Systemic Lupus Erythematosus

Systemic Lupus Erythematosus

Immune complexes and antibodies against DNA and nuclear antigens, fix complement

DNA, histones, ribosomes

SLE Autoantigen(s) - (3)

Glomerulonephritis, vasculitis, arthritis

Consequences of SLE - (3)

Malar Rash

Rash over cheeks and nose, in butterfly shape

Discord Rash

Rash that is red, raised, and disc-shaped patches

Seriositis

Inflammation of lung pleura or lining around heart leading to chest pain/pericarditis

Photosensitivity, oral, arthritis, antinuclear

Common diagnostic criteria of SLE

• __ to sun/light

• __ ulcers

• __ (-itis)

• Abnormal __ antibody

Persistent protein or cellular casts

Renal consequences of SLE - (2…) in the urine

Seizures or psychosis

Neuropsychological consequences of SLE - (2)

Anemia, leukopenia, lymphopenia, thrombocytopenia

Blood abnormalities in SLE - (4)

DNA, Dm, anti-phospholipid

Immunologic consequences in SLE

• Anti-__ or anti-__ or positive __ antibodies

B, histone 1, MHC, nucleic acid, H1-specific, tolerance

Epitope spreading in SLE

• Rogue _ cell binds to __ _
  - takes in histone and presents on __
  = autoantibodies

• DNA is a __ __, not a peptide to be presented on MHC

  • __-__ T cell is activated to kill normal cell components

• Diffuse break in __ (immune process) at all stages

Autoreactive lymphocytes, later, helper T, autoantibodies

Epitope spreading in SLE

• Self antigens that were NOT initial targets of __ __ at onset of autoimmunity may become targets at a __ stage

• Autoreactive __ _ cells of one specificity can drive the production of __ with several different specificities

Antigen release, APCs, H1 histone, nucleosome, H1

Epitope spreading in SLE

• Secondary targets come into play from __ __ → presence of more __ to take up and present antigens

• 2 B cells specific for different parts of complex (__ __ and __) get activated by T-cell specific for __ histone

Complexes, complement, IgG, utilized, phagocytosed

Why are ANA levels high and C3 levels low?

• Immune __ from SLE that are depositing, depletes sources of __ that attach to complexes

Which antibody isotype might be increased in SLE?

• Excess __ contributing to swollen lymph nodes

• Would this affect RBC levels?

  • It can if RBCs are __ or __ with SLE antibodies