Parris T M, Kimberly R P, Inman R D, McDougal J S, Gibofsky A, Christian C L
Ann Intern Med. 1982 Oct;97(4):526-32. doi: 10.7326/0003-4819-97-4-526.
To determine whether patients with systemic lupus erythematosus and nephritis have more profound defects in mononuclear phagocyte system clearance than their counterparts without renal disease, we studed Fc receptor-mediated splenic clearance function in 32 patients. Clearance half-times were prolonged in patients with lupus erythematosus compared with those in normal controls (p less than 0.0001) and longer in patients with renal disease than in those without (p less than 0.025). Both renal (tau = 0.45, p less than 0.0002) and nonrenal (tau = 0.35, p less than 0.003) disease activity were significantly but independently associated with clearance half-times. When matched for nonrenal activity, patients with nephritis had greater clearance dysfunction than their counterparts without renal disease. Circulating immune complexes did not correlate with clearance for all patients. Neither B8 nor DR3 histocompatibility antigen markers differentiated the renal and nonrenal disease subgroups. The greater Fc receptor-mediated clearance dysfunction, which occurs in patients with lupus erythematosus and nephritis, could lead to enhanced glomerular deposition of immune complexes as a primary event, or as a secondary event amplifying previously established lesions.
为了确定系统性红斑狼疮肾炎患者的单核吞噬细胞系统清除功能是否比无肾脏疾病的患者存在更严重的缺陷，我们研究了32例患者的Fc受体介导的脾脏清除功能。与正常对照组相比，红斑狼疮患者的清除半衰期延长（p<0.0001），且肾病患者的半衰期比无肾病患者更长（p<0.025）。肾脏疾病活动（tau=0.45，p<0.0002）和非肾脏疾病活动（tau=0.35，p<0.003）均与清除半衰期显著且独立相关。在非肾脏疾病活动匹配的情况下，肾炎患者的清除功能障碍比无肾脏疾病的患者更严重。所有患者的循环免疫复合物与清除功能均无相关性。B8和DR3组织相容性抗原标记物均不能区分肾脏疾病和非肾脏疾病亚组。红斑狼疮肾炎患者中出现的Fc受体介导的清除功能障碍增强，可能作为主要事件导致免疫复合物在肾小球的沉积增加，或作为放大先前已形成病变的次要事件。
