Katarzyna Jakuszko, Magdalena Krajewska and Marian Klinger
Impaired apoptosis and dysfunction of the immune cells are considered to be the most important pathogenic mechanisms of systemic lupus erythematosus. Pentraxins, which are natural opsonins, are directly involved in the removal of cellular material by binding to different antigens and initiating and enhancing phagocytosis of damaged cells. Therefore the deficiency of pentraxins is a crucial risk factor for the development and progression of systemic lupus erythematosus.
Despite the presence of elevated levels of interleukin-6, which under physiological conditions increases the expression of acute phase protein genes, in systemic lupus a deficiency of C reactive protein and other pentraxins is observed. Several mechanisms responsible for pentraxin deficiency have been postulated, including the impairment of pentraxin synthesis due to mutations in genes, gene inhibition by interferon-α, and removal of pentraxins by autoantibodies.
In this review, we summarize the significance of antibodies directed against pentraxins in assessing the activity and severity of systemic lupus erythematosus and lupus nephritis, as well as the usefulness of these antibodies as an additional marker of the response to treatment. The role of antibodies directed against monomeric C reactive protein in the pathogenesis of lupus nephritis is also discussed, as these antibodies are considered as a factor causing damage to the glomerular cells.