Sjögren Syndrome Candidate Autoantigen AQP5 Triggers AQP4 CNS Autoimmunity Through Self-Antigen Mimicry.

BACKGROUND AND

objectivesAquaporin (AQP)-4 (AQP4)-seropositive neuromyelitis optica (NMO) frequently coexists with rheumatologic autoimmune conditions, including Sjögren syndrome and systemic lupus erythematosus, 2 conditions that share a common

methodsPreviously, we examined binding of AQP4 T-cell epitopes to MHC II (I-A

resultsThe immunodominant AQP4 T-cell epitope was predicted to make optimal contacts within the pockets of the MHC II antigen-binding cleft. Like AQP4, the corresponding homologous AQP5 amino acid sequence was predicted to bind MHC II, albeit with modest affinity. In a reciprocal manner, T cells were detected that proliferated to both AQP4 and AQP5. Multi-tetramer analysis of individual T cells demonstrated that the same TCR could engage both AQP4 and AQP5. T cells from mice immunized with AQP4 or AQP5 caused paralysis and CNS inflammation in recipient mice, but not in AQP4-deficient mice, demonstrating that AQP4 expression is obligately required in this model of aquaporin CNS autoimmunity. DISCUSSION: T cells can express TCRs that recognize multiple AQPs. Autoimmunity can be initiated through molecular mimicry between distinct self-antigens such as AQP4 and AQP5 that are expressed in separate organs. These findings suggest that T-cell self-antigen mimicry may contribute to coexistence of NMO with other autoimmune conditions, such as Sjögren syndrome.