NDLI: The pathogenesis and diagnosis of systemic lupus erythematosus: still not resolved

Content Provider	Springer Nature Link
Author	Rekvig, Ole Petter Van der Vlag, Johan
Copyright Year	2014
Abstract	Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with various clinical manifestations affecting different tissues. A characteristic feature of SLE is the presence of autoantibodies against double-stranded (ds)DNA, histones and nucleosomes, and other chromatin components. SLE is a prototype type III hypersensitivity reaction. Local deposition of anti-nuclear antibodies in complex with released chromatin induces serious inflammatory conditions by activation of the complement system. The severe renal manifestation, lupus nephritis, is classified based on histological findings in renal biopsies. Apoptotic debris, including chromatin, is present in the extracellular matrix and circulation of patients with SLE. This may be due to an aberrant process of apoptosis and/or insufficient clearance of apoptotic cells/chromatin. The non-cleared apoptotic debris may lead to activation of both the innate and adaptive immune systems. In addition, an aberrant presentation of peptides by antigen-presenting cells, disturbed selection processes for lymphocytes, and deregulated lymphocyte responses may be involved in the development of autoimmunity. In the present review, we briefly will summarize current knowledge on the pathogenesis of SLE. We will also critically discuss and challenge central issues that need to be addressed in order to fully understand the pathogenic mechanisms involved in the development of SLE and in order to have an improved diagnosis for SLE. Disappointingly, in our opinion, there are still more questions than answers for the pathogenesis, diagnosis, and treatment of SLE.
Starting Page	301
Ending Page	311
Page Count	11
File Format	PDF
ISSN	18632297
Journal	Springer Seminars in Immunopathology
Volume Number	36
Issue Number	3
e-ISSN	18632300
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2014-04-25
Publisher Place	Berlin, Heidelberg
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Systemic lupus erythematosus Lupus nephritis Chromatin Apoptosis NETs DNaseI Renal Immunology Internal Medicine
Content Type	Text
Resource Type	Article
Subject	Immunology and Allergy Immunology

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