Immune podocytes in the immune microenvironment of lupus nephritis (Review)

Mol Med Rep. 2023 Nov;28(5):204. doi: 10.3892/mmr.2023.13091. Epub 2023 Sep 15.

Abstract

Systemic lupus erythematosus (SLE) is a systemic autoimmune disorder caused by the loss of tolerance to endogenous nuclear antigens such as double‑stranded DNA, leading to the proliferation of T cells and subsequent activation of B cells, which results in serious organ damage and life‑threatening complications such as lupus nephritis. Lupus nephritis (LN) develops as a frequent complication of SLE, accounting for >60% of SLE cases, and is characterized by proteinuria and heterogeneous histopathological findings. Glomerular injury serves a role in proteinuria as podocyte damage is the leading contributor. Numerous studies have reported that podocytes are involved in the immune response that promotes LN progression. In LN, immune complex deposition stimulates dendritic cells to secrete inflammatory cytokines that activate T cells and B cells. B cells secrete autoantibodies that attack and damage the renal podocytes, leading to renal podocyte injury. The injured podocytes trigger inflammatory cells through the expression of toll‑like receptors and trigger T cells through major histocompatibility complexes and CD86, thereby participating in the local immune response and the exacerbation of podocyte injury. Based on the existing literature, the present review summarizes the research progress of podocytes in LN under the local immune microenvironment of the kidney, explores the mechanism of podocyte injury under the immune microenvironment, and evaluates podocytes as a potential therapeutic target for LN.

Keywords: immune microenvironment; immune podocyte; immunosuppressants; lupus nephritis; treatment strategy.

Publication types

  • Review

MeSH terms

  • Humans
  • Kidney
  • Lupus Erythematosus, Systemic*
  • Lupus Nephritis*
  • Podocytes*
  • Proteinuria

Grants and funding

This work was supported by the National Natural Science Foundation of China and Shanxi Province Applied Basic Research Project (grant nos. 82202005 and 201901D211511), the National Natural Science Foundation of China (grant no. 81871292), the Key Research and Development (R&D) Projects of Shanxi Province (grant no. 201803D31136), the Four ‘Batches’ Innovation Project of Invigorating Medical Through Science and Technology of Shanxi Province (grant no. 2023XM002), and the Shanxi Province Postgraduate Practice Innovation Project (grant no. 2023SJ135).