Pathomechanisms of photosensitive lupus erythematosus.
Pathomechanisms of photosensitive lupus erythematosus.
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光敏性红斑狼疮的发病机制。
DOI：
10.1111/1523-1747.ep12355599
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
Norris,DA
中科院分区：
文献类型：
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作者：
Norris,DA
本文综述了不同光敏性狼疮综合征的发病机制：急性皮肤红斑狼疮、慢性皮肤红斑狼疮、亚急性皮肤红斑狼疮和新生儿红斑狼疮。我们认为狼疮光敏性的主要决定因素有三个：(1)对uvr诱导的表皮和真皮细胞因子释放的敏感性；(2)对uvr诱导的表皮或真皮中隔离抗原的释放或易位的易感性；(3)不同的特异性免疫效应机制，由细胞因子激活，直接针对离散的表皮靶点。本文详细讨论了光敏性狼疮的几个特征：自身抗体特异性、自身抗原易位、表皮细胞间粘附分子-a （ICAM-1）的诱导、血管活化、细胞因子释放和t细胞活化以及临床光检测。详细讨论了可提取核抗原Ro和La抗体的作用及其与亚急性皮肤红斑狼疮（SCLE）和新生儿红斑狼疮的关系，并提出了SCLE模型。
This review discusses the mechanisms involved in différent photosensitive lupus syndromes: acute cutaneous lupus erythematosus, chronic cutaneous (discoid) lupus erythematosus, subacute cutaneous lupus erythematosus, and neonatal lupus erythematosus. It is proposed that there are three principal determinants of photosensitivity in lupus: (1) susceptibility to UVR-induced release of epidermal and dermal cytokines; (2) susceptibility to UVR-induced release or translocation of sequestered antigens in the epidermis or dermis; and (3) different specific immunologic effector mechanisms, activated by cytokines and directed against discrete epidermal targets. Several characteristics of photosensitive lupus are discussed in detail: autoantibody specificities, autoantigen translocation, induction of epidermal intercellular adhesion molecule-a (ICAM-1), vascular activation, cytokine release and T-cell activation, and clinical phototesting. The role of antibodies to the extractable nuclear antigens Ro and La and the relationship to subacute cutaneous lupus erythematosus (SCLE) and neonatal lupus erythematosus is discussed in detail, and a model of SCLE is proposed.