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PubMed2005

T- and B-cell abnormalities in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by the production of antinuclear autoantibodies and clinical involvement in multiple organ systems. T cells from patients with SLE have been shown to be activated in vivo and provide help to autoreactive B cells. Abnormal expression of key signaling molecules, defective signal transduction pathways, and permanent mitochondrial dysfunction--associated with a significantly increased mitochondrial mass--appear to be the axis of T-lymphocyte dysfunction. Lupus T cells exhibit persistent mitochondrial hyperpolarization (MHP), cytoplasmic alkalinization, increased ROI production, and ATP depletion that mediate enhanced spontaneous and diminished activation-induced apoptosis and sensitize lupus T cells to necrosis. Necrotic, but not apoptotic, cell lysates activate dendritic cells and may account for increased interferon-alpha production, inflammation, and antinuclear antibody production. Recent data indicate that B cells are not merely the passive producers of autoantibodies, but also play a central role in autoimmunity via nonconventional mechanisms, including autoantigen presentation and modulation of other immune cells. This article reviews recent advancements in the understanding of the molecular mechanisms involved in the pathogenesis of lupus autoimmunity and highlights the development of novel therapies in SLE.

Animals↗
PubMed2006

Aberrant phenotype and function of myeloid dendritic cells in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is characterized by a systemic autoimmune response with profound and diverse T cell changes. Dendritic cells (DCs) are important orchestrators of immune responses and have an important role in the regulation of T cell function. The objective of this study was to determine whether myeloid DCs from individuals with SLE display abnormalities in phenotype and promote abnormal T cell function. Monocyte-derived DCs and freshly isolated peripheral blood myeloid DCs from lupus patients displayed an abnormal phenotype characterized by accelerated differentiation, maturation, and secretion of proinflammatory cytokines. These abnormalities were characterized by higher expression of the DC differentiation marker CD1a, the maturation markers CD86, CD80, and HLA-DR, and the proinflammatory cytokine IL-8. In addition, SLE patients displayed selective down-regulation of the maturation marker CD83 and had abnormal responses to maturation stimuli. These abnormalities have functional relevance, as SLE DCs were able to significantly increase proliferation and activation of allogeneic T cells when compared with control DCs. We conclude that myeloid DCs from SLE patients display significant changes in phenotype which promote aberrant T cell function and could contribute to the pathogenesis of SLE and organ damage.

Adult↗
PubMed1996

Protein losing enteropathy as the initial manifestation of childhood systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a multisystem organ disease, and involvement of the gastrointestinal system is relatively rare. We describe a 13-year-old girl who presented initially with abdominal pain, diarrhea, edema, and hypoalbuminemia. She was diagnosed with protein losing enteropathy (PLE) based on the significant increase of alpha 1-antitrypsin clearance in the stool. Two weeks after admission she developed clinical and serological findings that fulfilled the ACR criteria for SLE. Over 22 cases of lupus associated PLE have now been reported, but only 3 in children. Children with PLE should be evaluated for SLE. In addition, PLE should be suspected as a possible cause of unexplained edema and/or hypoalbuminemia in SLE.

Adolescent↗
PubMed1989

Monocyte function in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is characterized by multiple defects affecting B and T lymphocyte cell function. In view of the influence that monocytes may have on these functions, we have examined monocyte function in patients with SLE and normals. Monocytes were examined as to number, their ability to modulate IgG synthesis, phagocytose yeast particles, and acid phosphatase activity. Patients had more monocytes and mononuclear cells made more IgG, but these factors appear to be independent of each other. Monocytes from lupus patients are less phagocytic but show similar levels of acid phosphatase activity to normal controls. Normal, but not lupus monocytes, show enhanced phagocytosis following treatment with LPS. The effect of monocyte stimulation on acid phosphatase activity is the same in lupus and normal monocytes. Taken together, these observations suggest that the increased numbers of monocytes in lupus patients and some subtle functional differences in these cells may be important in the progression of this disease.

Humans↗
PubMed1989

Liver lymphoma in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) has been associated with an increased incidence of lymphoma. We describe the occurrence of hepatic lymphoma, which was likely primary in origin, in a patient with SLE and discuss the etiologic and diagnostic implications.

Aged↗
PubMedDate not supplied

Posture in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a connective autoimmune disease that may involve many organ systems and neural function impairment. Postural apparatus dysfunction in SLE may develop in the case of central and peripheral neural involvement. We studied the presence of postural abnormalities in SLE patients with different degrees of disease activity. Twenty-eight subjects (18 SLE patients and 10 normal controls) underwent postural evaluation by means of Static Computerised Posturography. Disease severity or specific clinical problems did not form selection criteria. Lupus activity was assessed using the Systemic Lupus Activity Measure (SLAM). A statistically significant (p < 0.05) increase in the parameters of trace length, trace surface, trace velocity, standard deviation in velocity, and Fast Fourier trX and Y (FET), were found in both the closed and opened eyes tests, when lupus patients were compared to controls subjects. No significant pattern variation in posture was observed between more active and less active SLE patients. Postural control alterations in SLE may be considered a complication of the chronic autoimmune inflammatory process, independent of disease activity as evaluated by the SLAM index. The site of the neuropathy remains uncertain, although we believe it to be peripheral rather than central in origin due to the absence of symptoms or clinical signs of CNS involvement or vascular degeneration.

