Laboratoire d'Immunologie, Pôle de Biologie, CHU Grenoble Alpes, CS 10217, 38043 Grenoble Cedex 9, France; BNI TIMC-IMAG, UMR5525, CNRS-Université Grenoble Alpes, BP170, 38042 Grenoble Cedex 9, France.
Laboratoire d'Immunologie, Pôle de Biologie, CHU Grenoble Alpes, CS 10217, 38043 Grenoble Cedex 9, France; BNI TIMC-IMAG, UMR5525, CNRS-Université Grenoble Alpes, BP170, 38042 Grenoble Cedex 9, France.
Autoimmun Rev. 2018 Sep;17(9):890-899. doi: 10.1016/j.autrev.2018.03.013. Epub 2018 Jul 29.
Lupus nephritis (LN) is one of the most frequent and severe manifestations of systemic lupus erythematosus (SLE), considered as the major predictor of poor prognosis. An early diagnosis of LN is a real challenge in the management of SLE and has an important implication in guiding treatments. In clinical practice, conventional parameters still lack sensitivity and specificity for detecting ongoing disease activity in lupus kidneys and early relapse of nephritis. LN is characterized by glomerular kidney injury, essentially due to deposition of immune complexes involving autoantibodies against cellular components and circulating proteins. One of the possible mechanisms of induction of autoantibodies in SLE is a defect in apoptotic cells clearance and subsequent release of intracellular autoantigens. Autoantibodies against soluble protective molecules involved in the uptake of dying cells, including complement proteins and pentraxins, have been described. In this review, we present the main autoantibodies found in LN, with a focus on the antibodies against these protective molecules. We also discuss their pathogenic role and conclude with their potential interest as serological biomarkers in LN.
狼疮性肾炎（LN）是系统性红斑狼疮（SLE）最常见和最严重的表现之一，被认为是预后不良的主要预测因素。LN 的早期诊断是 SLE 治疗管理中的一个真正挑战，对指导治疗具有重要意义。在临床实践中，常规参数仍然缺乏敏感性和特异性，无法检测狼疮肾脏的持续疾病活动和肾炎的早期复发。LN 的特征是肾小球肾脏损伤，主要是由于涉及针对细胞成分和循环蛋白的自身抗体的免疫复合物沉积。SLE 中自身抗体产生的一个可能机制是凋亡细胞清除缺陷和随后细胞内自身抗原的释放。已经描述了针对参与摄取死亡细胞的可溶性保护分子的自身抗体，包括补体蛋白和五聚素。在这篇综述中，我们介绍了在 LN 中发现的主要自身抗体，重点介绍了针对这些保护分子的抗体。我们还讨论了它们的致病作用，并得出结论，它们作为 LN 的血清学标志物具有潜在的意义。
