Pathogenesis of cutaneous lupus erythematosus.
Pathogenesis of cutaneous lupus erythematosus.
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DOI：
10.1016/0738-081x(85)90075-6
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发表时间：
1985-07-01
影响因子：
2.7
通讯作者：
Lee, L A
中科院分区：
文献类型：
--
作者：
Norris, D A;Lee, L A
组织损伤的抗体依赖性机制是系统性和皮肤性红斑狼疮疾病的主要机制。角质形成细胞损伤的抗体依赖性机制似乎是所有形式的丘疹鳞状皮肤狼疮的主要致病因素。光敏性丘疹鳞状狼疮综合征，如亚急性皮肤 LE、新生儿 LE、“ANA 阴性”LE 和补体缺陷 LE 均与核糖核蛋白 SSA 抗体密切相关。越来越多的证据表明，在所有这些狼疮综合征中，SSA（或许还有 SSB）抗体会诱导基底角质形成细胞产生抗体依赖性细胞介导的细胞毒性（ADCC）。越来越多的证据表明，皮肤 LE 综合征中的自身抗体直接参与疾病发病机制，而不仅仅是疾病亚型的标志物。光敏性抗 SSA 相关 LE 综合征与更经典的盘状 LE 或 SLE 患者中的急性丘疹鳞状 LE 之间的关系仍有待研究。在盘状 LE 和急性 LE 中，都可以看到基底角质形成细胞损伤，就像抗 SSA 相关的光敏 LE 综合征一样，但其他抗原抗体系统可能参与引发角质形成细胞损伤，或者其他细胞毒性机制可能产生这些综合征的角质形成细胞损伤特征。
Antibody-dependent mechanisms of tissue damage are the principle mechanism of disease in systemic and cutaneous lupus erythematosus. Antibody-dependent mechanisms of keratinocyte damage appear to be a primary pathogenetic factor in all forms of papulosquamous cutaneous lupus. Photosensitive papulosquamous lupus syndromes, such as subacute cutaneous LE, neonatal LE, "ANA-negative" LE, and complement-deficient LE are all strongly associated with antibodies to the ribonucleoprotein SSA. Evidence is accumulating that antibodies to SSA (and perhaps to SSB) induce antibody-dependent cell-mediated cytotoxicity (ADCC) of basal keratinocytes in all of these lupus syndromes. Evidence is also growing that autoantibodies in cutaneous LE syndromes are directly involved in disease pathogenesis, and are not simply markers of disease subsets. The relationship of the photosensitive anti-SSA-associated LE syndromes to more classical discoid LE or to acute papulosquamous LE in SLE patients remains to be studied. In both discoid LE and acute LE, basal keratinocyte damage can be seen, just as in the anti-SSA-associated photosensitive LE syndromes, but other antigen-antibody systems may be involved in initiating keratinocyte damage, or other cytotoxic mechanisms may produce keratinocyte damage characteristic of these syndromes.