Platelets and IgE: Shaping the Innate Immune Response in Systemic Lupus Erythematosus

Brilland, Benoît; Scherlinger, Marc; Khoryati, Liliane; Goret, Julien; Duffau, Pierre; Lazaro, Estibaliz; Charrier, Manon; Guillotin, Vivien; Richez, Christophe; Blanco, Patrick

doi:10.1007/s12016-019-08744-x

Cited by 15 publications

(8 citation statements)

References 164 publications

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“…Activation of basophils by ICs with autoreactive IgE amplifies autoantibody production [ 17 ]. Non-autoreactive IgE is negatively associated with the lupus erythematosus activity index (SLEDAI) and prevents the release of IFN by pDC [ 18 ]. Studies have revealed that 30%-50% of SLE patients with autoreactive IgE are mainly directed against dsDNA, Ro/SSA, La/SSB, and Sm [ 2 , 19 ], and anti-dsDNA IgE was discovered in all lupus subtypes [ 16 ] and have been linked with the activity of SLE disease [ 20 ] and kidney involvement.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have revealed that 30%-50% of SLE patients with autoreactive IgE are mainly directed against dsDNA, Ro/SSA, La/SSB, and Sm [ 2 , 19 ], and anti-dsDNA IgE was discovered in all lupus subtypes [ 16 ] and have been linked with the activity of SLE disease [ 20 ] and kidney involvement. Reducing the levels of autoreactive IgE and inhibiting their receptors or increasing non-autoreactive IgE are considered promising therapeutic objectives in the management of SLE [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

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Lupus Nephritis in an Adolescent Girl With Hyper-Immunoglobulin E

Alahmadi¹,

El-Desoky²,

Zahrani³

et al. 2023

Cureus

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We report the case of an adolescent girl with frequent hospital admissions for severe eczematous skin rashes with recurrent epistaxis and chest infections. Investigations revealed persistent severely elevated serum total immunoglobulin E (IgE) levels but normal levels of other immunoglobulins, suggesting hyper-IgE syndrome. The first skin biopsy revealed superficial dermatophytic dermatitis (tinea corpora). Another biopsy performed after six months revealed a prominent basement membrane with dermal mucin, suggesting an underlying autoimmune disease. Her condition was complicated by proteinuria, hematuria, hypertension, and edema. A kidney biopsy revealed class IV lupus nephritis, according to the International Society of Nephrology/Renal Pathology Society (ISN/RPS). Based on the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria, she was diagnosed with systemic lupus erythematosus (SLE). She was first administered with intravenous pulse methylprednisolone (600 mg/m 2 ) for three consecutive days, followed by oral prednisolone (40 mg/m 2 ) daily, mycophenolate mofetil tablets (600 mg/m 2 /dose) twice daily, hydroxychloroquine (200 mg) once daily, and three classes of antihypertensive medications. She maintained normal renal functions with no lupus morbidity for 24 months, then rapidly progressed to end-stage kidney disease, and was then started on three to four sessions of regular hemodialysis per week.Hyper-IgE is known to be a marker of immune dysregulation as it facilitates the generation of immune complexes (ICs) that mediate lupus nephritis and juvenile SLE.Regardless of the different factors that are impacting the production of IgE, the present case illustrated that juvenile patients with SLE may have increased IgE levels, indicating that higher IgE levels might have a role in lupus pathogenesis and prognosis. The mechanisms regarding the increased levels of IgE in subjects with lupus need further investigation. Further studies are thus required to assess the incidence, prognosis, and possible new specific management for hyper-IgE in juvenile SLE.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lupus Nephritis in an Adolescent Girl With Hyper-Immunoglobulin E

Alahmadi¹,

El-Desoky²,

Zahrani³

et al. 2023

Cureus

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“…Our focus on red blood cell and platelet cytopenias is relevant as both of these cellular subtypes are actively involved in the systemic inflammation that occurs in cSLE. 26–31 Recent blood transcriptome analyses of cSLE patients found a strong correlation between neutrophil signature and the presence of LN. 24 Similarly, another gene expression study of adult and pediatric SLE patients found neutrophil-driven clusters to be associated with an increased risk of proliferative LN.…”

