Mei Xiaole, Jin Hui, Zhao Ming, Lu Qianjin
Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
Key Laboratory of Basic and Translational Research on Immunological Dermatology, Chinese Academy of Medical Sciences, Nanjing, China.
Kidney Dis (Basel). 2022 Jun 9;8(4):286-296. doi: 10.1159/000524937. eCollection 2022 Jul.
The familial clustering phenomenon together with environmental influences indicates the presence of a genetic and epigenetic predisposition to systematic lupus erythematosus (SLE). Interestingly, regarding lupus nephritis (LN), the worst complication of SLE, mortality, and morbidity were not consistent with SLE in relation to sexuality and ethnicity.
Genetic and epigenetic alterations in LN include genes and noncoding RNAs that are involved in antigen-presenting, complements, immune cell infiltration, interferon pathways, and so on. Once genetic or epigenetic change occurs alone or simultaneously, they will promote the formation of immune complexes with autoantibodies that target various autoantigens, which results in inflammatory cytokines and autoreactive immune cells colonizing renal tissues and contributing to LN.
Making additional checks for immunopathology-related heredity and epigenetic factors may lead to a more holistic perspective of LN.
家族聚集现象以及环境影响表明系统性红斑狼疮(SLE)存在遗传和表观遗传易感性。有趣的是,关于狼疮性肾炎(LN)这一SLE最严重的并发症,其死亡率和发病率在性别和种族方面与SLE并不一致。
LN中的遗传和表观遗传改变包括参与抗原呈递、补体、免疫细胞浸润、干扰素途径等的基因和非编码RNA。一旦遗传或表观遗传变化单独或同时发生,它们将促进与靶向各种自身抗原的自身抗体形成免疫复合物,这导致炎性细胞因子和自身反应性免疫细胞在肾组织中定植并促成LN。
对免疫病理学相关的遗传和表观遗传因素进行额外检查可能会使对LN有更全面的认识。