Apoptosis in peripheral lymphocytes in systemic lupus erythematosus: a review

There is increasing evidence to suggest that abnormalities in apoptosis mayplay a part in the pathogenesis of systemic lupus erythematosus (SLE). Forexample, there is now considerable evidence that bel-2 expression isenhanced in a proportion of peripheral T cells, but not in B cells, in SLEpatients and correlates with overall disease activity regardless of theactivity index employed. Further work is required to establish whetherenhanced bel-2 expression by some T cells in SLE patients is related totheir activation or intrinsically enhanced by genetic predisposition.Mutations in Fas result in a lymphoproliferative syndrome and may play arole in accelerating autoimmune disease. A report of three children withmutations in Fas has once again focused attention on this regulator ofapoptosis. The relationships between inducers and inhibitors of apoptosismay differ in different cell types, and must be elucidated before theimplications of observations made in lymphocytes from SLE patients can befully understood.