Antinuclear Antibody Crossreacts with IgG Fc Fragments: The Nature of Immune Complexes in Lupus Nephritis in Humans and NZB/WF1 Mice

Author(s):  
Tetsuzo Sugisaki ◽  
Takanori Shibata ◽  
Hisashi Kawasumi ◽  
Shigeru Takase
2021 ◽  
Vol 5 (3) ◽  
pp. 698-703
Author(s):  
Ramadhan Ananda Putra ◽  
Raveinal ◽  
Fauzar ◽  
Deka Viotra

COVID-19 outbreak is currently being concerned for managing patients withimmunological disorders nowadays, including SLE. Lupus is a complexautoimmune disease characterized by the presence of autoantibodies that againstcell nucleus involved many organs in the body. Patients with SLE will increaserisk of severe infection because the intrinsic respond attack with their immunerespond though immunosuppressive drugs consumption, and will potentiallydamage some organs target associated with their disease. Lupus have multipleclinical manifestations with a fluctuating symptom. Patient who come with thesymptom ofbreathlessness will getworse day by day. The symptom could be felt inthe same time as fatigue, joint pain, hair loss, malar rash, oral ulcer, pleuraleffusion and swollen feet. There's a patient with antinuclear antibody positive foranti-smith and anti-Ro/SS-A. She was diagnosed with COVID-19, SLE withnephritis, haemolytic anemia, vasculitis and pleural effusions. The clinicalmanifestations of this patient indicate a COVID-19 with lupus nephritis that hassevere disease. She was being treated with methylprednisolone andhydroxychloroquine for SLE and azithromycin plus oseltamivir as a therapy forCOVID-19. The effect of hydroxychloroquine on SARS-CoV-2 was better seen inpatients with SLE who gotthe medication regularly. Patients went home after 24days of hospitalization after negative RT-PCR results and clinical improvement ofLES.


Lupus ◽  
1993 ◽  
Vol 2 (1_suppl) ◽  
pp. 261-268 ◽  
Author(s):  
Tatsuo Yamamoto ◽  
Mitsumasa Nagase ◽  
Akira Hishida ◽  
Nishio Honda

The significance of interstitial inflammatory and chronic tubulointerstitial lesions was studied in relation to the severity of glomerular lesions in 62 patients with lupus nephritis and 88 with IgA nephropathy. Severe interstitial inflammatory and chronic tubulointerstitial lesions were found in patients with severe glomerular lesions in both lupus nephritis and IgA nephropathy. In such cases, the serum creatinine levels at biopsy were high and the renal prognosis was poor regardless of the underlying disease (lupus nephritis or IgA nephropathy). No IgA nephropathy patients with nil or mild glomerular lesions had moderate or severe interstitial inflammatory and/or chronic tubulointerstitial lesions. In contrast, predominantly severe interstitial inflammatory lesions were found in 36% of lupus nephritis patients with nil or mild glomerular lesions. The prevalence of interstitial immune complexes deposition was markedly high in those with predominant interstitial inflammatory lesions. However, the severity of chronic tubulointerstitial lesions was mild and renal function did not deteriorate in the mean follow-up periods of 68.6 months. It is suggested that, besides the tubulointerstitial lesions attributable to the severe concomitant glomerular damage, the interstitial deposition of immune complexes per se plays a pathogenic role in the interstitial inflammatory lesions in lupus nephritis. Its prognostic significance, however, was considered to be minor.


Lupus ◽  
2011 ◽  
Vol 20 (13) ◽  
pp. 1396-1403 ◽  
Author(s):  
AA Satoskar ◽  
SV Brodsky ◽  
G Nadasdy ◽  
C Bott ◽  
B Rovin ◽  
...  

Background and objectives: Lupus nephritis is characterized by glomerular and extraglomerular immune complex deposition in the kidney. It is unclear whether the same circulating immune complexes deposit in the glomeruli and in extraglomerular structures, or whether they are pathogenetically different. Differences in the IgG subclass composition may point towards different pathways in the formation of glomerular and extraglomerular immune complexes. Therefore we investigated IgG subclass distribution in the immune complex deposits at these anatomic sites. Design: A total of 84 biopsies diagnosed as lupus nephritis and classified according to the International Society of Nephrology/Renal Pathology Society (ISN/RPS) 2003 classification, were examined by direct immunofluorescence staining for IgG subclasses. The IgG subclass composition in the glomerular, tubular basement membrane (TBM) and vascular wall deposits was compared. We also correlated the presence/absence of interstitial inflammation and IgG subclasses in the TBM and vascular deposits. Lastly, we looked for correlation between staining for IgG subclasses and complement C1q and C3 staining. Results: IgG staining was present in the TBM in 52/84 biopsies, and in the vascular walls in 40/84 biopsies. IgG subclass distribution was discrepant between glomerular and TBM deposits in 36/52 biopsies, and between glomerular and vascular deposits in 27/40 biopsies. Interstitial inflammation did not correlate with the presence of IgG staining or distribution of IgG subclasses in the TBM. Interstitial inflammation was more common in biopsies of African–American patients than Caucasian patients. The IgG subclass staining correlated with C1q staining in all the three compartments. Conclusions: The antibody composition of the glomerular and extraglomerular immune complex deposits appear to differ from each other. They may not represent the same preformed immune complexes from the circulation. It is likely that their pathogenesis and site of formation are different.


Nephron ◽  
1982 ◽  
Vol 32 (4) ◽  
pp. 320-328 ◽  
Author(s):  
R. Coppo ◽  
G.M. Bosticardo ◽  
B. Basolo ◽  
M. Messina ◽  
G. Mazzucco ◽  
...  

The Lancet ◽  
1977 ◽  
Vol 309 (8011) ◽  
pp. 564-567 ◽  
Author(s):  
R.J. Levinsky ◽  
J.S. Cameron ◽  
J.F. Soothill

1991 ◽  
Vol 91 (4) ◽  
pp. 355-362 ◽  
Author(s):  
Takeshi Sasaki ◽  
Tai Muryoi ◽  
Akira Hatakeyama ◽  
Masahiko Suzuki ◽  
Hiroshi Sato ◽  
...  

2017 ◽  
Vol 137 (10) ◽  
pp. S267
Author(s):  
F. Olaru ◽  
T. Döbel ◽  
A. Lonsdorf ◽  
S. Oehrl ◽  
A. Enk ◽  
...  

2021 ◽  
Vol 10 (4) ◽  
pp. 626
Author(s):  
Nicholas L. Li ◽  
Daniel J. Birmingham ◽  
Brad H. Rovin

The complement system is an innate immune surveillance network that provides defense against microorganisms and clearance of immune complexes and cellular debris and bridges innate and adaptive immunity. In the context of autoimmune disease, activation and dysregulation of complement can lead to uncontrolled inflammation and organ damage, especially to the kidney. Systemic lupus erythematosus (SLE) is characterized by loss of tolerance, autoantibody production, and immune complex deposition in tissues including the kidney, with inflammatory consequences. Effective clearance of immune complexes and cellular waste by early complement components protects against the development of lupus nephritis, while uncontrolled activation of complement, especially the alternative pathway, promotes kidney damage in SLE. Therefore, complement plays a dual role in the pathogenesis of lupus nephritis. Improved understanding of the contribution of the various complement pathways to the development of kidney disease in SLE has created an opportunity to target the complement system with novel therapies to improve outcomes in lupus nephritis. In this review, we explore the interactions between complement and the kidney in SLE and their implications for the treatment of lupus nephritis.


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