In systemic lupus erythematosus (SLE), the predominant mechanism by which nuclear antigens become accessible to the immune system involves defective clearance of which cellular process?

• A Necrosis — massive cellular lysis releasing intracellular content
• B Autophagy — excessive self-digestion exposing nuclear material
• C Apoptosis — impaired clearance of apoptotic nuclear debris presenting self-antigens ✓
• D Pyroptosis — caspase-1-mediated inflammatory cell death

Explanation

SLE pathogenesis centrally involves defective apoptotic cell clearance: complement deficiency (especially C1q) impairs opsonization and phagocytic removal of apoptotic bodies, causing secondary necrosis and release of nucleosomal antigens (dsDNA, histones, Ro, La). These activate autoreactive B and T cells that escaped tolerance, generating pathogenic autoantibodies. Anti-dsDNA antibodies form immune complexes deposited in kidneys and vessels. C1q deficiency is the strongest single-gene risk for SLE.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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