B cell-derived IL-4 acts on podocytes to induce proteinuria and foot process effacement

JCI Insight. 2017 Nov 2;2(21):e81836. doi: 10.1172/jci.insight.81836.

Abstract

The efficacy of B cell depletion therapies in diseases such as nephrotic syndrome and rheumatoid arthritis suggests a broader role in B cells in human disease than previously recognized. In some of these diseases, such as the minimal change disease subtype of nephrotic syndrome, pathogenic antibodies and immune complexes are not involved. We hypothesized that B cells, activated in the kidney, might produce cytokines capable of directly inducing cell injury and proteinuria. To directly test our hypothesis, we targeted a model antigen to the kidney glomerulus and showed that transfer of antigen-specific B cells could induce glomerular injury and proteinuria. This effect was mediated by IL-4, as transfer of IL-4-deficient B cells did not induce proteinuria. Overexpression of IL-4 in mice was sufficient to induce kidney injury and proteinuria and could be attenuated by JAK kinase inhibitors. Since IL-4 is a specific activator of STAT6, we analyzed kidney biopsies and demonstrated STAT6 activation in up to 1 of 3 of minimal change disease patients, suggesting IL-4 or IL-13 exposure in these patients. These data suggest that the role of B cells in nephrotic syndrome could be mediated by cytokines.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antigen-Antibody Complex
  • B-Lymphocytes / metabolism*
  • Biopsy
  • Cyclic Nucleotide Phosphodiesterases, Type 3 / drug effects
  • Cytokines / metabolism
  • Disease Models, Animal
  • Female
  • HEK293 Cells
  • HeLa Cells
  • Humans
  • Interleukin-13 / metabolism
  • Interleukin-4 / genetics
  • Interleukin-4 / metabolism*
  • Janus Kinase 3
  • Janus Kinases
  • Kidney / immunology
  • Kidney / injuries
  • Kidney / pathology
  • Kidney Diseases / immunology
  • Kidney Diseases / pathology
  • Kidney Glomerulus
  • Mice
  • Mice, Knockout
  • Nephrotic Syndrome / immunology
  • Nephrotic Syndrome / pathology
  • Podocytes / metabolism*
  • Proteinuria / immunology*
  • Proteinuria / pathology
  • Rituximab / pharmacology
  • STAT6 Transcription Factor / metabolism

Substances

  • Antigen-Antibody Complex
  • Cytokines
  • Interleukin-13
  • STAT6 Transcription Factor
  • Stat6 protein, mouse
  • Interleukin-4
  • Rituximab
  • Jak3 protein, mouse
  • Janus Kinase 3
  • Janus Kinases
  • Cyclic Nucleotide Phosphodiesterases, Type 3
  • sphingomyelinase-like phosphodiesterase 3b, mouse