Centre de Recherche sur l'Inflammation, INSERM UMR1149, CNRS ERL8252, Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine site Bichat, Laboratoire d'Excellence Inflamex, DHU FIRE, Paris, France.
Service de Néphrologie, Hôpital Bichat, AP-HP, Université Paris Diderot, DHU FIRE, INSERM U1149, Paris, France.
Nephrol Dial Transplant. 2019 May 1;34(5):750-756. doi: 10.1093/ndt/gfy245.
Lupus nephritis (LN) affects a large proportion of patients with systemic lupus erythematosus (SLE). LN can lead to end-stage renal disease depending on when it is diagnosed and on the adequacy of the treatment administered to the patient based on the class of LN. Determination of the class and activity of LN is only possible by histological analysis of kidney biopsies. In this context, the development of non-invasive early diagnostic tools for determining the class of LN and biomarkers predicting the response to treatment would greatly benefit patients with SLE. Basophils, which are one of the rarest types of circulating leucocytes, are well-established effectors of allergic and parasitic diseases. Recent advances in the understanding of the immune regulatory role of basophils in several auto immune conditions, including SLE and LN, have demonstrated their involvement in the amplification of auto-antibody production and LN pathogenesis in both human SLE and lupus-like mouse models. The present review summarizes the currently available literature describing dysregulation of basophil counts, basophil activation status and basophil activating factors in patients with SLE and the involvement of basophils in the pathogenesis of SLE. We also discuss the potential utility of these biological and immunological parameters as diagnostic and prognostic biomarkers, used alone or in combination with other known SLE and LN activity biomarkers. Finally, considering basophils as contributors to the disease, they may also constitute a future treatment target for the management of SLE and LN.
狼疮肾炎（LN）影响了很大一部分系统性红斑狼疮（SLE）患者。LN 可导致终末期肾病，具体取决于何时诊断以及根据 LN 类别为患者提供的治疗是否充分。只有通过肾活检的组织学分析才能确定 LN 的类别和活动。在这种情况下，开发用于确定 LN 类别的非侵入性早期诊断工具以及预测治疗反应的生物标志物将使 SLE 患者受益匪浅。嗜碱性粒细胞是循环白细胞中最罕见的类型之一，是过敏和寄生虫病的有效效应物。最近对嗜碱性粒细胞在包括 SLE 和 LN 在内的几种自身免疫性疾病中的免疫调节作用的理解的进展表明，它们参与了自身抗体产生的放大和人类 SLE 和狼疮样小鼠模型中的 LN 发病机制。本综述总结了目前描述 SLE 患者嗜碱性粒细胞计数、嗜碱性粒细胞活化状态和嗜碱性粒细胞激活因子失调以及嗜碱性粒细胞在 SLE 发病机制中的参与情况的可用文献。我们还讨论了这些生物学和免疫学参数作为诊断和预后生物标志物的潜在用途，单独使用或与其他已知的 SLE 和 LN 活性生物标志物联合使用。最后，考虑到嗜碱性粒细胞是疾病的促成因素，它们也可能成为 SLE 和 LN 管理的未来治疗靶点。
