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Publication : Neonatal Fc receptor promotes immune complex-mediated glomerular disease.

First Author  Olaru F Year  2014
Journal  J Am Soc Nephrol Volume  25
Issue  5 Pages  918-25
PubMed ID  24357670 Mgi Jnum  J:309917
Mgi Id  MGI:6708269 Doi  10.1681/ASN.2013050498
Citation  Olaru F, et al. (2014) Neonatal Fc receptor promotes immune complex-mediated glomerular disease. J Am Soc Nephrol 25(5):918-25
abstractText  The neonatal Fc receptor (FcRn) is a major regulator of IgG and albumin homeostasis systemically and in the kidneys. We investigated the role of FcRn in the development of immune complex-mediated glomerular disease in mice. C57Bl/6 mice immunized with the noncollagenous domain of the alpha3 chain of type IV collagen (alpha3NC1) developed albuminuria associated with granular capillary loop deposition of exogenous antigen, mouse IgG, C3 and C5b-9, and podocyte injury. High-resolution imaging showed abundant IgG deposition in the expanded glomerular basement membrane, especially in regions corresponding to subepithelial electron dense deposits. FcRn-null and -humanized mice immunized with alpha3NC1 developed no albuminuria and had lower levels of serum IgG anti-alpha3NC1 antibodies and reduced glomerular deposition of IgG, antigen, and complement. Our results show that FcRn promotes the formation of subepithelial immune complexes and subsequent glomerular pathology leading to proteinuria, potentially by maintaining higher serum levels of pathogenic IgG antibodies. Therefore, reducing pathogenic IgG levels by pharmacologic inhibition of FcRn may provide a novel approach for the treatment of immune complex-mediated glomerular diseases. As proof of concept, we showed that a peptide inhibiting the interaction between human FcRn and human IgG accelerated the degradation of human IgG anti-alpha3NC1 autoantibodies injected into FCRN-humanized mice as effectively as genetic ablation of FcRn, thus preventing the glomerular deposition of immune complexes containing human IgG.
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