Abstract
Autoantibodies against a panoply of self-antigens are seen in systemic lupus erythematosus, but only a few (anti-Sm/RNP, anti-Ro/La, anti-dsDNA) are common. The common lupus autoantigens are nucleic acid complexes and levels of autoantibodies can be extraordinarily high. We explore why that is the case. Lupus is associated with impaired central or peripheral B-cell tolerance and increased circulating autoreactive B cells. However, terminal differentiation is necessary for autoantibody production. Nucleic acid components of the major lupus autoantigens are immunostimulatory ligands for toll-like receptor (TLR)7 or TLR9 that promote plasma cell differentiation. We show that the levels of autoantibodies against the U1A protein (part of a ribonucleoprotein) are markedly higher than autoantibodies against other antigens, including dsDNA and the non-nucleic acid-associated autoantigens insulin and thyroglobulin. In addition to driving autoantibody production, TLR7 engagement is likely to contribute to the pathogenesis of inflammatory disease in lupus.
Highlights
Autoantibodies against a panoply of self-antigens are seen in systemic lupus erythematosus, but only a few are common
We show that the levels of autoantibodies against the U1A protein are markedly higher than autoantibodies against other antigens, including dsDNA and the non-nucleic acidassociated autoantigens insulin and thyroglobulin
We argue that abnormal B-cell censoring accounts for the diversity of autoantibodies that can be detected in systemic lupus erythematosus (SLE) patients’ sera by sensitive techniques such as ELISA, whereas the highly restricted list of commonly produced, high-level autoantibodies is a consequence of innate immune recognition of autologous, nucleic acids associated with these antigens
Summary
Autoantibodies against a panoply of self-antigens are seen in systemic lupus erythematosus, but only a few (anti-Sm/RNP, anti-Ro/La, anti-dsDNA) are common. The common lupus autoantigens are nucleic acid complexes and levels of autoantibodies can be extraordinarily high. Nucleic acid components of the major lupus autoantigens are immunostimulatory ligands for toll-like receptor (TLR) or TLR9 that promote plasma cell differentiation. The production of autoantibodies, in particular antinuclear antibodies (ANA), is nearly universal among patients with systemic lupus erythematosus (SLE). We argue that abnormal B-cell censoring accounts for the diversity of autoantibodies that can be detected in SLE patients’ sera by sensitive techniques such as ELISA, whereas the highly restricted list of commonly produced, high-level autoantibodies is a consequence of innate immune recognition of autologous (immunostimulatory), nucleic acids associated with these antigens
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