Lupus nephritis immune response

Circulating Immune Complex. Anti-dsDNA/DNA immune complexes have long been considered responsible for the development of lupus nephritis. The level of immune complexes in SLE patients with active disease detected by monoclonal anti-DNA antibodies is higher (T7). About half of SLE patients had elevated amounts of DNA antigen in the immune complexes (N4, R2, S27). 

Similar antibodies are found in patients with systemic lupus erythematosus and it has been proposed that lupus nephritis results from IgG binding to I(H2A-H2B)-DNA] in nucleosomal material that is deposited in the glomerulus by the circulation (78). Because renal involvement is not a feature of drug-induced lupuS/ it appears that factors other than antibody binding to I(H2A-H2B)-DNA] are responsible for nephritis. However/ the systemic symptoms of drug-induced lupus may result from inflammatory mechanisms involved in the clearance of immune complexes. 

CalvanI N, Richards HB, TuccIM, Pannarale G, Silvestris F. Up-regulation of IL-18 and prominence ofThI immune response as a hallmark of lupus nephritis. Clin Exp Immunol 2004 138 171-178. 

Systemic lupus erythematosus is an autoimmune disease that causes affectation not only of the skin but also of other organs, resulting in photosensitive skin eruptions, arthritis, serositis, nephritis, and hematologic abnormalities. It is produced by circulating autoantibodies, immune complexes, and complement deposition that leads to cell and tissue injury [145]. In several open clinical trials, patients with systemic lupus erythematosus have been treated with ECP using 8-MOP, showing a significant response to the treatment, with no or minor side effects [146]. 

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