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Ulf Sibelius^*, Katja Hattar^*, Angelika Schenkel^*, Thomas Noll, Elena Csernok, Wolfgang Ludwig Gross, Werner-Johannes Mayet^||, Hans-Michael Piper, Werner Seeger^*, and Friedrich Grimminger^*

From the ^* Department of Internal Medicine, Justus-Liebig-University, D-35392 Giessen, Germany; the Institute of Physiology, Justus-Liebig-University, D-35392 Giessen, Germany; the Department of Rheumatology of the Medical University of Lübeck, 23538 Lübeck, Germany; and the ^|| First Medical Department, University of Mainz, 55131 Mainz, Germany

Anti–neutrophil cytoplasmic antibodies (ANCAs) targeting proteinase 3 (PR3) have a high specifity for Wegener's granulomatosis (WG), and their role in activating leukocytes is well appreciated. In this study, we investigated the influence of PR3-ANCA and murine monoclonal antibodies on human umbilical vascular endothelial cells (HUVECs). Priming of HUVECs with tumor necrosis factor induced endothelial upregulation of PR3 message and surface expression of this antigen, as measured by Cyto-ELISA, with a maximum occurrence after 2 h. Primed cells responded to low concentrations of both antibodies (25 ng–2.5 µg/ml), but not to control immunoglobulins, with pronounced, dose-dependent phosphoinositide hydrolysis, as assessed by accumulation of inositol phosphates. The signaling response peaked after 20 min, in parallel with the appearance of marked prostacyclin and platelet-activating factor synthesis. The F(ab)₂ fragment of ANCA was equally potent as ANCA itself. Disrupture of the endothelial F-actin content by botulinum C2 toxin to avoid antigen–antibody internalization did not affect the response. In addition to the metabolic events, anti-PR3 challenge, in the absence of plasma components, provoked delayed, dose-dependent increase in transendothelial protein leakage. We conclude that anti-PR3 antibodies are potent inductors of the preformed phosphoinositide hydrolysis–related signal tranduction pathway in human endothelial cells. Associated metabolic events and the loss of endothelial barrier properties suggest that anti-PR3–induced activation of endothelial cells may contribute to the pathogenetic sequelae of autoimmune vasculitis characterizing WG.

¹ Abbreviations used in this paper: ANCA, anti–neutrophil cytoplasmic antibodies; c-ANCA, cytoplasmic ANCA; HUVEC, human umbilical cord endothelial cell; IP, inositol phosphate; IPx, IP1, IP2, and IP3; MoAb-PR3, mAb to proteinase 3; PAF, platelet-activating factor; PR3, proteinase 3; WG, Wegener's granulomatosis.

This work was supported by the Deutsche Forschungsgemeinschaft (SFB 547).

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