **P < 0.01, ***P < 0.001. Wilcoxon test (A–C and F), mixed-effects analysis (E), and Mann-Whitney test (G).

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