Means Terry K, Luster Andrew D
Center for Immunology and Inflammatory Diseases and Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, 149 13th St., Charlestown, MA 02129, USA.
Ann N Y Acad Sci. 2005 Dec;1062:242-51. doi: 10.1196/annals.1358.027.
Systemic lupus erythematosus (SLE) is characterized by the production of pathogenic autoantibodies to nucleoproteins and DNA. The level of anti-DNA antibodies correlates with disease severity, and the deposition of these immune complexes (ICs) in the kidneys is thought to contribute to disease pathogenesis. Recent evidence suggests that the DNA component of ICs purified from SLE patients (SLE DNA-ICs) contributes to the development of SLE pathology. SLE DNA-ICs induce proliferation of self-reactive B cells and cytokine production by plasmacytoid dendritic cells (PDCs) in a TLR9-dependent manner. One of the cytokines induced by DNA-containing ICs is interferon alpha (IFN-alpha). Elevated serum levels of IFN-alpha and overexpression of interferon-induced genes have been observed in SLE patient blood and shown to correlate with disease severity. We have recently found that the mechanism of IFN-alpha production by PDCs depends on TLR9 and FcgammaRIIa (CD32), and CD32 delivers SLE DNA-ICs to intracellular lysosomes containing TLR9. This CD32-TLR9 pathway, which is operative in PDCs, is distinct from the BCR/TLR9 pathway in B cells and may prove to be a novel target for future SLE therapies. In this article, the role of toll-like receptors, cytokines, and Fc receptors expressed by PDCs in the pathogenesis of SLE is summarized.
系统性红斑狼疮(SLE)的特征是产生针对核蛋白和DNA的致病性自身抗体。抗DNA抗体水平与疾病严重程度相关,并且这些免疫复合物(ICs)在肾脏中的沉积被认为与疾病发病机制有关。最近的证据表明,从SLE患者中纯化的ICs的DNA成分(SLE DNA-ICs)有助于SLE病理的发展。SLE DNA-ICs以TLR9依赖的方式诱导自身反应性B细胞增殖和浆细胞样树突状细胞(PDCs)产生细胞因子。含DNA的ICs诱导的细胞因子之一是干扰素α(IFN-α)。在SLE患者血液中观察到血清IFN-α水平升高和干扰素诱导基因的过表达,并且显示与疾病严重程度相关。我们最近发现,PDCs产生IFN-α的机制取决于TLR9和FcγRIIa(CD32),并且CD32将SLE DNA-ICs递送至含有TLR9的细胞内溶酶体。这种在PDCs中起作用的CD32-TLR9途径不同于B细胞中的BCR/TLR9途径,并且可能被证明是未来SLE治疗的新靶点。在本文中,总结了PDCs表达的Toll样受体、细胞因子和Fc受体在SLE发病机制中的作用。