Background Systemic sclerosis (scleroderma) is characterizedby immunologic abnormalities, injury of endothelial cells, andtissue fibrosis. Abnormal oxidative stress has been documentedin scleroderma and linked to fibroblast activation. Since platelet-derivedgrowth factor (PDGF) stimulates the production of reactive oxygenspecies (ROS) and since IgG from patients with scleroderma reactswith human fibroblasts, we tested the hypothesis that patientswith scleroderma have serum autoantibodies that stimulate thePDGF receptor (PDGFR), activating collagen-gene expression.
Methods We analyzed serum from 46 patients with sclerodermaand 75 controls, including patients with other autoimmune diseases,for stimulatory autoantibodies to PDGFR by measuring the productionof ROS produced by the incubation of purified IgG with mouse-embryofibroblasts carrying inactive copies of PDGFR or chains orthe same cells expressing PDGFR or . Generation of ROS wasassayed with and without specific PDGFR inhibitors. Antibodieswere characterized by immunoprecipitation, immunoblotting, andabsorption experiments.
Results Stimulatory antibodies to the PDGFR were found in allthe patients with scleroderma. The antibodies recognized nativePDGFR, inducing tyrosine phosphorylation and ROS accumulation.Autoantibody activity was abolished by preincubation with cellsexpressing the PDGFR chain or with recombinant PDGFR or byPDGFR tyrosine kinase inhibitors. Stimulatory PDGFR antibodiesselectively induced the Ha-Ras-ERK1/2 and ROS cascades and stimulatedtype I collagengene expression and myofibroblast phenotypeconversion in normal human primary fibroblasts.
Conclusions Stimulatory autoantibodies against PDGFR appearto be a specific hallmark of scleroderma. Their biologic activityon fibroblasts strongly suggests that they have a causal rolein the pathogenesis of the disease.
Source Information
From the Dipartimento di Scienze Mediche e Chirurgiche, Sezione di Clinica Medica, Università Politecnica delle Marche, Ancona (S.S.B., F.B., M.L., T.S., M.M., P.F., P.S., A.G.); the Sezione di Fisiologia (M.S.) and the Dipartimento di Biologia e Patologia Molecolare e Cellulare, Centro di Endocrinologia ed Oncologia Sperimentale del CNR (E.V.A.), Università Federico II, Naples; the Dipartimento di Genetica, Biologia e Biochimica and the Research Center for Experimental Medicine, Università di Torino, Turin (A.F.) all in Italy; and Schepens Eye Research Institute, Harvard Medical School, Boston (A.K.).
Address reprint requests to Dr. Gabrielli at the Dipartimento di Scienze Mediche e ChirurgicheUniversità Politecnica delle Marche, Polo Didattico, Via Tronto 10, 60020 Ancona, Italy, or at a.gabrielli{at}univpm.it, or to Dr. Avvedimento at the Dipartimento di Biologia e Patologia Molecolare e Cellulare, Istituto di Endocrinologia ed Oncologia Sperimentale del CNR, Università Federico II, Via Pansini 5, 80131 Napoli, Italy, or at avvedim{at}unina.it.
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