Systemic Lupus Erythematosus: Is It One Disease?

Rivas-Larrauri, Francisco; Yamazaki‐Nakashimada, Marco Antonio

doi:10.1016/j.reumae.2016.01.002

Cited by 22 publications

(16 citation statements)

References 90 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune syndrome with pleiotropic clinical manifestations and profound dysregulation of innate and adaptive immune responses (1)(2)(3)(4)(5). Standard of care treatment for SLE involves fairly nonspecific immunosuppression, and there is a need for more targeted approaches (6,7).…”

Section: Introductionmentioning

confidence: 99%

Effects of Gasdermin D in Modulating Murine Lupus and its Associated Organ Damage

Wang

Blanco

Carmona‐Rivera

et al. 2020

Arthritis & Rheumatology

View full text Add to dashboard Cite

Objective Gasdermin D (GSDMD) is the key executioner of an inflammatory cell death mechanism known as pyroptosis. Recent reports have also implicated GSDMD in other mechanisms of cell death, including apoptosis, necroptosis, and NETosis. Given the role of dysregulated cell death in autoimmune syndromes such as systemic lupus erythematosus (SLE), this study was undertaken in a murine lupus model to investigate whether GSDMD plays a pathogenic role in systemic autoimmunity by promoting inflammatory cell death, leading to increased generation of nuclear autoantigens and autoantibodies. Methods An imiquimod‐induced model of SLE was tested in GSDMD−/− mice (n = 30), with wild‐type (WT) mice as controls (n = 34), on a C57BL/6 background. At the time of euthanasia, the mice were examined for serum autoantibodies, immune complex deposition, organ inflammation, immune dysregulation, and type I interferon responses. A model of pristane‐induced lung injury in GSDMD−/− mice (n = 7), with WT mice as controls (n = 10), was used to confirm the pulmonary phenotype. Regulation of various mechanisms of cell death by GSDMD was investigated in the mice. Results Unexpectedly, GSDMD−/− mice developed enhanced mortality, more severe renal and pulmonary inflammation, and exacerbated autoantibody production in response to imiquimod. Pulmonary involvement was also more severe in the absence of GSDMD in mice with pristane‐induced lung injury. Compared to WT mice, lack of GSDMD was associated with increased levels of circulating nuclear autoantigens (P < 0.01), anti–double‐stranded DNA autoantibodies (P < 0.01), tissue immune complex deposition (P < 0.05), expansion of myeloid cell subsets (P < 0.05), and enhanced B cell activation and plasma cell differentiation (P = 0.001). Moreover, in the absence of GSDMD, enhanced autoantigen generation was associated with increased local induction of cell death in vivo. Conclusion GSDMD negatively regulates autoantigen generation and immune dysregulation in response to tissue injury and may play previously unappreciated protective roles in systemic autoimmunity.

show abstract

Section: Introductionmentioning

confidence: 99%

Effects of Gasdermin D in Modulating Murine Lupus and its Associated Organ Damage

Wang

Blanco

Carmona‐Rivera

et al. 2020

Arthritis & Rheumatology

View full text Add to dashboard Cite

show abstract

“…However, there were no reported cases of SLE with the only or the initial symptom of hypothyroidism, the present study reported on a case to highlight the diversity of the disease. SLE is a multifactorial autoimmune disease with a complex pathogenesis and clinical manifestations (28). The present case and previous studies suggest that hypothyroidism is more likely to occur in patients with SLE in whom there is a higher incidence of anti-thyroid antibodies (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26); the reason for this remains elusive.…”

Section: Discussionmentioning

confidence: 62%

Systemic lupus erythematosus with hypothyroidism as the initial clinical manifestation: A case report

Zhang

Liu

et al. 2020

Exp Ther Med

View full text Add to dashboard Cite

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease and hypothyroidism is an organ-specific autoimmune disease. The two diseases may occur successively or simultaneously. The majority of previous studies observed that thyroid disease was more frequent in patients with SLE than in the general population, particularly those who had a higher incidence of anti-thyroid antibodies. However, there are no reported cases of SLE with hypothyroidism as the initial clinical manifestation, to the best of our knowledge. The present study reported on a case of SLE with this unusual initial clinical manifestation and reviewed the literature to estimate the prevalence of clinical hypothyroidism in patients with SLE (range, 3.0-21.4%). The case of the present study had no obvious facial erythema, photosensitivity or recurrent oral ulcers, and only had hypothyroidism as the initial clinical symptom, but the laboratory examination supported the diagnosis of SLE. The present study suggested that in the clinical diagnosis, attention should be paid to screening for connective tissue diseases when diagnosing hypothyroidism, and the importance of thyroid dysfunction should also be recognized in the treatment of SLE.

show abstract

“…Systemic lupus erythematosus (SLE) is characterized by gradual worsening of general symptoms with periodic remissions and relapses under treatment. There is no cure for this disease and available therapies can only postpone disability and fatality [3]. SLE is treated with a variety of drugs, including nonsteroidal anti-inflammatory drugs, corticosteroids (CSs), antimalarials, immunosuppressants (ISs), and disease-modifying antirheumatic drugs (DMARDs).…”

Section: Introductionmentioning

confidence: 99%

Patient-reported Satisfaction with Current Clinical Management of Systemic Lupus Erythematosus in Kazakhstan

Khamitov

Khismetova

Goremykina

et al. 2020

Open Access Maced J Med Sci

View full text Add to dashboard Cite

BACKGROUND: Over the past decades, patient satisfaction has been increasingly recognized as a powerful tool to measure the quality of health-care services. AIM: This study evaluated the satisfaction of systemic lupus erythematosus (SLE) patients with current clinical management in Semey, East Kazakhstan, and explored the factors associated with dissatisfaction. METHODS: All adult SLE patients registered at health-care facilities of Semey were enrolled in a cross-sectional study. RESULTS: Out of 67 patients, 66 were females and their mean age was 39 years. Symptoms associated with the musculoskeletal system were the most commonly reported (95.5%), followed by fatigue (88.1%) and neurological symptoms (53.7%). None of the patients were very satisfied or satisfied with current clinical management and the overall rate of patient dissatisfaction was 83.6%. Education (p = 0.04), monthly income (p = 0.01), SLE disease activity index score (p = 0.031), therapy with biologic agents (p = 0.029), immunosuppressants (p = 0.01), and corticosteroids (p = 0.01) were predictors of patient dissatisfaction in multiple logistic regression analysis. CONCLUSION: This real-world study is the first effort to understand the experience of SLE patients within the health-care system of Kazakhstan and the results may facilitate doctor-patient discussions on the initiatives that need to be taken to improve the quality of the medical services provided.

show abstract

Systemic Lupus Erythematosus: Is It One Disease?

Cited by 22 publications

References 90 publications

Effects of Gasdermin D in Modulating Murine Lupus and its Associated Organ Damage

Effects of Gasdermin D in Modulating Murine Lupus and its Associated Organ Damage

Systemic lupus erythematosus with hypothyroidism as the initial clinical manifestation: A case report

Patient-reported Satisfaction with Current Clinical Management of Systemic Lupus Erythematosus in Kazakhstan

Contact Info

Product

Resources

About