Section: Discussionmentioning

confidence: 99%

Impact of autoimmune cytopenias on severity of childhood-onset systemic lupus erythematosus: A single-center retrospective cohort study

Ogbu

Chandrakasan

Rouster‐Stevens

et al. 2020

Lupus

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Objective To assess whether children with autoimmune cytopenias prior to or at diagnosis of systemic lupus erythematosus (cSLE), differ phenotypically from other cSLE patients; and have a lower risk and severity of lupus nephritis (LN) as observed in prior adult studies. To assess the effect of prior immune therapy for autoimmune cytopenias on 2-year risk of LN. Methods This was a retrospective cohort study of incident cSLE cases. We included patients aged less than 17 years at diagnosis. We excluded patients with LN at cSLE diagnosis. Our follow-up period was 2 years. We defined autoimmune cytopenias as either autoimmune hemolytic anemia, immune thrombocytopenia or Evan’s syndrome. Results Forty-three (33%) of the 130 patients had autoimmune cytopenias before or at cSLE diagnosis. Those with autoimmune cytopenias had significantly more neuropsychiatric symptoms and higher mean ESR but less arthritis, malar rash and myositis versus those without autoimmune cytopenias. They had lower 2-year incidence proportion of LN compared to other cSLE patients (7% vs 15%). Of the 16 patients who developed LN, those with autoimmune cytopenias had mostly class V (2 of 3 patients) versus mostly class III and IV in those without autoimmune cytopenias (6 of 12 patients). None of the 13 patients pre-treated for autoimmune cytopenias developed LN. Conclusion Patients with autoimmune cytopenias before or at cSLE diagnosis have intriguing differences from other cSLE patients. They may represent a unique sub-type of cSLE patients and should be further explored.

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“…TLR-7 can regulate the extra-follicular B cells response in the germinal center which may enhance autoantibody generation, while TLR-9 can limit the TLR-7 stimulatory activity, demonstrating its protective function in lupus etiology [ 11 ]. Platelets have functional TLR-7, which is responsible for their activation, leading to platelet–leukocyte aggregates possibly involved in priming the immune system upon viral attack [ 12 ]. Other TLRs such as TLR-2 and 4 were also found to be highly expressed in the saliva of SLE patients, however, their low expression was demonstrated with the presence of chronic periodontitis in lupus patients [ 13 ].…”

Section: Sle Immunobiologymentioning

confidence: 99%

Systemic lupus erythematosus: latest insight into etiopathogenesis

et al. 2023

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Systemic lupus erythematosus (SLE) is a complex autoimmune disorder of unknown etiology. Multifactorial interaction among various susceptible factors such as environmental, hormonal, and genetic factors makes it more heterogeneous and complex. Genetic and epigenetic modifications have been realized to regulate the immunobiology of lupus through environmental modifications such as diet and nutrition. Although these interactions may vary from population to population, the understanding of these risk factors can enhance the perception of the mechanistic basis of lupus etiology. To recognize the recent advances in lupus, an electronic search was conducted among search engines such as Google Scholar and PubMed, where we found about 30.4% publications of total studies related to genetics and epigenetics, 33.5% publications related to immunobiology and 34% related to environmental factors. These outcomes suggested that management of diet and lifestyle have a direct relationship with the severity of lupus that influence via modulating the complex interaction among genetics and immunobiology. The present review emphasizes the knowledge about the multifactorial interactions between various susceptible factors based on recent advances that will further update the understanding of mechanisms involved in disease pathoetiology. Knowledge of these mechanisms will further assist in the creation of novel diagnostic and therapeutic options.

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Platelets and IgE: Shaping the Innate Immune Response in Systemic Lupus Erythematosus

Cited by 15 publications

References 164 publications

Lupus Nephritis in an Adolescent Girl With Hyper-Immunoglobulin E

Lupus Nephritis in an Adolescent Girl With Hyper-Immunoglobulin E

Impact of autoimmune cytopenias on severity of childhood-onset systemic lupus erythematosus: A single-center retrospective cohort study

Systemic lupus erythematosus: latest insight into etiopathogenesis

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