EndoS from
IntroductionThe presence and pathogenicity of autoantibodies directed against red blood cells (RBCs) have been extensively investigated and implicated in a number of autoimmune diseases, such as autoimmune hemolytic anemia (AIHA) 1 and systemic lupus erythematosus. 2 The RBC surface contains many epitopes recognizable by alloantibodies and autoantibodies, including the more than 300 blood group antigens located on glycoproteins and glycolipids but also nonpolymorphic/nonblood group protein structures. 3 The most common targets of pathogenic RBC autoantibodies are epitopes on the Rh protein, encoded by 2 homologous genes on chromosome 1, RHD and RHCE. 4 More than half of all autoantibody specificities in patients with AIHA of the common so-called warm type include immunoglobulin G (IgG) antibodies against these Rh epitopes, which are consequently often used to model AIHA experimentally.Human antibodies against RhD (anti-D) or rabbit antibodies against human RBC (anti-RBC) can result in accelerated phagocytosis and removal of RBC from the circulation by monocytes/ macrophages in the spleen and liver. 5,6 Fc␥ receptor (Fc␥R)-mediated erythrophagocytosis, in addition to other IgG effector functions, such as activated complement, oxidative burst, and cytokine production by Fc␥R expressing effectors cells, play an essential role in shortened RBC survival. [7][8][9][10][11] The ability of normal human monocytes to bind and phagocyte IgG-sensitized RBCs via Fc␥R and mediate immune RBC destruction is highly related to the glycosylation status of the Fc domain on the anti-RBC antibodies. [12][13][14][15][16][17] Endoglycosidase S (EndoS) is secreted by Streptococcus pyogenes and has a specific endoglycosidase activity on native IgG by hydrolyzing the conserved asparagine-linked glycans on the heavy chains of IgG. 18,19 EndoS is the first known bacterial enzyme with a unique specificity for native IgG. EndoS affects the functionality of opsonizing IgG by decreased binding to Fc␥Rs on a monocyte-like cell line and impaired classic complement activation in vitro. 19 EndoS has recently been shown to modulate human IgG/Fc␥R interactions by influencing the binding/dissociation of IgG to soluble and cell-bound Fc␥R. 20 Furthermore, the pretreatment of pathogenic antibodies by EndoS has a protective function in a mouse model of collagen-induced arthritis, and EndoS cures mice from lethal IgG-driven immune thrombocytopenic purpura (ITP). 21,22 The present study was undertaken to establish the effects of EndoS on antibody-mediated destruction of RBCs with a future therapeutic application in mind. Here we show, using monocytes from blood and the THP-1 monocytic cell line, that pretreatment of anti-RBC with EndoS abrogates erythrophagocytosis and subsequent activation of monocytes. The complement-dependent hemolytic effects of anti-RBC added to whole human blood were greatly decreased by pretreatment of this antibody with EndoS. Finally and most importantly, EndoS showed inhibitory effects on a model of AIHA in mice. These...