van Es L A, Daha M R
Adv Nephrol Necker Hosp. 1984;13:341-67.
The MPS plays an important role in the removal of both particulate and soluble immunogenic material from the circulation. E.IgG adhere to mononuclear phagocytes if the Fc portion of the IgG can interact with the phagocyte's Fc receptors (Fc gamma R). Simultaneous sensitization with IgG and C3b via complement activation enhances the effectiveness of binding and ingestion. E.IgM adhere mainly via C3b to C3b receptors (C3bR) of macrophages. Unstimulated macrophages do not ingest E.C3b. Stimulated macrophages, on the other hand, can ingest E.C3b. If soluble material cannot adhere to the surface of macrophages, it will be endocytosed in vitro via fluid-phase pinocytosis at the concentration that is present in the medium. If the material adheres to the cell's surface via its chemical properties or via specific receptors, it will be selectively concentrated at the cell's surface and endocytosed by adsorptive pinocytosis. Ingestion of IC via Fc gamma R and C3b depends on the ability of the antibodies to interact with Fc gamma R and their capacity to activate the complement system. IC-bound C3b enhances the adsorptive pinocytosis of IC. Soluble AIgG are also pinocytosed more effectively when C3b is bound to AIgG. The degree of endocytosis varies with the level of C3b sensitization. The highly effective C3b-mediated pinocytosis can be abolished by treating with trypsin to inactivate C3bR. This observation illustrates that C3b-mediated pinocytosis can replace Fc-mediated pinocytosis in unstimulated macrophages. When macrophages are stimulated in vivo, Fc-mediated pinocytosis increases significantly. Under these conditions, the binding of C3b no longer stimulates; instead, it sterically interferes with Fc-Fc gamma R interaction. In vivo, E.IgG are removed mainly by splenic macrophages. C4-deficient guinea pigs clear E.IgG less effectively than guinea pigs with an intact complement system. On the other hand, soluble IC and AIgG are removed from the circulation mainly by hepatic Kupffer cells. Complement depletion does not seem to influence the clearance rates of these soluble IC or AIgG. The different results obtained in vitro and in vivo and the finding that different effector organs are responsible for the removal of sensitized erythrocytes and soluble Ic in vivo, suggest that more reliable techniques have to be developed to measure IC clearance in patients with a supposedly deficient or saturated MPS.
单核吞噬细胞系统(MPS)在从循环中清除颗粒性和可溶性免疫原性物质方面发挥着重要作用。如果IgG的Fc部分能够与吞噬细胞的Fc受体(FcγR)相互作用,致敏红细胞(E.IgG)就会黏附于单核吞噬细胞。通过补体激活同时用IgG和C3b致敏可增强结合和摄取的效果。E.IgM主要通过C3b黏附于巨噬细胞的C3b受体(C3bR)。未受刺激的巨噬细胞不会摄取E.C3b。另一方面,受刺激的巨噬细胞能够摄取E.C3b。如果可溶性物质不能黏附于巨噬细胞表面,它将在体外以培养基中存在的浓度通过液相胞饮作用被内吞。如果该物质通过其化学性质或通过特异性受体黏附于细胞表面,它将被选择性地浓缩在细胞表面并通过吸附胞饮作用被内吞。通过FcγR和C3b摄取免疫复合物(IC)取决于抗体与FcγR相互作用的能力及其激活补体系统的能力。与IC结合的C3b可增强IC的吸附胞饮作用。当C3b与可溶性自身IgG(AIgG)结合时,AIgG也能更有效地被胞饮。内吞程度随C3b致敏水平而变化。用胰蛋白酶处理使C3bR失活可消除高效的C3b介导的胞饮作用。这一观察结果表明,在未受刺激的巨噬细胞中,C3b介导的胞饮作用可替代Fc介导的胞饮作用。当巨噬细胞在体内受到刺激时,Fc介导的胞饮作用显著增加。在这些条件下,C3b的结合不再起刺激作用;相反,它在空间上干扰Fc - FcγR相互作用。在体内,E.IgG主要被脾巨噬细胞清除。C4缺陷的豚鼠清除E.IgG的效率低于补体系统完整的豚鼠。另一方面,可溶性IC和AIgG主要通过肝库普弗细胞从循环中清除。补体耗竭似乎不影响这些可溶性IC或AIgG的清除率。体外和体内获得的不同结果以及体内不同效应器官负责清除致敏红细胞和可溶性IC的发现表明,必须开发更可靠的技术来测量假定MPS功能缺陷或饱和的患者的IC清除率。