Patients with systemic lupus erythematosus (SLE) are photosensitive, developing skin inflammation with even ambient ultraviolet radiation (UVR), and this cutaneous photosensitivity can be associated with UVR-induced flares of systemic disease, with increased autoantibodies and further end organ injury.
Mechanistic insight into the link between skin disease and autoimmunity is limited. Signals from skin are transmitted directly to the immune system via lymphatic vessels, and here we show evidence for potentiation of UVR-induced lymphatic flow dysfunction in SLE patients and murine models. Improving lymphatic flow by manual lymphatic drainage (MLD) or with a transgenic model reduces both cutaneous photosensitivity and lymph node B cell responses. Mechanistically, improved flow restrains B cell responses by activating a fibroblastic reticular cell-monocyte axis. Our results point to a lymphatic flow- lymph node stromal axis as a link between photosensitivity and autoimmune responses and as a therapeutic target in lupus, have implications for understanding skin-immune interactions in other diseases such as skin cancer, and suggest the possibility of MLD as an immediately available, cost- effective adjunctive treatment in lupus and related diseases.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.