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Variants in STAT4 are associated with systemic lupus erythematosus (SLE) and other autoimmune diseases. How disease-associated variants affect STAT4 expression, in particular in CD4 T cells where STAT4 plays an essential role, is unknown.We compared Th1 differentiation between naïve CD4 T cells from healthy donors (HD) homozygous for the risk (R/R) or non-risk (NR/NR) alleles. We analyzed epigenetic marks in STAT4 and evaluated the relevance of its third intron. We assessed the consequences of Stat4 overexpression in vivo. We analyzed the effects of the STAT4 genotype in patients with lupus nephritis.Naïve CD4 T cells from NR/NR HD, downregulated STAT4 in response to IL-12. In contrast, cells from R/R HD maintained high levels. R/R cells exhibited higher abundance of transcriptionally active STAT4 and increased IFN-γ production. Accordingly, R/R HD exhibited a stronger induction of local active enhancer marks. Genetic editing confirmed the presence of a negative regulatory region in the STAT4 third intron, where most of the SLE-associated STAT4 SNPs are located. In vivo forced expression demonstrated that increases in Stat4 levels in T cells enhanced glomerulonephritis. Accordingly, the R/R genotype was associated with suboptimal response to treatment and with worse clinical outcomes in patients with proliferative lupus nephritis.The SLE-associated STAT4 haplotype is associated with abnormal IL-12-mediated STAT4 transcriptional regulation. Carriers of the risk variant exhibit exaggerated CD4 pro-inflammatory capacities that, in the context of SLE, contribute to a more severe disease. R/R patients may benefit from blockade of the IL-12-STAT4 pathway. This article is protected by copyright. All rights reserved.

TCR-αβ(+) double negative (DN) T cells (CD3(+) TCR-αβ(+) CD4(-) CD8(-) NK1.1(-) CD49b(-) ) represent a minor heterogeneous population in healthy humans and mice. These cells have been ascribed pro-inflammatory and regulatory capacities and are known to expand during the course of several autoimmune diseases. Importantly, previous studies have shown that self-reactive CD8(+) T cells become DN after activation by self-antigens, suggesting that self-reactive T cells may exist within the DN T-cell population. Here, we demonstrate that programmed cell death 1 (PD-1) expression in unmanipulated mice identifies a subset of DN T cells with expression of activation-associated markers and a phenotype that strongly suggests they are derived from self-reactive CD8(+) cells. We also found that, within DN T cells, the PD-1(+) subset generates the majority of pro-inflammatory cytokines. Finally, using a TCR-activation reporter mouse (Nur77-GFP), we confirmed that in the steady-state PD-1(+) DN T cells engage endogenous antigens in healthy mice. In conclusion, we provide evidence that indicates that the PD-1(+) fraction of DN T cells represents self-reactive cells.

Cytotoxic T Lymphocyte Antigen-4 (CTLA-4) is a costimulatory receptor in the immunoglobulin superfamily closely related to CD28 and ICOS, and binds to CD80 and CD86 (1;2). Expression of CTLA-4 is constitutive on regulatory T cells (3) and induced following activation on effector T cells (1). It exerts an essential inhibitory role and its absence causes an early and lethal autoimmune disease in mice (4). The CTLA4 gene is highly conserved (76% homology between human and mouse) (5). It is comprised of 4 exons: exon 1 codes for the signal peptide; exon 2 for the ligand-binding domain; exon 3 for the transmembrane region; exon 4 for the intra-cytoplasmic tail (Figure 1A) (6). Human peripheral blood lymphocytes express 3 isoforms of CTLA-4 produced by alternative splicing: full length CTLA-4 (flCTLA-4; all four exons), soluble CTLA-4 (exons 1, 2, and 4), and a short variant that lacks both the ligand-binding domain and the transmembrane domain (1/4 CTLA-4) (6). Allelic variations and single nucleotide polymorphisms in the CTLA4 gene have been associated to several human autoimmune diseases including autoimmune thyroid disease (6), rheumatoid arthritis (7) and systemic lupus erythematosus (SLE) (8;9). Interestingly, the polymorphisms associated with autoimmune disease affect CTLA4 splicing and thus the relative expression of each variant isoform (6). How the differential expression of CTLA-4 isoforms impacts susceptibility to autoimmune disease is not yet clear. Figure 1 The 1/4 CTLA-4 splice variant codes for a secreted protein The 1/4 CTLA-4 isoform lacks the CD80/86-binding domain and the transmembrane portion and thus its function remains unclear. Forced expression of the 1/4 CTLA-4 isoform in T cells was shown to induce spontaneous autoimmune disease and facilitate the development of experimental allergic encephalomyelitis in C57BL/6 mice through an unknown mechanism (10). Here we demonstrate that in lupus-prone mice increased expression of 1/4 CTLA-4 accelerates autoimmunity, exacerbates disease pathology, and causes early mortality.

