Preventive strategies in systemic lupus erythematosus

Doria, Andrea; Arienti, Silvia; Rampudda, Mariaelisa; Canova, Mariagrazia; Tonon, Michele; Sarzi-Puttini, Piercarlo

doi:10.1016/j.autrev.2007.11.004

Cited by 60 publications

(29 citation statements)

References 37 publications

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“…1 Awareness of the need to prevent and treat disease flares and comorbidities in SLE is growing, while the traditional therapy fails to fulfill patient's needs. 2 Although data on comorbidities is incomplete, it is obvious that certain comorbidities add risk to unfavourable outcomes, and must be taken into account while treating SLE patients. 1 Metabolic syndrome is common, even in early SLE, 3 and the risk of cardiovascular diseases (CVDs) is estimated to be at least two times higher in SLE patients than in the population as a whole.…”

Section: Introductionmentioning

confidence: 99%

Drugs used in incident systemic lupus erythematosus – results from the Finnish nationwide register 2000–2007

Elfving

Puolakka

Kautiainen

et al. 2016

Lupus

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The objectives of the study were to examine the initial, first-year anti-rheumatic outpatient therapy in patients with incident SLE, as well as the concomitant use of drugs for certain comorbidities, compared to the use in the general population. The Finnish nationwide register data on special reimbursements for medication costs was screened to identify the inception cohort of 566 adult SLE patients (87% females, mean age 46.5 AE 15.9 years) over the years [2000][2001][2002][2003][2004][2005][2006][2007]. The patients were linked to the national Drug Purchase Register. Of those, 90% had purchased at least once some disease-modifying anti-rheumatic drugs (DMARDs) during the first year. Hydroxychloroquine was the most common (76%), followed by azathioprine (15%) and methotrexate (13%). With the exception of increase in mycophenolate mofetil, the proportions remained stable over the whole study period 2000-2007. Drugs for cardiovascular diseases, dyslipidemia, diabetes mellitus, hypothyroidism and obstructive pulmonary disease were more frequently purchased than in the sex-and age-adjusted population, with rate ratios ranging from 1.6 to 7.8. Over the years 2000-2007, almost all the patients with incident SLE in Finland started with a DMARD. Higher percentages of SLE patients were on medication for several common chronic diseases than in the population as a whole. Lupus (2016) 25, 666-670.

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Section: Introductionmentioning

confidence: 99%

Drugs used in incident systemic lupus erythematosus – results from the Finnish nationwide register 2000–2007

Elfving

Puolakka

Kautiainen

et al. 2016

Lupus

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“…Thanks to recent advances in technology [102], detection of these autoantibodies in an early phase of the autoimmune process might lead to the introduction of strategies for their manipulation with the aim of preventing autoimmunity [103][104][105]. …”

Section: Resultsmentioning

confidence: 99%

Protective molecules and their cognate antibodies: new players in autoimmunity

Zen

Bassi

Campana

et al. 2010

Autoimmun Highlights

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Impairment of the clearance of apoptotic material seems to contribute to autoantigen exposure, which can initiate or maintain an autoimmune response in predisposed individuals. Complement component C1q, Creactive protein (CRP), serum amyloid P (SAP), mannose-binding lectin (MBL), apolipoprotein A-1 (Apo A-1) and long pentraxin 3 (PTX3) are molecules involved in the removal of apoptotic bodies and pathogens, and in other antiinflammatory pathways. For this reason they have been called “protective” molecules. C1q has a key role in the activation of the complement cascade and acts as a bridging molecule between apoptotic bodies and macrophages favouring phagocytosis. In addition to other functions, CRP, SAP and MBL bind to the surface of numerous pathogens as well as cellular debris and activate the complement cascade, thus stimulating their clearance by immune cells. The role of PTX3 is more controversial. In fact, PTX also promotes the clearance of microorganisms, but the activation of the complement cascade through C1q and removal of apoptotic material can be either stimulated or inhibited by this molecule. Antibodies against protective molecules have been recently reported in systemic lupus erythematosus and other autoimmune rheumatic diseases. Some of them seem to be pathogenetic and others protective. Thus, protective molecules and their cognate antibodies may constitute a regulatory network involved in autoimmunity. Dysregulation of this system might contribute to the development of autoimmune diseases in predisposed individuals.

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“…Studies suggest a link between vitamin D deficiency and autoimmune diseases, such as rheumatoid arthritis, systemic sclerosis and systemic lupus erythematosus [21,22]. Prospective studies on the involvement of vitamin D in autoimmune disorders are understandably limited, but most cross-sectional studies show an inverse relationship between concentrations of vitamin D and disease activity [23,24].…”

Section: Vitamin D and Inflammationmentioning

confidence: 98%

Use of Vitamin D in Various Disorders

Khadilkar

2012

Indian J Pediatr

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Approximately 1 billion people worldwide have been identified as vitamin D deficient in the 21st century, and the number is on the rise; non-classical actions of vitamin D were initially recognized around 30 y ago when receptors for vitamin D were detected in neoplastic cells lines. The aim of this review is to provide a brief overview of the non-classical actions of vitamin D. Reports describing the associations of non skeletal actions of vitamin D, especially pertaining to the immune system, inflammatory disorders, cancers and cardiovascular disease have been summarized in this paper. Reports support a role for the active form of vitamin D in mediating normal function of both the innate and adaptive immune systems. Studies also suggest a link between vitamin D deficiency and autoimmune diseases, such as rheumatoid arthritis, systemic sclerosis, systemic lupus erythematosus and type 1 diabetes. There is believed to be an inverse association between serum 25-hydroxyvitamin D concentrations and the incidence of colorectal cancer, sporadic colorectal adenoma and breast cancer. Vitamin D deficiency has been linked with various cardiovascular diseases such as hypertension, myocardial infarction, and stroke. Several epidemiological and genetic studies suggest a strong association between vitamin D and non skeletal acute and chronic disorders. However, currently, robust clinical data are still lacking to support raising intake requirements and target vitamin D plasma levels. Nonetheless, the high prevalence of vitamin D deficiency is alarming and requires implementation of clear supplementation guidelines.

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Preventive strategies in systemic lupus erythematosus

Cited by 60 publications

References 37 publications

Drugs used in incident systemic lupus erythematosus – results from the Finnish nationwide register 2000–2007

Drugs used in incident systemic lupus erythematosus – results from the Finnish nationwide register 2000–2007

Protective molecules and their cognate antibodies: new players in autoimmunity

Use of Vitamin D in Various Disorders

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