Pathogenesis of lung injury mediated by lung-restricted antibodies

Project: Research project

Project Details


Lung-restricted autoantibodies (LRA) against non-polymorphic lung self-antigens, collagen type V (COLV) and K-alpha1 tubulin (KAT), are present in over a third of patients undergoing lung transplantation. Since these self-antigens are expressed in all humans, pre-existing LRA in the recipient can bind to cognate antigens exposed in the freshly transplanted lungs. Indeed, LRA have emerged as the predominant risk factor for the development of primary graft dysfunction, the principal cause of early mortality following lung transplantation. In murine models, LRA are causally linked to severe lung allograft injury, and in patients they are associated with development of donor specific alloimmune responses. However, the mechanisms underlying their pathogenicity have not been elucidated. Given the high prevalence of LRA and their causal association with allograft injury, delineating these mechanisms should lead to relevant strategies to improve lung transplant survival. We have reported that LRA mediated allograft injury is associated with the deposition of complement and neutrophil infiltration. However, we do not understand the mechanisms by which LRA drive complement deposition or neutrophil recruitment, nor whether either is necessary for LRA-mediated injury. Since these lung self-antigens are located in the interstitial spaces, it is also unclear how circulating LRA gain access to these antigens. We have recently reported that spleen-derived Ly6ChighCCR2+ classical monocytes (CM) are recruited to the lungs following ischemia-reperfusion injury where they are necessary to open endothelial gap junctions by activating IL1β receptors (IL1R). Consistent with these findings, our preliminary data shows that syngeneic or allogeneic lung grafts from Il1r-/- donors are protected from LRA-mediated lung graft injury. We have also reported that Ly6ClowCCR2- pulmonary intravascular non-classical monocytes (NCM) are necessary for neutrophil recruitment into the donor lung. Our new
Effective start/end date4/1/193/31/23


  • National Heart, Lung, and Blood Institute (5R01HL147290-04)


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