Li Nicholas L, Birmingham Daniel J, Rovin Brad H
Department of Internal Medicine, Division of Nephrology, The Ohio State University, Columbus, OH 43210, USA.
J Clin Med. 2021 Feb 7;10(4):626. doi: 10.3390/jcm10040626.
The complement system is an innate immune surveillance network that provides defense against microorganisms and clearance of immune complexes and cellular debris and bridges innate and adaptive immunity. In the context of autoimmune disease, activation and dysregulation of complement can lead to uncontrolled inflammation and organ damage, especially to the kidney. Systemic lupus erythematosus (SLE) is characterized by loss of tolerance, autoantibody production, and immune complex deposition in tissues including the kidney, with inflammatory consequences. Effective clearance of immune complexes and cellular waste by early complement components protects against the development of lupus nephritis, while uncontrolled activation of complement, especially the alternative pathway, promotes kidney damage in SLE. Therefore, complement plays a dual role in the pathogenesis of lupus nephritis. Improved understanding of the contribution of the various complement pathways to the development of kidney disease in SLE has created an opportunity to target the complement system with novel therapies to improve outcomes in lupus nephritis. In this review, we explore the interactions between complement and the kidney in SLE and their implications for the treatment of lupus nephritis.
补体系统是一个先天性免疫监测网络，可抵御微生物、清除免疫复合物和细胞碎片，并连接先天性免疫和适应性免疫。在自身免疫性疾病的背景下，补体的激活和失调会导致不受控制的炎症和器官损伤，尤其是对肾脏的损伤。系统性红斑狼疮（SLE）的特征是耐受性丧失、自身抗体产生以及免疫复合物在包括肾脏在内的组织中沉积，并伴有炎症后果。早期补体成分有效清除免疫复合物和细胞废物可预防狼疮性肾炎的发生，而补体的不受控制激活，尤其是替代途径的激活，会促进SLE患者的肾脏损伤。因此，补体在狼疮性肾炎的发病机制中起双重作用。对各种补体途径在SLE肾病发展中的作用的进一步了解，为采用新疗法靶向补体系统以改善狼疮性肾炎的治疗效果创造了机会。在本综述中，我们探讨了SLE中补体与肾脏之间的相互作用及其对狼疮性肾炎治疗的影响。
