医学
免疫学
免疫系统
发病机制
抗磷脂综合征
血小板
中性粒细胞胞外陷阱
免疫失调
血小板活化
炎症
系统性红斑狼疮
狼疮性肾炎
先天免疫系统
止血
获得性免疫系统
疾病
抗体
内科学
作者
Marie Robert,Kiran S. Kedlaya
标识
DOI:10.1016/j.jbspin.2023.105622
摘要
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by immune dysregulation and organ injury with a premature mortality due to cardiovascular diseases. Platelets, that are primarily known for their role in hemostasis, have been shown to play an active role in the pathogenesis and in the progression of immune-mediated inflammatory diseases. Here we summarize the evidence of their roles in SLE pathogenesis which supports the development of targeted treatments. Platelets and their precursors, the megakaryocytes, are intrinsically different in SLE patients compared with healthy controls. Different triggers related to innate and adaptive immunity activate platelets which release extracellular vesicles, soluble factors and interact with immune cells, thereby perpetuating inflammation. Platelets are involved in organ damage in SLE, especially in lupus nephritis and participate in the heightened cardiovascular mortality. They also play a clear role in antiphospholipid syndrome which can be associated with both thrombocytopenia and thrombosis. To tackle platelet activation and their interactions with immune cells now constitute promising therapeutic strategies in SLE.
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