REVIEW ARTICLE
Removal of dying cells and systemic lupus erythematosus
Gerhard E. Grossmayer1, Luis E. Munoz1, Udo S. Gaipl1, Sandra Franz1, Ahmed Sheriff1, Reinhard E. Voll2, Joachim R. Kalden1 and Martin Herrmann1
| (1) |
Institute for Clinical Immunology, Department of Medicine 3, Friedrich-Alexander University of Erlangen-Nuremberg, Gluckstrasse 4a, 91054 Erlangen, Germany |
| (2) |
IZKF Research Group N2, Nikolaus-Fiebiger Center of Molecular Medicine, Erlangen, Germany |
Received: 29 July 2005 Accepted: 23 August 2005
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Abstract Systemic lupus erythematosus (SLE) is a very heterogeneous systemic autoimmune disease, in which autoantibody synthesis against nuclear constituents is the main immunological characteristic. These autoantibodies underwent affinity maturation and isotype switching. Additionally, T-cell tolerance against nuclear autoantigens should be affected in these autoimmune patients. Nuclear material derived from apoptotic and/or necrotic cells may serve as an important source of autoantigens. However, dead and dying cells as well as cellular debris are rapidly removed from tissues by phagocytes without eliciting inflammation or immune responses under healthy conditions. During apoptosis nuclear components are strongly modified through enzymatic reactions. If these cells are not timely cleared, those autoantigens may be released, taken up, and presented by dendritic cells in tissues or presented by follicular dendritic cells in lymph nodes to T and B cells, respectively. This could be a mechanism for breaking the peripheral self-tolerance. In this article we focus on the deficient clearance of apoptotic cells in SLE patients and its importance in development of this autoimmune disease.
Key words Apoptosis - Autoimmunity - Clearance - Necrosis - Systemic lupus erythematosus (SLE)
G.E.G. and L.E.M. contributed equally to this work