Systemic lupus erythematosus

Reviews

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  Systemic lupus erythematosus

  Systemic lupus erythematosus is an autoimmune disease that can affect many organs, including the skin, joints, the central nervous system and the kidneys. Here, Kaul et al. highlight the heterogeneity of the disease, the management approaches and provide an outlook on the future research directions.

  • Arvind Kaul
  • Caroline Gordon
  • Graham Hughes

  Primer16 Jun 2016 Nature Reviews Disease Primers
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  New insights into the immunopathogenesis of systemic lupus erythematosus

  In this Review, Tsokos et al. describe recent advances in our understanding of systemic lupus erythematosus (SLE) that are driving repurposing of existing drugs as well as development of new treatments. Cytokines, tolerance pathways, local tissue mediators, and epigenetic mechanisms all show promise as novel targeted therapies that could lead to individualized care in SLE.

  • George C. Tsokos
  • Mindy S. Lo
  • Kathleen E. Sullivan

  Review Article22 Nov 2016 Nature Reviews Rheumatology
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  T cells and autoimmune kidney disease

  T cells are critical drivers of autoimmunity and related organ damage, by supporting B-cell differentiation and antibody production or by directly promoting inflammation and cytotoxicity. This Review discusses the immune features of autoimmune nephropathies, with a focus on systemic lupus erythematosus and the role of T cells.

  • Abel Suárez-Fueyo
  • Sean J. Bradley
  • George C. Tsokos

  Review Article13 Mar 2017 Nature Reviews Nephrology
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  Beyond pan-B-cell-directed therapy — new avenues and insights into the pathogenesis of SLE

  Reverse translation of data obtained from trials of B-cell-targeted therapies in systemic lupus erythematosus (SLE), along with advances in understanding of B-cell intracellular signalling pathways and post-activation status, highlight pathogenic roles for autoantigen-presenting B cells and regulatory B cells in autoimmune diseases. These insights could lead to innovative treatments for SLE based on modulation of B-cell activation and regulatory functions.

  • Thomas Dörner
  • Peter E. Lipsky

  Review Article13 Oct 2016 Nature Reviews Rheumatology
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  Altered dendritic cell functions in autoimmune diseases: distinct and overlapping profiles

  Dendritic cells are key regulators of both immunity and tolerance, and display a remarkable functional heterogeneity. In this Review, the authors discuss how the function and distribution of different dendritic cell subsets change in autoimmune diseases.

  • Frédéric Coutant
  • Pierre Miossec

  Review Article22 Sep 2016 Nature Reviews Rheumatology
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  The global burden of SLE: prevalence, health disparities and socioeconomic impact

  Understanding the global burden of SLE, and the factors that contribute to the considerable variation in its worldwide incidence and prevalence (particularly health disparities, costs, and socioeconomic status), is expected to inform future efforts to improve patient outcomes while optimizing resource allocation and decreasing associated health-care costs.

  • Erin E. Carter
  • Susan G. Barr
  • Ann E. Clarke

  Review Article25 Aug 2016 Nature Reviews Rheumatology
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  Biologics for the treatment of autoimmune renal diseases

  Biological therapeutics that target autoimmune responses have markedly improved the treatment of numerous chronic diseases. In this Review, Stephen Holdsworth and colleagues discuss the opportunities for biologic intervention in autoimmune renal disorders. They outline the key targets that are known to contribute to an injurious inflammatory response, and the biologics that are already available to modulate them.

  • Stephen R. Holdsworth
  • Poh-Yi Gan
  • A. Richard Kitching

  Review Article7 Mar 2016 Nature Reviews Nephrology
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  The role of neutrophils and NETosis in autoimmune and renal diseases

  Neutrophils are crucial regulators of the innate immune response and act as a first line of defence against invading microorganisms. To target microorganisms, neutrophils release extracellular structures called neutrophil extracellular traps (NETs), which externalize key autoantigens. In this Review, Gupta and Kaplan explore the contribution of neutrophils and NETs to the pathophysiology of systemic autoimmune disorders that can affect the kidneys, and discuss neutrophils as novel therapeutic targets for these diseases.

