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    Proc Natl Acad Sci U S A. 2007 Apr 10;104(15):6317-22. Epub 2007 Apr 2.

    Subversion of B lymphocyte tolerance by hydralazine, a potential mechanism for drug-induced lupus.

    Mazari L, Ouarzane M, Zouali M.

    Institut National de la Santé et de la Recherche Médicale, U430, University of Paris 6, F-75674 Paris, France.

    Accumulating evidence indicates that epigenetic alterations contribute to exacerbated activation or deregulation of the mechanisms that maintain tolerance to self-antigens in patients with lupus, a systemic autoimmune disease that can be triggered by medications taken to treat a variety of conditions. Here, we tested the effect of hydralazine, an antihypertensive drug that triggers lupus, on receptor editing, a chief mechanism of B lymphocyte tolerance to self-antigens. Using mice expressing transgenic human Igs, we found that hydralazine impairs up-regulation of RAG-2 gene expression and reduces secondary Ig gene rearrangements. Receptor editing was also partially abolished in a dose-dependent manner by a specific inhibitor of MEK1/2. Adoptive transfer of bone marrow B cells pretreated with hydralazine or with a MEK inhibitor to naïve syngeneic mice resulted in autoantibody production. We conclude that, by disrupting receptor editing, hydralazine subverts B lymphocyte tolerance to self and contributes to generation of pathogenic autoreactivity. We also postulate that inhibition of the Erk signaling pathway contributes to the pathogenesis of hydralazine-induced lupus and idiopathic human lupus.

    PMID: 17404230 [PubMed - indexed for MEDLINE]

    PMCID: 1851062

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