Objective. To analyze whether the expression and modulation of T cell receptor (TCR) signaling is dependent on Casitas B lineage lymphoma b (Cbl-b) in T cells from patients with systemic lupus erythematosus (SLE) upon stimulation with a tolerogenic substance.Methods. Peripheral blood mononuclear cells were obtained from 20 patients with SLE (active disease or in remission) and 20 healthy controls. Levels of Cbl-b expression were measured using reverse transcriptionpolymerase chain reaction and Western blotting in peripheral CD4؉ T cells from SLE patients and healthy controls upon anergy induction. Cell proliferation was measured using the carboxyfluorescein diacetate succinimidyl ester dilution method. Cytokine production was analyzed by luminometry, and surface expression of activation markers was assessed by flow cytometry. Transfection assays were performed to induce overexpression of Cbl-b, and phosphorylation of TCRassociated kinases was evaluated.Results. CD4؉ T cells from SLE patients displayed resistance to anergy (as evidenced by increased cell proliferation, interleukin-2 production, and expression of activation and costimulatory markers), and this was associated with altered Cbl-b expression. Upon ionomycin treatment, primary T cells showed enhanced MAPK activity and decreased Akt phosphorylation, which was representative of the anergic state. In T cells from lupus patients, Cbl-b overexpression led to increased expression of phosphorylated MAPK, thus indicating the reversibility of anergy resistance.Conclusion. These findings suggest that abnormal peripheral tolerance in SLE is caused by a deficiency in Cbl-b, and that this ubiquitin ligase plays a key role in regulating TCR signaling during the induction of peripheral tolerance.The ubiquitination system mediates highly specific and regulated posttranslational modifications through the conjugation of ubiquitin to a protein substrate in a highly ordered sequence of enzyme reactions. This system is involved in a diverse array of cellular processes, including modulation of the immune response. Both proteolysis-dependent and -independent mechanisms have been implicated in ubiquitination (1). Ubiquitin ligases confer specificity to the ubiquitination system, as they catalyze the transfer of activated ubiquitin molecules to the corresponding residue (primarily, lysine) in the substrate, and their relationship to the immune system is based on their capacity to modulate peripheral tolerance mechanisms such as anergy and the differentiation of regulatory T cells (2). In particular, the role of ubiquitin or E3 ligases, such as Casitas B lineage lymphoma b (Cbl-b), gene related to anergy in lymphocytes (GRAIL), and Itch, as negative regulators of the immune response has been well characterized. These E3 ligases are components of the anergy-induced genetic program that can be modulated by the calcium/ calcineurin pathway (3,4).Cbl-b belongs to the single-protein RING family of ubiquitin ligases, and the RING-finger domain serves to recruit ubiquitin-loaded E2 an...