scholarly journals Immune Profiling and Precision Medicine in Systemic Lupus Erythematosus

Cells ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. 140 ◽  
Author(s):  
Yasuo Nagafuchi ◽  
Hirofumi Shoda ◽  
Keishi Fujio

Systemic lupus erythematosus (SLE) is an autoimmune disorder with a wide range of clinical symptoms. Enormous progress has been made in the immunological and genetic understanding of SLE. However, the biology of disease heterogeneity in SLE has remained largely unexplored. Human immune profiling studies, helped by recent technological advances especially in single-cell and “omics” analyses, are now shedding light on the cellular and molecular basis of clinical symptoms and disease flares in individual patients. Peripheral blood immunophenotyping analysis with flow cytometry or mass cytometry are identifying responsible cell subsets and markers characteristic of disease heterogeneity. Transcriptome analysis is discovering molecular networks responsible for disease activity, disease subtype and future relapse. In this review, we summarize recent advances in the immune profiling analysis of SLE patients and discuss how they will be used for future precision medicine.

2020 ◽  
Vol 31 (3) ◽  
pp. 296-307
Author(s):  
Erin K. Gasser ◽  
Hildy M. Schell-Chaple

Systemic lupus erythematosus is a chronic autoimmune disorder that causes a wide range of mild to life-threatening conditions that require hospitalization and critical care. The morbidity and mortality of systemic lupus erythematosus are associated with the organ system damage caused by intermittent or chronic disease activity and with the complications of long-term and toxic immunosuppressant medication regimens. This article reviews the epidemiologic, clinical, diagnostic, and therapeutic information essential for critical care clinicians who provide care to patients with systemic lupus erythematosus.


2018 ◽  
Vol 9 (2) ◽  
Author(s):  
Rahadian Nugi Sutrisno ◽  
Andri Reza Rahmadi ◽  
Nita Novita ◽  
Laniyati Hamijoyo

Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease with wide range of clinical symptoms. The patients frequently complain musculoskeletal involvement during the active state of the disease. Musculoskeletal manifestation in SLE patients is an important sign in making early diagnosis and monitoring treatment response. This study aims to determine the presentation of musculoskeletal involvement of SLE patients in Dr. Hasan Sadikin General Hospital Bandung.Methods: a descriptive cross-sectional quantitative study done by interviewing SLE patients concerning musculoskeletal manifestation as the primary data and tracking their medical record as the secondary data. Study was conducted between September to November 2016 in Rheumatology Clinic Dr. Hasan Sadikin General Hospital Bandung.Result: Ninety-seven SLE patients, 91 females (93,81%) and 6 males (6,19%), were enrolled in this study with mean age 35.12 (±10.91) years. The three highest proportions of muskuloskeltal manifestations were arthritis of the knee (84,5%), myalgia of upper back(40,2%), and muscle weakness (15,5%). We did not find any Jaccoud’s Arthropathy (JA) and tendinitis manifestation. Osteoporosis were occured in 4 patients (4,12%), whereas gout arthritis, spondytlitis, osteoarthritis, rotator cuff syndrome, and rhupus wereonly occured in one patient (1,03%), respectively.Conclusion: The common musculoskeletal manifestation in SLE patients were arthritis of knee, myalgia of upper back, and muscle weakness. Only small portion of patients suffered from osteoporosis, gout arthritis, spondytlitis, osteoarthritis, rotator cuff syndrome, and rhupus.Keyword: musculoskeletal manifestation, musculoskletal involment, SLE


2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Massimiliano Sarra ◽  
Giovanni Monteleone

Systemic Lupus Erythematosus (SLE) is an autoimmune disorder characterized by excessive production of a variety of autoantibodies and a wide range of clinical manifestations. Pathogenesis of SLE is complex and not fully understood. There is however evidence that B and T cells are critical to the development of disease, and that T cell-derived cytokines are involved in the SLE-associated inflammatory response. One such cytokine seems to be interleukin (IL)-21, the latest identified member of the -chain-related cytokine family. IL-21 has an important role in the control of the growth, survival, differentiation, and function of both T and B cells, and excessive production of IL-21 has been associated with the development of multiple immune-mediated diseases. Here we review data supporting the involvement of IL-21 in the pathogenesis of SLE.


