Identifying autoimmune associated genes in patrolling monocytes that promote lupus nephritis - PROJECT SUMMARY
Lupus nephritis (LN) is seen in ~50% of individuals with the chronic autoimmune disease systemic lupus
erythematosus and is a serious cause of morbidity in this disease, with ~10% of SLE cases leading to end stage
renal disease within 5 years of diagnosis. LN occurs disproportionately in women of non-European ancestry,
including African-Americans, Hispanics and Asians, and despite many years of study, there are few targeted
treatments. The recent approval of the first two specific LN therapeutics, belimumab and voclosporin targeting
adaptive immune cells (T and B cells), was an important milestone. However, these therapeutics only have ~40%
efficacy. Thus, a major challenge in the field is to identify therapies that treat or prevent LN in all patients. There
is growing evidence that innate immune cells also contribute to LN. In particular, non-classical, patrolling
monocytes have recently been implicated in glomerulonephritis, suggesting that a novel innate immune
mechanism through recruitment of patrolling monocytes to the kidney contributes to LN, and that interfering with
accumulation of patrolling monocytes early in disease could be therapeutically efficacious. There are no existing
therapies that specifically target patrolling monocyte accumulation in the kidney, or other organs, thus, a better
understanding of the genes and mechanisms that drive this process holds promise for identifying new therapeutic
targets for LN and is the focus of this proposal. Informed by human lupus genetic risk loci, we will define key
genes involved in patrolling monocyte accumulation in the kidney in LN. Though many genetic risk variants have
been identified as associated with increased risk for SLE, the function of most genes regulated by these variants
have not been systematically assessed in innate immune cells such as monocytes. We hypothesize that genes
associated with GWAS risk variants may serve as a rich source of regulators of patrolling monocyte accumulation
in glomerular capillaries and therefore of LN. To understand how genetic risk loci contribute to patrolling
monocyte accumulation in LN, we will use an in vivo CRISPR screen using the TLR7.1 mouse model of lupus-
like disease with validation in additional mouse lupus models. Upon completion, we will illuminate genes and
pathways that may be targeted by novel therapeutic interventions, which could be used prior to the onset of
kidney nephritis. Additionally, risk haplotypes correlated with identified genes could help predict the efficacy of
such therapeutic approaches as well as risk for LN.