Functional Interaction of the Ankylosing Spondylitis-associated Endoplasmic Reticulum Aminopeptidase 1 Polymorphism and HLA-B27 in Vivo

The association of ERAP1 with ankylosing spondylitis (AS)¹ among HLA-B27-positive individuals suggests that ERAP1 polymorphism may affect pathogenesis by altering peptide-dependent features of the HLA-B27 molecule. Comparisons of HLA-B*27:04-bound peptidomes from cells expressing different natural variants of ERAP1 revealed significant differences in the size, length, and amount of many ligands, as well as in HLA-B27 stability. Peptide analyses suggested that the mechanism of ERAP1/HLA-B27 interaction is a variant-dependent alteration in the balance between epitope generation and destruction determined by the susceptibility of N-terminal flanking and P1 residues to trimming. ERAP1 polymorphism associated with AS susceptibility ensured efficient peptide trimming and high HLA-B27 stability. Protective polymorphism resulted in diminished ERAP1 activity, less efficient trimming, suboptimal HLA-B27 peptidomes, and decreased molecular stability. This study demonstrates that natural ERAP1 polymorphism affects HLA-B27 antigen presentation and stability in vivo and proposes a mechanism for the interaction between these molecules in AS.The mechanism underlying the strong association of HLA-B27 with ankylosing spondylitis (AS) remains unknown. Three main possibilities, each one based on a different molecular feature of HLA-B27, are currently being investigated. The arthritogenic peptide hypothesis (1), based on the canonic antigen-presenting properties of Major Histocompatibility Complex class I (MHC-I) molecules, assumes that a peptide epitope of external origin would activate HLA-B27-restricted T-cells, whose cross-reactivity with a self-derived HLA-B27 ligand would result in autoimmune damage. The misfolding hypothesis (2) is based on the slow folding and tendency to misfold of HLA-B27 (3, 4). An accumulation of misfolded heavy chains (HCs) in the endoplasmic reticulum (ER) would elicit an unfolded protein response and activate pro-inflammatory pathways. The surface homodimer hypothesis (5, 6) is based on the expression of HLA-B27 HC homodimers at the cell surface and their recognition by leukocyte receptors (7), which leads to immunomodulation of inflammatory responses. Because the constitutive binding of endogenous peptides by MHC-I molecules determines not only their antigen-presenting specificity, but also their folding and stability, it was proposed that the HLA-B27 peptidome, through its global influence on the biological behavior of the molecule, is critical to its pathogenetic role (8). This idea found strong support with the discovery of the association of ER aminopeptidase (ERAP) 1 with AS (9) in HLA-B27-positive, but not B27-negative, disease (10). With an estimated population attributable risk of 26%, ERAP1 is the non-MHC gene most strongly associated with AS. Given that ERAP1 is involved in the N-terminal trimming of peptides to their optimal size for MHC-I binding (11–13), its association with AS suggests a pathogenetic mechanism of functional interaction with HLA-B27 that influences peptide binding and antigen presentation. ERAP1 trimming is limited by peptide size, becoming highly inefficient for 8-mers and shorter peptides (13, 14). This is a seemingly unique feature of ERAP1 that is not even shared by its analog ERAP2 (14, 15). The only putative exception, which has not been entirely ruled out, might be insulin-regulated amino peptidase (IRAP), an endosomal analog of ERAP1 involved in cross-presentation, but probably not in processing of constitutive MHC-I ligands (16, 17). IRAP degrades peptides to smaller products than ERAP1 in vitro (18). The three-dimensional structure of ERAP1 reveals a substrate binding cavity close to the catalytic site, as well as four domains; the conformational rearrangement between an open and a closed conformation, presumably induced upon substrate binding, regulates its enzymatic activity (19, 20). The polymorphic residues found among natural ERAP1 variants (21), and often co-occurring in complex allotypes, are located in various topological regions, including some in close proximity to the catalytic site, the substrate binding cavity, or domain junctions. Therefore, they might alter ERAP1 activity by directly affecting catalysis, altering substrate binding, or modulating domain rearrangements. The association of ERAP1 with AS does not by itself reveal the specific feature(s) determining the pathogenetic role of HLA-B27. Indeed, ERAP1 might influence the generation of specific pathogenetic epitopes; have a general effect on the HLA-B27 peptidome, altering the stability or other features of the molecule; or both. This study investigated general effects of ERAP1 polymorphism on the HLA-B27 peptidome by comparing the size distribution, molecular features, and N-terminal flanking sequences of peptides from human cells expressing the AS-associated B*27:04 subtype and different natural variants of ERAP1.