Department of Microbiology and Immunology, Basic Medical College, Shanxi Medical University, Jinzhong, Shanxi 030619, P.R. China.
Department of Rheumatology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China.
Mol Med Rep. 2023 Nov;28(5). doi: 10.3892/mmr.2023.13091. Epub 2023 Sep 15.
Systemic lupus erythematosus (SLE) is a systemic autoimmune disorder caused by the loss of tolerance to endogenous nuclear antigens such as double‑stranded DNA, leading to the proliferation of T cells and subsequent activation of B cells, which results in serious organ damage and life‑threatening complications such as lupus nephritis. Lupus nephritis (LN) develops as a frequent complication of SLE, accounting for >60% of SLE cases, and is characterized by proteinuria and heterogeneous histopathological findings. Glomerular injury serves a role in proteinuria as podocyte damage is the leading contributor. Numerous studies have reported that podocytes are involved in the immune response that promotes LN progression. In LN, immune complex deposition stimulates dendritic cells to secrete inflammatory cytokines that activate T cells and B cells. B cells secrete autoantibodies that attack and damage the renal podocytes, leading to renal podocyte injury. The injured podocytes trigger inflammatory cells through the expression of toll‑like receptors and trigger T cells through major histocompatibility complexes and CD86, thereby participating in the local immune response and the exacerbation of podocyte injury. Based on the existing literature, the present review summarizes the research progress of podocytes in LN under the local immune microenvironment of the kidney, explores the mechanism of podocyte injury under the immune microenvironment, and evaluates podocytes as a potential therapeutic target for LN.
系统性红斑狼疮(SLE)是一种由对双链 DNA 等内源性核抗原的耐受性丧失引起的全身性自身免疫性疾病,导致 T 细胞增殖和随后 B 细胞的激活,从而导致严重的器官损伤和危及生命的并发症,如狼疮性肾炎。狼疮性肾炎(LN)是 SLE 的常见并发症之一,占 SLE 病例的>60%,其特征是蛋白尿和异质组织病理学发现。肾小球损伤在蛋白尿中起作用,因为足细胞损伤是主要贡献者。许多研究报告称,足细胞参与促进 LN 进展的免疫反应。在 LN 中,免疫复合物沉积刺激树突状细胞分泌炎症细胞因子,激活 T 细胞和 B 细胞。B 细胞分泌自身抗体攻击和破坏肾脏足细胞,导致肾脏足细胞损伤。受损的足细胞通过 Toll 样受体表达触发炎症细胞,并通过主要组织相容性复合物和 CD86 触发 T 细胞,从而参与局部免疫反应和足细胞损伤的加剧。基于现有文献,本综述总结了肾脏局部免疫微环境下 LN 中足细胞的研究进展,探讨了免疫微环境下足细胞损伤的机制,并评估了足细胞作为 LN 潜在治疗靶点的潜力。