The complement system in systemic lupus erythematosus: an update

Jonatan Leffler1, Anders A Bengtsson2, Anna M Blom3

  • 1Division of Medical Protein Chemistry, Department of Laboratory Medicine Malmö, Lund University, Malmö, Sweden Division of Cell Biology and Immunology, Telethon Kids Institute, University of Western Australia, Subiaco, Australia.

Insights

The complement system

Area of Science:

  • Immunology and Rheumatology
  • Autoimmune Disease Research

Background:

  • The complement system is integral to the immune response but has a complex role in systemic lupus erythematosus (SLE), potentially both protecting against and worsening the disease.
  • Genetic factors, including C1q deficiency and mutations in complement receptors and inhibitors, are linked to SLE development and severity.
  • Autoantibodies are key to SLE pathogenesis, and the complement system's influence on adaptive immunity is a critical area of study.

Purpose of the Study:

  • To review recent advancements in understanding the complement system's role in systemic lupus erythematosus (SLE) pathogenesis.
  • To highlight the dual role of complement in SLE, encompassing both protective and detrimental effects.
  • To explore the diagnostic and monitoring potential of complement biomarkers in SLE.

Main Methods:

  • Literature review of recent complement-focused research in SLE.
  • Analysis of genetic associations with complement components and receptors in SLE patients.
  • Examination of complement's impact on SLE-specific manifestations and autoantibody production.

Main Results:

  • C1q deficiency, though rare, is a significant genetic risk factor for SLE.
  • New genetic associations with complement receptors and inhibitors indicate their involvement in SLE onset and nephritis.
  • Complement contributes to SLE manifestations like glomerulonephritis and thrombosis, and influences autoantibody responses.
  • Complement components in plasma show potential as accessible biomarkers for SLE diagnosis and activity monitoring.

Conclusions:

  • The complement system is a critical player in SLE pathogenesis, with complex and multifaceted roles.
  • Recent genetic discoveries and insights into complement's influence on immune responses deepen our understanding of SLE.
  • Complement's accessibility in plasma positions it as a promising avenue for SLE biomarker development and disease management.

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