Granzyme B inhibition reduces disease severity in autoimmune blistering diseases

Nat Commun. 2021 Jan 12;12(1):302. doi: 10.1038/s41467-020-20604-3.

Abstract

Pemphigoid diseases refer to a group of severe autoimmune skin blistering diseases characterized by subepidermal blistering and loss of dermal-epidermal adhesion induced by autoantibody and immune cell infiltrate at the dermal-epidermal junction and upper dermis. Here, we explore the role of the immune cell-secreted serine protease, granzyme B, in pemphigoid disease pathogenesis using three independent murine models. In all models, granzyme B knockout or topical pharmacological inhibition significantly reduces total blistering area compared to controls. In vivo and in vitro studies show that granzyme B contributes to blistering by degrading key anchoring proteins in the dermal-epidermal junction that are necessary for dermal-epidermal adhesion. Further, granzyme B mediates IL-8/macrophage inflammatory protein-2 secretion, lesional neutrophil infiltration, and lesional neutrophil elastase activity. Clinically, granzyme B is elevated and abundant in human pemphigoid disease blister fluids and lesional skin. Collectively, granzyme B is a potential therapeutic target in pemphigoid diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Autoantigens / metabolism
  • Autoimmune Diseases / enzymology*
  • Autoimmune Diseases / pathology*
  • Blister
  • Chemokine CXCL2 / metabolism
  • Chemotactic Factors / pharmacology
  • Collagen Type XVII
  • Disease Models, Animal
  • Epidermolysis Bullosa / enzymology
  • Epidermolysis Bullosa / pathology
  • Granzymes / antagonists & inhibitors*
  • Granzymes / metabolism*
  • Humans
  • Inflammation / pathology
  • Integrin alpha6 / metabolism
  • Interleukin-8 / metabolism
  • Neutrophil Infiltration / drug effects
  • Non-Fibrillar Collagens / metabolism
  • Pemphigoid, Bullous / enzymology
  • Pemphigoid, Bullous / pathology
  • Severity of Illness Index

Substances

  • Autoantigens
  • Chemokine CXCL2
  • Chemotactic Factors
  • Cxcl2 protein, mouse
  • Integrin alpha6
  • Interleukin-8
  • Non-Fibrillar Collagens
  • GZMB protein, human
  • Granzymes
  • Gzmb protein, mouse

Grants and funding