Hristova M H, Stoyanova V S
1 Clinic of Nephrology, University Hospital Alexandrovska, Medical University - Sofia, Bulgaria.
2 Department of Chemistry, Biochemistry, Physiology and Pathophysiology, Sofia University "St. Kliment Ohridski", Bulgaria.
Lupus. 2017 Dec;26(14):1550-1555. doi: 10.1177/0961203317709347. Epub 2017 May 18.
Many complement structures and a number of additional factors, i.e. autoantibodies, receptors, hormones and cytokines, are implicated in the complex pathogenesis of systemic lupus erythematosus. Genetic defects in the complement as well as functional deficiency due to antibodies against its components lead to different pathological conditions, usually clinically presented. Among them hypocomplementemic urticarial vasculitis, different types of glomerulonephritis as dense deposit disease, IgA nephropathy, atypical haemolytic uremic syndrome and lupus nephritis are very common. These antibodies cause conformational changes leading to pathological activation or inhibition of complement with organ damage and/or limited capacity of the immune system to clear immune complexes and apoptotic debris. Finally, we summarize the role of complement antibodies in the pathogenesis of systemic lupus erythematosus and discuss the mechanism of some related clinical conditions such as infections, thyroiditis, thrombosis, acquired von Willebrand disease, etc.
许多补体结构以及一些其他因素,即自身抗体、受体、激素和细胞因子,都与系统性红斑狼疮复杂的发病机制有关。补体的基因缺陷以及针对其成分的抗体导致的功能缺陷会引发不同的病理状况,通常会有临床症状表现。其中,低补体血症性荨麻疹性血管炎、不同类型的肾小球肾炎如致密物沉积病、IgA肾病、非典型溶血性尿毒症综合征和狼疮性肾炎都很常见。这些抗体引起构象变化,导致补体的病理激活或抑制,进而造成器官损伤和/或免疫系统清除免疫复合物及凋亡碎片的能力受限。最后,我们总结了补体抗体在系统性红斑狼疮发病机制中的作用,并讨论了一些相关临床病症如感染、甲状腺炎、血栓形成、获得性血管性血友病等的发病机制。