Mechanisms behind flare of renal lupus during murine pregnancy.
The outcome of pregnancy in systemic lupus erythematosus is still controversial. The authors recently reported the disappearance of the manifestation of the skin disease but a diminished survival rate in lupus-prone animals undergoing several pregnancies. It was postulated that lupus-prone animals must have subclinical renal symptoms at an early age and that immune and hormonal changes during pregnancy exacerbate immune reactions in the kidneys, leading to a shortened life span. Here, the authors analysed changes at day 14 of pregnancy in lupus-prone LPR (MRL/lpr) mice and MRL controls regarding cytokines, regulatory T (Treg) cells and deposition of immunocomplexes. Worsened kidney function was observed during pregnancy, even in the absence of lupus signs. This was accompanied by renal inflammation and higher interferon-gamma and interleukin-10 levels. C3 and immunoglobulin G deposition was enhanced in kidney and placenta from lupus-prone pregnant animals. Pregnancy enhanced the levels of Treg cells in control animals but not in lupus-prone animals. As pregnancy-induced Treg cells were shown to be specific for paternal antigens it is not to be expected that these Treg cells can help to destroy autoreactive cells. The authors conclude that early subclinical kidney disease in lupus-prone animals exacerbates during pregnancy. Albeit obtained with an experimental animal model, their data are potentially of importance for lupus patients of reproductive age.
Zenclussen
Ana Claudia
AC
Institute of Medical Immunology, Charité, Medical University of Berlin, Germany. ana.zenclussen@med.ovgu.de
Kökény
Gábor
G
Thimm
Odina
O
Sollwedel
André
A
Godo
Maria
M
Casalis
Pablo Ariel
PA
Zenclussen
Maria Laura
ML
Volk
Hans-Dieter
HD
Hamar
Péter
P
D000818:Animals; D003176:Complement C3 / Q000378:metabolism; D005260:Female; D007074:Immunoglobulin G / Q000378:metabolism; D007371:Interferon-gamma / Q000378:metabolism; D016753:Interleukin-10 / Q000378:metabolism; D007668:Kidney / Q000473:pathology; D008181:Lupus Nephritis / Q000175:diagnosis* / Q000209:etiology*; D051379:Mice; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011270:Pregnancy, Animal; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013154:Spleen / Q000166:cytology
D003176:Complement C3; D007074:Immunoglobulin G; D016753:Interleukin-10; D007371:Interferon-gamma