2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Sriram Krishnamurthy ◽  
Subramanian Mahadevan

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder associated with multiple immunological abnormalities and a wide range of clinical manifestations. Recent progress in genetics has expanded the number of the genes associated with SLE to more than 20 in number and has contributed to improvement of understanding of the pathogenesis of the disease. This has enhanced the development of novel therapeutic targets and biomarkers for individualized and tailor-made clinical management of lupus patients. Despite this knowledge, however, it is a challenge to fully understand the genetic pathogenesis of the disease. The present paper describes the current concepts in the mechanisms, genomics, and pathogenesis of SLE and their implications for management of the disorder. The potential role of gene therapy, biological agents, intravenous immunoglobulin, anti-inflammatory cytokines, and cytokine inhibitors is discussed.


Author(s):  
Rahmatika R ◽  
Rudy Handoyo ◽  
Tanti Ajoe K

ABSTRACTIntroduction: Systemic Lupus Erythematosus (SLE) is a prototype of an autoimmune disease characterized by the production of antibodies against cell nucleus components with a broad spectrum of clinical patterns. The SLE will cause long-term complications so that SLE patients tend to have sedentary lifestyle and decrease physical activity which reduces exercise capacity. The aim of therapeutic exercise is to improve a variety of clinical symptoms in SLE patients by alleviate the inflammatory process andmodifying the disease’s natural course. Methods: All of references have searched in 2018 within the areas of rheumatology, immunology,cardiology, physical education and physiotherapy. Results: Therapeutic exercise in SLE has an anti-inflammatory effect by inhibiting the release of inflammatory mediators including TNF-α. Therapeutic exercise in the form of aerobic and resistance exercise able to improve aerobic capacity, reduced fatigue, increasing chronotropic reserve, heart rate recovery, functional performance, functional capacity, muscle strength and increase bone turn over.Therapeutic exercise was not aggravated disease activity as measured by SLE Activity Index (SLEDAI) and SLE Activity Measure (SLAM) index. Conclusion: Supervised aerobic and resistance exercise seems to help improve health, vitality and self perceived physical capacity in SLE patients.


2017 ◽  
Vol 104 (1) ◽  
pp. 35-41 ◽  
Author(s):  
A Kern ◽  
E Barabás ◽  
A Balog ◽  
Sz Burcsár ◽  
M Kiszelák ◽  
...  

Systemic lupus erythematosus (SLE) is a multisystemic inflammatory autoimmune disorder. Thrombotic events occur at a higher incidence among SLE patients. The investigation of thrombin generation (TG) with calibrated automated thrombogram (CAT) test as a global hemostasis assay is applicable for the overall functional assessment of the hemostasis. The aim of this study was to characterize the hemostatic alterations observed in SLE by CAT assay. In this study, CAT parameters and basic coagulation parameters of SLE patients (n = 22) and healthy control subjects (n = 34) were compared. CAT area under the curve (i.e., endogenous thrombin potential) was lower than normal in SLE (807 vs. 1,159 nM*min, respectively), whereas other CAT parameters (peak, lag time, time to peak, and velocity index) and the basic coagulation tests were within the normal range. The presence of anti-phospholipid antibodies and the applied therapy was not associated with hemostasis parameters in SLE. We concluded that the reported high risk of thrombosis is not related to TG potential.


2016 ◽  
Vol 39 (1) ◽  
pp. 303-315 ◽  
Author(s):  
Dongmei Liu ◽  
Na Zhang ◽  
Xiaomei Zhang ◽  
Muting Qin ◽  
Youdan Dong ◽  
...  