  • Sarthak Gupta
  • Mariana J. Kaplan

  Review Article31 May 2016 Nature Reviews Nephrology
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  Plasma cells as an innovative target in autoimmune disease with renal manifestations

  Autoantibodies are produced by plasma cells and contribute to the pathogenesis of many diseases, including systemic or organ-specific autoimmune diseases that involve the kidneys. In contrast to short-lived plasma cells, long-lived plasma cells reside in survival niches in the bone marrow and inflamed tissue, and provide the basis of humoral memory and refractory autoimmune disease activity. Here, the authors discuss the generation of plasma cells, their role in autoimmune disease, and current and future strategies for the depletion of autoreactive plasma cells, including novel approaches that target humoral memory.

  • Falk Hiepe
  • Andreas Radbruch

  Review Article29 Feb 2016 Nature Reviews Nephrology
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  Towards new avenues in the management of lupus glomerulonephritis

  This Review discusses the progress made by international networks in the USA, Europe and Asia towards improving the efficacy of existing and novel therapies for lupus nephritis. Strategies being actively pursued include biomarker identification and optimization of induction and maintenance treatment. These approaches aim to improve patients' outcomes by raising complete response rates, reducing renal flares, preserving long-term renal function, and minimizing treatment-related toxic effects.

  • C. C. Mok

  Review Article5 Jan 2016 Nature Reviews Rheumatology
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  What is damaging the kidney in lupus nephritis?

  Nephritis remains an important cause of morbidity and mortality in many patients with systemic lupus erythematosus (SLE), but knowledge of the factors contributing to the heterogeneity of kidney disease in these patients has been lacking. This article outlines various pathogenic pathways that contribute to renal damage in SLE and explains how disease phenotyping based on these mechanisms could lead to the novel and individualized therapies for patients with lupus nephritis.

  • Anne Davidson

  Review Article19 Nov 2015 Nature Reviews Rheumatology
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  Anti-DNA antibodies — quintessential biomarkers of SLE

  Anti-DNA antibodies are serological hallmarks of systemic lupus erythematosus, but many questions remain unanswered regarding their origins and pathological properties, as well as the relative merits of different assay formats. Understanding the mechanisms of DNA binding and pathogenesis relating to anti-DNA antibodies can aid the development of diagnostic and theranostic assays.

  • David S. Pisetsky

  Review Article19 Nov 2015 Nature Reviews Rheumatology
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  Pathogenesis and targeted treatment of skin injury in SLE

  Ultraviolet light, immune cells, cytokines and deposition of immunoglobulins all seem to have a role in the development of skin lesions in SLE. This Review discusses recent advances in understanding of the cellular, cytokine and molecular processes underlying the cutaneous manifestations of SLE, focussing on processes or molecules that could potentially be exploited therapeutically.

  • Guo-Min Deng
  • George C. Tsokos

  Review Article4 Aug 2015 Nature Reviews Rheumatology
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  Genetics and pathogenesis of systemic lupus erythematosus and lupus nephritis

  Systemic lupus erythematosus (SLE) is a complex, autoimmune disorder that can have debilitating effects on various organs, including the kidneys. Here, Mohan and Putterman discuss the genetic candidates associated with SLE and lupus nephritis, and highlight possible molecular mechanisms that might contribute to disease pathology. Given the highly variable clinical presentation of SLE, the authors propose that greater understanding of the molecular basis of SLE and lupus nephritis is required to facilitate the generation of specific tailored therapies in the future.

  • Chandra Mohan
  • Chaim Putterman

  Review Article31 Mar 2015 Nature Reviews Nephrology
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  Treatment of severe lupus nephritis: the new horizon

  Lupus nephritis is a severe manifestation of systemic lupus erythematosus and a major cause of both acute kidney injury and end-stage renal disease. Preventing, or delaying progression of lupus nephritis is the primary objective of treatment. New treatments, or treatment regimens have substantially improved the overall prognosis of patients with lupus nephritis over the past 30 years. Here, Tak Mao Chan provides a detailed summary of the clinical efficacy of current treatment approaches, and the potential roles of emerging treatments for lupus nephritis.

  • Tak Mao Chan

  Review Article25 Nov 2014 Nature Reviews Nephrology