1(st) Department of Propedeutic and Internal Medicine, University of Athens Medical School, Athens, Greece.
Semin Arthritis Rheum. 2010 Jun;39(6):491-503. doi: 10.1016/j.semarthrit.2008.11.002. Epub 2009 Jan 15.
To review current developments, regarding the pathophysiologic role of monocytes and macrophages in systemic lupus erythematosus (SLE).
We searched Medline for articles written in the English language using the following terms: monocyte(s) or macrophage(s) and lupus. Although our search spanned the years 1971 to 2008, the majority of the short-listed articles belonged to the period 2000 to 2008. Published literature on phenotypic and functional properties of monocytes/macrophages (Mo/Mphi) in SLE was reviewed. References from identified articles were also selected. Currently available experimental data and their relevance to the pathogenesis of SLE are critically discussed.
It has traditionally been held that impaired phagocytosis by monocytes and macrophages in SLE allows for the accumulation of apoptotic debris leading to a sequel of autoimmune phenomena. Recent paradigms derived from animal models of systemic autoimmunity, however, has broadened our understanding regarding the possible pathophysiologic roles of Mo/Mphi in SLE. Data derived from studies in patients with SLE show multiple aberrations in activation status and secretory functions of circulating and tissue-infiltrating Mo/Mphi. Such aberrations may be associated with dysregulation of T-cell function and autoantibody production in SLE. Moreover, emerging evidence suggests that phagocytic capacity and antigen-presenting properties of Mo/Mphi are enhanced in some patients with SLE.
While defective phagocytosis represents a distinctive feature of monocyte function in some patients with SLE, aberrant activation of the Mo/Mphi system may be a more appropriate concept to encompass the broad spectrum of Mo/Mphi disorders in SLE. Aberrant function of lupus Mo/Mphi appears to play a dynamic role in the initiation and perpetuation of the systemic autoimmune response and organ damage. Delineation of the altered biology of lupus Mo/Mphi could provide possible future therapeutic targets for patients with SLE.
综述目前关于单核细胞和巨噬细胞在系统性红斑狼疮（SLE）中的病理生理作用的研究进展。
我们使用以下术语在 Medline 中搜索英文文献：单核细胞或巨噬细胞和狼疮。尽管我们的搜索涵盖了 1971 年至 2008 年的年份，但大部分入选的文章都属于 2000 年至 2008 年的时间段。我们综述了 SLE 中单核细胞/巨噬细胞（Mo/Mphi）的表型和功能特性的已发表文献。还选择了确定文章中的参考文献。批判性地讨论了当前可用的实验数据及其与 SLE 发病机制的相关性。
传统上认为 SLE 中单核细胞和巨噬细胞的吞噬作用受损会导致凋亡碎片的积累，从而导致自身免疫现象的一系列后果。然而，源于系统性自身免疫动物模型的新范例拓宽了我们对 Mo/Mphi 在 SLE 中可能的病理生理作用的理解。来自 SLE 患者的研究数据显示，循环和组织浸润的 Mo/Mphi 的激活状态和分泌功能存在多种异常。这些异常可能与 SLE 中 T 细胞功能和自身抗体产生的失调有关。此外，新出现的证据表明，一些 SLE 患者的吞噬能力和抗原呈递特性增强。
虽然吞噬作用缺陷是一些 SLE 患者单核细胞功能的一个特征，但 Mo/Mphi 系统的异常激活可能是一个更合适的概念，以涵盖 SLE 中 Mo/Mphi 紊乱的广泛谱。狼疮 Mo/Mphi 的异常功能似乎在启动和维持全身性自身免疫反应和器官损伤中发挥了动态作用。阐明狼疮 Mo/Mphi 的改变生物学特性可能为 SLE 患者提供未来可能的治疗靶点。
