自身免疫性疾病中补体蛋白和固有免疫的免疫病理学。

The Immunopathology of Complement Proteins and Innate Immunity in Autoimmune Disease.

机构信息

Laboratoire d'Immunologie, Pôle de Biologie, CHU Grenoble Alpes, 10217, Cedex 9, 38043, Grenoble, CS, France.

Université Grenoble Alpes, CNRS, CEA, IBS, F-38000, Grenoble, France.

出版信息

Clin Rev Allergy Immunol. 2020 Apr;58(2):229-251. doi: 10.1007/s12016-019-08774-5.

Abstract

The complement is a powerful cascade of the innate immunity and also acts as a bridge between innate and acquired immune defence. Complement activation can occur via three distinct pathways, the classical, alternative and lectin pathways, each resulting in the common terminal pathway. Complement activation results in the release of a range of biologically active molecules that significantly contribute to immune surveillance and tissue homeostasis. Several soluble and membrane-bound regulatory proteins restrict complement activation in order to prevent complement-mediated autologous damage, consumption and exacerbated inflammation. The crucial role of complement in the host homeostasis is illustrated by association of both complement deficiency and overactivation with severe and life-threatening diseases. Autoantibodies targeting complement components have been described to alter expression and/or function of target protein resulting in a dysregulation of the delicate equilibrium between activation and inhibition of complement. The spectrum of diseases associated with complement autoantibodies depends on which complement protein and activation pathway are targeted, ranging from autoimmune disorders to kidney and vascular diseases. Nevertheless, these autoantibodies have been identified as differential biomarkers for diagnosis or follow-up of disease only in a small number of clinical conditions. For some autoantibodies, a clear relationship with clinical manifestations has been identified, such as anti-C1q, anti-Factor H, anti-C1 Inhibitor antibodies and C3 nephritic factor. For other autoantibodies, the origin and the functional consequences still remain to be elucidated, questioning about the pathophysiological significance of these autoantibodies, such as anti-mannose binding lectin, anti-Factor I, anti-Factor B and anti-C3b antibodies. The detection of autoantibodies targeting complement components is performed in specialized laboratories; however, there is no consensus on detection methods and standardization of the assays is a real challenge. This review summarizes the current panorama of autoantibodies targeting complement recognition proteins of the classical and lectin pathways, associated proteases, convertases, regulators and terminal components, with an emphasis on autoantibodies clearly involved in clinical conditions.

摘要

补体是先天免疫系统的强大级联反应,也是先天免疫防御与获得性免疫防御之间的桥梁。补体激活可通过三条不同途径发生,即经典途径、替代途径和凝集素途径,每条途径都会导致共同的终末途径。补体激活导致一系列生物活性分子的释放,这些分子对免疫监视和组织稳态有重要贡献。几种可溶性和膜结合的调节蛋白限制补体激活,以防止补体介导的自身损伤、消耗和炎症加剧。补体在宿主稳态中的关键作用体现在补体缺乏和过度激活与严重的、危及生命的疾病有关。针对补体成分的自身抗体已被描述为改变靶蛋白的表达和/或功能,从而导致补体激活和抑制之间的微妙平衡失调。与补体自身抗体相关的疾病谱取决于靶补体蛋白和激活途径,范围从自身免疫性疾病到肾脏和血管疾病。然而,这些自身抗体仅在少数临床情况下被确定为诊断或疾病随访的差异生物标志物。对于一些自身抗体,已经确定了与临床表现的明确关系,例如抗 C1q、抗因子 H、抗 C1 抑制剂抗体和 C3 肾炎因子。对于其他自身抗体,其来源和功能后果仍有待阐明,这引发了对这些自身抗体的病理生理学意义的质疑,例如抗甘露糖结合凝集素、抗因子 I、抗因子 B 和抗 C3b 抗体。针对经典途径和凝集素途径的补体识别蛋白、相关蛋白酶、转化酶、调节剂和终末成分的自身抗体的检测在专门的实验室中进行;然而,目前还没有关于检测方法的共识,标准化检测方法是一个真正的挑战。本综述总结了目前针对经典途径和凝集素途径的补体识别蛋白、相关蛋白酶、转化酶、调节剂和终末成分的自身抗体的概况,重点介绍了明确与临床情况相关的自身抗体。

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