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Systemic Lupus Erythematosus
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TLDR
Contributions are gathered from physicians and researchers from North America, South America, Europe, and Asia that highlight several important and/or novel aspects of the molecular pathogenesis, clinical organ involvement, and experimental therapies in this prototypical systemic autoimmune disease.Abstract:
In sharp distinction to organ-specific autoimmune diseases such as thyroiditis, diabetes, or myasthenia gravis, systemic lupus erythematosus (SLE) is a constellation of signs and symptoms classified as one nosologic entity. Indeed, it is the diversity of presentation, accumulation of manifestations over time, and undulating disease course that challenge the most astute of clinicians. With rare exception, the unifying laboratory abnormality is the presence of circulating antinuclear antibodies (ANA). Acknowledging the complexity of this disease, its broad differential diagnosis, and the need to develop better and more specific therapies, the American College of Rheumatology (ACR) has designated 11 diagnostic criteria (presented in Table 15A-1) (1,2). These criteria reflect the major clinical features of the disease (mucocutaneous, articular, serosal, renal, neurologic) and incorporate the associated laboratory findings (hematologic and immunologic). The presence of four or more criteria is required for diagnosis. They need not necessarily present simultaneously: a single criterion such as arthritis or thrombocytopenia may recur over months or years before the diagnosis can be confirmed by the appearance of additional features. While there is incomplete agreement among rheumatologists as to whether these criteria need to be strictly applied in a practice setting, or reserved only for formal academic studies, they do facilitate a methodologic approach to evaluate a patient.read more
Citations
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Journal ArticleDOI
Autoimmunity, Polyclonal B-Cell Activation and Infection:
Norman A. Granholm,T Cavallo +1 more
TL;DR: Data is summarized to indicate that polyclonal B-cell activation is central to the pathogenesis of systemic autoimmune disease, and it is explored the mechanism of tissue injury when autoimmune disease is induced or exacerbated.
Journal Article
Treatment of Cutaneous Lupus Erythematosus: Review and Assessment of Treatment Benefits Based on Oxford Centre for Evidence-based Medicine Criteria.
TL;DR: The need for randomized, controlled trials and systematic reviews of all cutaneous lupus erythematosus interventions in order to meet increasing standards and demand for evidence-based practice is demonstrated.
Journal ArticleDOI
Platelets in Rheumatic Diseases: Friend or Foe?
TL;DR: Current evidence necessitates a balanced approach to platelet-activating and suppressing drug therapies in inflammatory rheumatic diseases, and emerging data suggest that the release rate of activated platelets applied topically to the inflamed cartilage in arthritis or skin ulcers in scleroderma may suppress the inflammation and facilitate tissue repair.
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Interferon regulatory factor 5 in the pathogenesis of systemic lupus erythematosus.
TL;DR: Data support a model in which SLE-risk variants of IRF5 participate in a “feed-forward” mechanism, predisposing to Sle-associated autoantibody formation, and subsequently facilitating IFN-α production downstream of Toll-like receptors stimulated by immune complexes composed of these autoantsibodies.
Journal ArticleDOI
The need to define treatment goals for systemic lupus erythematosus
TL;DR: The potential benefits of a treatment-target definition are explored, obstacles to the development of areatment target in SLE are identified, and possible strategies to achieve this goal are discussed.
References
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Journal ArticleDOI
Systemic lupus erythematosus
Jessica J Manson,Anisur Rahman +1 more
TL;DR: Systemic lupus erythematosus is a relapsing and remitting disease, and treatment aims are threefold: managing acute periods of potentially life-threatening ill health, minimizing the risk of flares during periods of relative stability, and controlling the less life- threatening, but often incapacitating day to day symptoms.
Journal ArticleDOI
The bimodal mortality pattern of systemic lupus erythematosus
Murray B. Urowitz,Arthur Bookman,Barry E. Koehler,Duncan A. Gordon,Hugh A. Smythe,Metro A. Ogryzlo +5 more
TL;DR: An examination of the deaths in a long-term systematic analysis of 81 patients followed for five years at the University of Toronto Rheumatic Disease Unit found death is associated with inactive lupus, long duration of steroid therapy and a striking incidence of myocardial infarction due to atherosclerotic heart disease.
Journal ArticleDOI
Immunological studies concerning the nephritis of systemic lupus erythematosus
TL;DR: The immunochemical evidence for the high specific activity of antinuclear antibodies and the association of DNA antigen with DNA antibody in glomeruli add further support for the antigen-antibody complex hypothesis for renal injury in systemic lupus erythematosus.
Journal ArticleDOI
The neurological manifestations of systemic lupus erythematosus.
Journal ArticleDOI
Immunologic Factors and Clinical Activity in Systemic Lupus Erythematosus
Peter H. Schur,John I. Sandson +1 more
TL;DR: Serial immunochemical observations may be useful in the management of patients with systemic lupus erythematosus, as they reflect the in vivo formation of immune complexes that cause nephritis.
Related Papers (5)
Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus.
Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus.
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