Objective Systemic lupus erythematosus (SLE) is a chronic inflammatory disease associated with aberrant immune cell function. Treatment involves the use of indiscriminate immunosuppression, which results in significant side effects. SLE T cells express high levels of calcium/calmodulin-dependent protein kinase type IV (CaMKIV), which translocates to the nucleus upon engagement of the T cell receptor–CD3 complex and accounts for abnormal T cell function. The purpose of this study was to determine whether inhibition of CaMKIV would improve disease pathology. Methods We treated MRL/lpr mice with KN-93, a CaMKIV inhibitor, starting at week 8 or week 12 of age and continuing through week 16 and evaluated skin lesions, proteinuria, kidney histopathology, proinflammatory cytokine production, and costimulatory molecule expression. We also determined the effect of silencing of CAMK4 on interferon-γ (IFNγ) expression by human SLE T cells. Results CaMKIV inhibition in MRL/lpr mice resulted in significant suppression of nephritis and skin disease, decreased expression of the costimulatory molecules CD86 and CD80 on B cells, and suppression of IFNγ and tumor necrosis factor α production. In human SLE T cells, silencing of CAMK4 resulted in suppression of IFNγ production. Conclusion We conclude that suppression of CaMKIV mitigates disease development in lupus-prone mice by suppressing cytokine production and costimulatory molecule expression. Specific silencing of CAMK4 in human T cells results in similar suppression of IFNγ production. Our data justify the development of small-molecule CaMKIV inhibitors for the treatment of patients with SLE.

Objective To quantify the expression of CD44 and variant isoforms CD44v3 and CD44v6 on T cells from patients with systemic lupus erythematosus (SLE), and to assess correlations of the level of expression of these molecules with disease manifestations. Methods Information on clinical and demographic characteristics was collected, and blood samples were obtained from 72 patients with SLE and 32 healthy control subjects matched to the patients by sex, race, and age. Expression of CD44 and variants CD44v3 and v6 on T cell subsets was determined by flow cytometry, and Pearson's correlations of their expression levels with clinical variables, SLE Disease Activity Index (SLEDAI) scores, and presence of lupus nephritis were determined. Wilcoxon's rank sum tests and conditional multivariable regression analyses were applied to identify differences in the expression of CD44 between patients with SLE and healthy controls. Results Expression of CD44 was higher on CD4+ and CD8+ T cells from SLE patients compared with controls (P ≤ 0.03). Expression of CD44v3 and CD44v6 was also higher on total T cells and CD4+ and CD8+ T cells from SLE patients compared with controls (P ≤ 0.03). Cell surface levels of CD44v3 on total T cells, CD4+ T cells, and CD8+ T cells as well as cell surface expression of CD44v6 on total T cells and CD4+ T cells were correlated with the SLEDAI score (P < 0.05). The presence of lupus nephritis was associated with the expression of CD44v6 on total T cells, CD4+ T cells, and CD4−CD8− T cells (P < 0.05). Positivity for anti–double-stranded DNA antibodies was associated with the expression levels of CD44v6 on T cells (P < 0.05). Conclusion These results indicate that expression levels of CD44v3 and CD44v6 on T cells may represent useful biomarkers of SLE activity.