Humoral intestinal immunity in systemic lupus erythematosus

Area of Science:

• Gastroenterology
• Immunology
• Rheumatology

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
• Intestinal immune system involvement in SLE is not fully understood.
• Secretory immunity in the gut may play a role in SLE pathogenesis.

Purpose of the Study:

• To investigate intestinal secretory immunity in patients with SLE.
• To evaluate the distribution of immunoglobulin-bearing plasma cells and complement components in the jejunal mucosa.
• To correlate intestinal immune findings with disease activity, treatment, and gastrointestinal symptoms.

Main Methods:

• Cross-sectional study of 45 SLE patients and 12 healthy volunteers.
• Peroral jejunal biopsy.
• Histologic and immunohistochemical assessment of jejunal mucosa.
• Analysis of immunoglobulin and complement deposits.

Main Results:

• Altered distribution of immunoglobulin-bearing plasma cells in the lamina propria was observed in SLE patients.
• Complementary components were invariably present, especially in patients with active SLE.
• Immunoglobulin and complement deposits were found in the basement membrane of intestinal crypt epithelium, resembling the lupus band test.
• No correlation was found between immunologic findings and medical treatment or peripheral blood analysis.
• Local intestinal immune changes did not correlate with gastrointestinal symptoms.

Conclusions:

• Patients with SLE exhibit significant alterations in intestinal secretory immunity.
• The presence of immunoglobulin and complement deposits in the jejunal mucosa suggests local immune system involvement in SLE.
• These findings may reflect the systemic effects of SLE on the gut immune system, independent of gastrointestinal symptoms or treatment.