Arthritis in the K/BxN mouse model results from pathogenic immunoglobulins (Igs) that recognize the ubiquitous cytoplasmic enzyme glucose-6-phosphate isomerase (GPI). But how is a joint-specific disease of autoimmune and inflammatory nature induced by systemic self-reactivity? No unusual amounts or sequence, splice or modification variants of GPI expression were found in joints. Instead, immunohistological examination revealed the accumulation of extracellular GPI on the lining of the normal articular cavity, most visibly along the cartilage surface. In arthritic mice, these GPI deposits were amplified and localized with IgG and C3 complement. Similar deposits were found in human arthritic joints. We propose that GPI–anti-GPI complexes on articular surfaces initiate an inflammatory cascade via the alternative complement pathway, which is unbridled because the cartilage surface lacks the usual cellular inhibitors. This may constitute a generic scenario of arthritogenesis, in which extra-articular proteins coat the cartilage or joint extracellular matrix.
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We thank J. L. Pasquali for enlightening discussions; J. Hergueux, S. Johnson and Q. M. Pham for managing the KRN colony; C. Cahill for help with confocal microscopy; P. Gerber for ELISAs and chromatography; and D. Bowman and A. Calderone for sections. Supported by institutional funds from the INSERM, CNRS and the Centre Hospitalo-Universitaire and by grants from the Association pour la Recherche contre la Polyarthrite and the NIH (1R01 AR/AI46580-01, to D. M. and C. B), the Arthritis Foundation (I. M.), the Fondation pour la Recherche Medicale and CONICET (M. M.) and the Howard Hughes Medical Institute (D. L.).
The authors declare no competing financial interests.
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Matsumoto, I., Maccioni, M., Lee, D. et al. How antibodies to a ubiquitous cytoplasmic enzyme may provoke joint-specific autoimmune disease. Nat Immunol 3, 360–365 (2002). https://doi.org/10.1038/ni772
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