Background/Aims: Systemic lupus erythematosus (SLE) is a heterogeneous chronic inflammatory autoimmune disorder, in the pathogenesis of which miRNAs play a versatile function. The purpose of this study was to investigate the effect of miRNA-410 on the pathogenesis of SLE in T cells of SLE patients. Methods: Real-time PCR was used to test the mRNA levels of miRNA-410 in SLE patients and healthy controls. ELISA analysis was performed to examine the production levels of IL-10. Luciferase Assay was used to confirm the targeting effect of miRNA-410 on 3'UTR of STAT3 mRNA. Results: We found that the expression level of miR-410 in T cells of SLE patients was decreased comparing to that in healthy controls, whereas overexpression of miR-410 significantly reduced the expression levels of IL-10. Furthermore, miR-410 suppresses the transcription activity of STAT3 by binding directly to the 3 'UTR of STAT3 mRNA. Moreover, silence of STAT3 down regulated IL-10 expression in CD3+ T cells. Conclusion: Our results demonstrate that miR-410 is the key regulatory factor in the pathogenesis of SLE by regulating the expression of IL-10 through targeting STAT3. These data suggest a novel function of miR-410 and bring new insight into understanding the complex mechanisms involved in SLE.


2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Liuye Huang ◽  
Yuan Yang ◽  
Yu Kuang ◽  
Dapeng Wei ◽  
Wanyi Li ◽  
...  

Objective. Systemic lupus erythematosus (SLE) is an autoimmune disease identified by a plethora of production of autoantibodies. Autoreactive T cells may play an important role in the process. Attenuated T cell vaccination (TCV) has proven to benefit some autoimmune diseases by deleting or suppressing pathogenic T cells. However, clinical evidence for TCV in SLE is still limited. Therefore, this self-controlled study concentrates on the clinical effects of TCV on SLE patients. Methods. 16 patients were enrolled in the study; they accepted TCV regularly. SLEDAI, clinical symptoms, blood parameters including complements 3 and 4 levels, ANA, and anti-ds-DNA antibodies were tested. In addition, the side effects and drug usage were observed during the patients’ treatment and follow-up. Results. Remissions in clinical symptoms such as facial rash, vasculitis, and proteinuria were noted in most patients. There are also evident reductions in SLEDAI, anti-ds-DNA antibodies, and GC dose and increases in C3 and C4 levels, with no pathogenic side effects during treatment and follow-up. Conclusions. T cell vaccination is helpful in alleviating and regulating systemic lupus erythematosus manifestation.


2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Risa Yamada ◽  
Kazuhisa Nozawa ◽  
Takashi Yoshimine ◽  
Yoshinari Takasaki ◽  
Hideoki Ogawa ◽  
...  

Thrombotic thrombocytopenia purpura (TTP) caused by a deficiency in ADAMTS-13 activity is considered to involve a subset of thrombotic microangiopathy (TMA). Although concept of TTP is included under the umbrella of TMA, discrimination of TTP from TMA is occasionally difficult in an autoimmune disorder. Herein, we report a case with TTP associated with systemic lupus erythematosus (SLE). In this case, it was difficult to discriminate TTP from TMA and the measurement of ADAMTS-13 activity was useful for obtaining an accurate diagnosis. SLE patients having thrombocytopenia in complication with anemia should be considered a monitoring of ADAMTS-13 activity even though the patients lacked symptoms of TTP related to the microvascular coagulation.


Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 562-564 ◽  
Author(s):  
Ruiqiang Wang ◽  
Bowen Zheng ◽  
Biyue Wang ◽  
Pupu Ma ◽  
Fengmei Chen ◽  
...  

AbstractChronic intestinal pseudo-obstruction (CIPO) is a functional gastrointestinal disorder with symptoms of ileus. CIPO can either be idiopathic or secondary to other diseases such as systemic lupus erythematosus (SLE). SLE is involved in many parts of the gastrointestinal system with variable clinical presentations. Reports about reduplicated CIPO as a complication of SLE is infrequent. A 49-year-old female suffering from clinical symptoms of ileus has been hospitalized 3 times over 1 year. Her examination results showed no observation of mechanical obstruction. In August 2017, she came to the nephrology department due to edema in both lower limbs along with symptoms of ileus. After thorough examination, she was diagnosed with secondary CIPO related to SLE. Results of renal biopsy confirmed to be lupus nephritis (Class III-(A) + V). The symptoms of ileus are gradually improved after treatment of full-dose intravenous corticosteroid for 5 days.


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