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Review
. 2021 Jan 15;206(2):302-309.
doi: 10.4049/jimmunol.2000905.

Immune Cell-Stromal Circuitry in Lupus Photosensitivity

Ji Hyun Sim  1   2 , William G Ambler  1   3 , Isabel F Sollohub  1 , Mir J Howlader  1   4 , Thomas M Li  1 , Henry J Lee  5 , Theresa T Lu  6   2   3
Affiliations
Review

Immune Cell-Stromal Circuitry in Lupus Photosensitivity

Ji Hyun Sim et al. J Immunol. .

Abstract

Photosensitivity is a sensitivity to UV radiation (UVR) commonly found in systemic lupus erythematosus (SLE) patients who have cutaneous disease. Upon even ambient UVR exposure, patients can develop inflammatory skin lesions that can reduce the quality of life. Additionally, UVR-exposed skin lesions can be associated with systemic disease flares marked by rising autoantibody titers and worsening kidney disease. Why SLE patients are photosensitive and how skin sensitivity leads to systemic disease flares are not well understood, and treatment options are limited. In recent years, the importance of immune cell-stromal interactions in tissue function and maintenance is being increasingly recognized. In this review, we discuss SLE as an anatomic circuit and review recent findings in the pathogenesis of photosensitivity with a focus on immune cell-stromal circuitry in tissue health and disease.

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Figures

Figure 1.
Figure 1.. Photosensitivity in lupus.
In patients with CLE or SLE, even ambient exposure to sunlight can trigger the development of skin lesions. In SLE patients, this photosensitivity can be associated with flares of systemic disease. Photos from American College of Rheumatology Image Library (c) 2020 American College of Rheumatology.
Figure 2.
Figure 2.. SLE as an anatomic immune circuit.
The circuitry that may contribute to propagating information from the skin to draining nodes and systemically, based on the principles of immune circuitry.
Figure 3.
Figure 3.. Immune-stromal circuits in the skin that may contribute to photosensitivity.
Protective circuits are denoted by blue arrows, pathogenic circuits by red arrows, and circuits that can have dual roles by purple arrows. (A) Langerhans cell-keratinocyte circuit. (B) Monocyte-epidermal circuit. (C) a. keratinocyte-neutrophil circuit; b. neutrophil-endothelial cell circuit; c. neutrophil-immune cell circuit. (D) IFN-I circuits involving IFN-I originating from a. immune cells and b. stromal cells. (E) cGAMP originating from skin for systemic signal transmission. (F) Lymphatic flow and function that connects skin to draining lymph nodes and systemic circulation. (G) Neuronal control of immunity. (H) Migration of skin-derived Langerhans cells and dendritic cells connects skin events to draining lymph nodes. See text for details.
See this image and copyright information in PMC

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