The Pathophysiologic Role of Monocytes and Macrophages in Systemic Lupus Erythematosus: A Reappraisal

doi:10.1016/j.semarthrit.2008.11.002

Seminars in Arthritis and Rheumatism

Volume 39, Issue 6, June 2010, Pages 491-503

https://doi.org/10.1016/j.semarthrit.2008.11.002 Get rights and content

Objectives

To review current developments, regarding the pathophysiologic role of monocytes and macrophages in systemic lupus erythematosus (SLE).

Methods

We searched Medline for articles written in the English language using the following terms: monocyte(s) or macrophage(s) and lupus. Although our search spanned the years 1971 to 2008, the majority of the short-listed articles belonged to the period 2000 to 2008. Published literature on phenotypic and functional properties of monocytes/macrophages (Mo/Mφ) in SLE was reviewed. References from identified articles were also selected. Currently available experimental data and their relevance to the pathogenesis of SLE are critically discussed.

Results

It has traditionally been held that impaired phagocytosis by monocytes and macrophages in SLE allows for the accumulation of apoptotic debris leading to a sequel of autoimmune phenomena. Recent paradigms derived from animal models of systemic autoimmunity, however, has broadened our understanding regarding the possible pathophysiologic roles of Mo/Mφ in SLE. Data derived from studies in patients with SLE show multiple aberrations in activation status and secretory functions of circulating and tissue-infiltrating Mo/Mφ. Such aberrations may be associated with dysregulation of T-cell function and autoantibody production in SLE. Moreover, emerging evidence suggests that phagocytic capacity and antigen-presenting properties of Mo/Mφ are enhanced in some patients with SLE.

Conclusions

While defective phagocytosis represents a distinctive feature of monocyte function in some patients with SLE, aberrant activation of the Mo/Mφ system may be a more appropriate concept to encompass the broad spectrum of Mo/Mφ disorders in SLE. Aberrant function of lupus Mo/Mφ appears to play a dynamic role in the initiation and perpetuation of the systemic autoimmune response and organ damage. Delineation of the altered biology of lupus Mo/Mφ could provide possible future therapeutic targets for patients with SLE.

Section snippets

Methods

We searched Medline for articles written in the English language using the following terms: monocyte(s) or macrophage(s) and lupus. The abstracts were screened for relevance and the publications relating to Mo/Mφ in SLE were obtained. Additional references were identified from the bibliographies of the retrieved reports. Although our search spanned the years 1971 to 2008, the majority of the short-listed articles belonged to the period 2000 to 2008. Published literature on phenotypic and

The Model of “Defective” Monocyte Function in SLE

Defective clearance represents the hallmark of the model of “defective” monocyte function in SLE (6). Reduced clearance of apoptotic cells led to the hypothesis that uningested apoptotic cells might represent an important source of autoantigens with the potential to trigger an autoimmune process such as the one seen in SLE. Moreover, defective clearance of immune complexes (IC) allowing tissue deposition of IC represents a mechanism by which tissue damage may occur in SLE. Data on phagocytosis

Discussion

It has traditionally been held that lupus Mo/Mφ are defective. The model of “defective” function supports the idea that lupus Mo/Mφ, either overwhelmed by their environment or because of intrinsic defects, become powerless cells unable to perform their physiologic tasks contributing in this way to disease expression (Table 1). While defective function of Mo/Mφ is encountered in some patients with SLE, emerging experimental data in murine models (Table 2) and humans with SLE (Table 3) support

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Systemic lupus erythematosisThe Pathophysiologic Role of Monocytes and Macrophages in Systemic Lupus Erythematosus: A Reappraisal

Objectives

Methods

Results

Conclusions

Section snippets

Methods

The Model of “Defective” Monocyte Function in SLE

Discussion

Immunity

Semin Immunol

J Autoimmun

J Biol Chem

Blood

Am J Pathol

Kidney Int

Kidney Int

Kidney Int

Kidney Int

Clin Immunol

Biochem Biophys Res Commun

Cytokine

Best Pract Res Clin Rheumatol

Immunity

Clin Immunol

Clin Immunol

The biology of macrophage

New insights into the pathogenesis of systemic lupus erythematosus

Curr Rheumatol Rep

Cellular interactions in the pathogenesis of lupus nephritis: the role of T cells and macrophages in the amplification of the inflammatory process in the kidney

Lupus

The autologous mixed lymphocyte reaction in systemic lupus erythematosus

Arthritis Rheum

Reduced function of HLA-DR-positive monocytes in patients with systemic lupus erythematosus (SLE)

J Clin Immunol

Defective antigen-presenting cell function in patients with systemic lupus erythematosus: role of the B7-1 (CD80) costimulatory molecule

Arthritis Rheum

Defective monocyte production of, and T lymphocyte response to, interleukin-1 in the peripheral blood of patients with systemic lupus erythematosus

Clin Exp Immunol

Phagocytosis and clearance of apoptotic cells is mediated by MER

Nature

Homeostatic regulation of the immune system by receptor tyrosine kinases of the Tyro 3 family

Science

Phagocyte receptors for apoptotic cells: recognition, uptake, and consequences

J Clin Invest

Persistence of apoptotic cells without autoimmune disease or inflammation in CD14−/− mice

J Cell Biol

Cytokine dysregulation induced by apoptotic cells is a shared characteristic of murine lupus

J Immunol

Abnormal regulation of the cytoskeletal regulator Rho typifies macrophages of the major murine models of spontaneous autoimmunity

J Leukoc Biol

No constitutive defect in phagocytosis of apoptotic cells by resident peritoneal macrophages from pre-morbid lupus mice

Lupus

Uncoupling of immune complex formation and kidney damage in autoimmune glomerulonephritis

Science

FcR-bearing myeloid cells are responsible for triggering murine lupus nephritis

J Immunol

The type I interferon system in systemic lupus erythematosus

Arthritis Rheum

Deficiency of the type I interferon receptor protects mice from experimental lupus

Arthritis Rheum

A novel type I IFN-producing cell subset in murine lupus

J Immunol

Upregulation of renal and systemic cyclooxygenase-2 in patients with active lupus nephritis

J Am Soc Nephrol

The sialoadhesin (CD169) expressing a macrophage subset in human proliferative glomerulonephritis

Nephrol Dial Transplant

Characterization of heterogeneity in the molecular pathogenesis of lupus nephritis from transcriptional profiles of laser-captured glomeruli

J Clin Invest

Expression of MRP8 and MRP14 by macrophages is a marker for severe forms of glomerulonephritis

J Leukoc Biol

Do urinary mononuclear cells reflect disease activity in lupus nephritis?

Cell Mol Biol (Noisy-le-grand)

Correlative insights into immunoexpression of monocyte chemoattractant protein-1, transforming growth factor beta-1 and CD68+ cells in lupus nephritis

Pol J Pathol

Lymphocyte apoptosis and macrophage function: correlation with disease activity in systemic lupus erythematosus

Clin Rheumatol

Increased serum soluble CD14, ICAM-1 and E-selectin correlate with disease activity and prognosis in systemic lupus erythematosus

Lupus

Elevated levels of soluble CD14 in serum of patients with systemic lupus erythematosus

Systemic lupus erythematosis
The Pathophysiologic Role of Monocytes and Macrophages in Systemic Lupus Erythematosus: A Reappraisal