Objective. Systemic lupus erythematosus (SLE) is a complex autoimmune disease that is driven in part by chronic B and T lymphocyte hyperresponsiveness to self antigens. A deficiency of interleukin-21 (IL-21) or IL-21 receptor (IL-21R) in mice dramatically reduces inflammation and B and T cell activation in models of autoimmunity, including SLE. However, whether IL-21 is essential for the maintenance and amplification of preestablished inflammation has not been widely examined in various animal models. The purpose of this study was to examine the impact of novel mouse IL-21R neutralizing antibodies on recall responses to antigen challenge and on disease progression in the (NZB 3 NZW)F1 (NZB/NZW) mouse model of SLE.Methods. Humoral and cellular immune responses to immunization with sheep red blood cells (SRBCs) were measured in mice dosed with IL-21R blocking antibodies. Progression of nephritis and markers of immune activation was monitored in NZB/NZW mice following different anti-IL-21R treatment regimens.Results. IL-21R blockade specifically inhibited secondary IgG responses to SRBC immunization. In NZB/NZW mice, IL-21R blockade completely inhibited the onset of nephritis, which was associated with dramatic reductions in splenomegaly and in B cell and T cell activation. When administered to mice with preexisting disease, anti-IL-21R antibody halted the disease progression and mortality and reversed the nephritis in a subset of mice. Furthermore, treatment cessation was not followed by rapid reemergence of disease.
Conclusion. Our results highlight the importance of IL-21 in promoting humoral recall responses and in sustaining autoimmune inflammation.Interleukin-21 (IL-21), a member of the type I/ common g-chain family of cytokines, is in many respects, the quintessential "helper" cytokine, in that it is expressed primarily by CD41 T cells and induces effector mechanisms in all lymphocytes (1). Although dispensable for normal B and T cell development, IL-21 is required for T celldependent affinity-matured antibody production in response to immunization, and it drives autoantibody production in rodent models of lupus, type 1 diabetes mellitus, and arthritis (1). A key driver of germinal center formation, IL-21 acts on both B cells and, in an autocrine manner, follicular helper T (Tfh) cells to sustain B cell maturation, antibody class switching, and ultimately, plasma cell formation (2). Similarly, in in vitro assays for human T cell-dependent B cell activation, IgG and IgA production is entirely IL-21 dependent (3). IL-21 also stimulates CD41 and CD81 T cell differentiation and production of multiple proinflammatory mediators, such as IL-17, interferon-g (IFNg), chemokines, granzymes, and perforin (1).In mouse models of spontaneous autoimmunity, such as systemic lupus erythematosus (SLE), type 1 diabetes mellitus, and arthritis, IL-21/IL-21 receptor (IL-21R) deficiency completely abrogates all manifestations of disease (1,4). Furthermore, in a model of chronic viral infection characterized by attenuated CD81 T c...