Absence of β₂ integrins impairs regulatory T cells and exacerbates CD4⁺ T cell-dependent autoimmune carditis

The immunopathogenic mechanisms mediating inflammation in multiorgan autoimmune diseases may vary between the different target tissues. We used the K/BxN TCR transgenic mouse model to investigate the contribution of CD4 ⁺ T cells and β₂ integrins in the pathogenesis of autoimmune arthritis and endocarditis. Depletion of CD4⁺ T cells following the onset of arthritis specifically prevented the development of cardiac valve inflammation. Genetic absence of β₂ integrins had no effect on the severity of arthritis and unexpectedly increased the extent of cardiovascular pathology. The exaggerated cardiac phenotype of the β₂ integrin-deficient K/BxN mice was accompanied by immune hyperactivation and was linked to a defect in regulatory T cells. These findings are consistent with a model in which the development of arthritis in K/BxN mice relies primarily on autoantibodies, whereas endocarditis depends on an additional contribution of effector T cells. Furthermore, strategies targeting β₂ integrins for the treatment of systemic autoimmune conditions need to consider not only the role of these molecules in leukocyte recruitment to sites of inflammation, but also their impact on the regulation of immunological tolerance.