Mechanisms of the pathogenic autoimmune response in lupus: prospects for specific immunotherapy.

A major step towards understanding the basic mechanism of systemic lupus erythematosus (SLE), the prototypic autoimmune disease that develops spontaneously, has been the identification of nucleosomes as a primary immunogen in this disease. The production of pathogenic autoantibodies in SLE results from an MHC class-II-restricted, cognate interaction between select populations of T helper cells and B cells that are specific for nucleosomal components. These observations pave the way for specific immunotherapy that blocks this pathogenic T and B cell interaction.