Adult↗
PubMed2026

Mapping the plasma proteomic architecture of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a heterogeneous systemic autoimmune disease, yet the molecular basis underlying this variability remains incompletely understood. We profiled the plasma proteome in 260 SLE patients and 86 healthy volunteers (HVs) using the SomaScan v4.1 platform, quantifying 7,288 analytes corresponding to 6,595 unique proteins. We identified 215 proteins that were robustly differentially abundant between SLE patients and HVs in both discovery (n = 207 SLE, n = 45 HVs) and validation sets (n = 53 SLE, n = 41 HVs). Within-cases analyses identified 421 proteins associated with disease activity. Network-based clustering delineated correlated protein modules, including an interferon-associated (IFN-associated) module and a kidney-associated module. Autoantibody-stratified analyses further uncovered distinct proteomic endotypes; positivity for antibodies targeting RNA-binding proteins (anti-Sm, anti-Ro-60, anti-RNP68, anti-RNP-A) was associated with increased IFN-stimulated protein levels (e.g., MX1, ISG15, and CXCL10), independent of disease activity. Anti-Sm, anti-RNP-A, and anti-Ro52 antibodies were associated with reduced plasma levels of their respective autoantigens. Anti-dsDNA antibodies were associated with elevated levels of CD40 ligand (CD40LG) and the neutrophil protease, proteinase-3. Moreover, we identified an association between CD40LG and disease activity specific to the anti-dsDNA-positive subgroup. Together, these data define plasma protein signatures of SLE and disease activity, highlight autoantibody-specific molecular phenotypes, and provide a basis for precision medicine.

Humans↗
PubMed1988

Pedal manifestations of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is an autoimmune disease with numerous pedal manifestations. Since pedal manifestations are often its first presentation, it is important that the podiatrist knows how to recognize the disease. This article discusses the manifestations, diagnosis, and treatment of SLE as they relate to podiatry.

Foot Diseases↗
PubMed1988

Autoantibodies in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease in which the predominant autoantibodies are antinuclear antibodies (ANA) reactive with DNA and histones, and antibodies reactive with the non-histone extractable nuclear antigens (ENA), Sm and Ro. Racial differences demonstrable in predisposition to SLE are also evident in the prevalence of autoantibodies, the frequency of anti-Sm and anti-Ro being 2-4 times higher in Asians with SLE than in Caucasians with SLE. Autoantibodies have also played a role in the classification of lupus and the recognition of multisystem autoimmune diseases that fail to meet the classical criteria for the identification of patients with SLE but appear to be variants of lupus. Anti-Ro is a diagnostic marker for subacute cutaneous lupus, anti-(U1)RNP a marker for mixed connective tissue disease, antibodies to phospholipids a marker for the syndrome comprising stroke, fetal wastage, thromboembolism and thrombocytopenia and antibodies to histones a marker for lupus induced by the drugs hydralazine and procainamide. There is still no unaminity on whether these antibodies play an integral role in the disease process or whether they are "epiphenomena". The challenge for research in the 1980s is the understanding of the relationship of these antibodies to the pathogenesis of SLE.

Antibodies, Antinuclear↗
PubMed1993

Why so many women? Part 1. Systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder that predominantly affects women. While numerous factors may account for the etiology of SLE, the influence of gender-based sex hormones on the prevalence of SLE and autoimmune disorders among women is currently being evaluated.

Adult↗
PubMedDate not supplied

Systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is an autoimmune disease that exhibits a wide range of clinical symptoms, including skin rashes, oral ulcers, arthritis, pulmonary pleuritis, anemia and seizures. Medical imaging plays a role in assessing the extent of disease, neurological involvement, treatment complications and disease progression. This article describes the known risk factors for SLE and SLE diagnosis and treatment.

Humans↗
PubMed1995

Systemic lupus erythematosus.

Systemic lupus erythematosus is a disease with both genetic and environmental pathogenesis. It has protean manifestations and can mimic most other clinical entities. Its severity varies widely among patients and its course commonly fluctuates from mild to severe in a single patient as the disease waxes and wanes. Since disease presentation is variable its treatment requires individualization. Some patients can be managed with NSAIDs and antimalarials without steroids. Patients with involvement of the nervous system, kidney and hematologic system usually require steroids--often in high doses. Immunosuppressants such as cyclophosphamide are useful in managing lupus emergencies and in maintaining control of disease in others.

Humans↗
PubMed1999

Tumid lupus erythematosus.

BACKGROUND: Tumid lupus erythematosus (TLE) is a subtype of discoid lupus erythematosus (DLE) whose clinical characteristics rarely have been described in the literature. OBJECTIVE: To describe the clinical, histopathologic, and other laboratory findings in tumid lupus erythematosus. METHODS: Clinical and laboratory findings were reviewed in four patients who had been diagnosed with tumid lupus erythematosus by conventional microscopy. The diagnoses were characterized by a superficial and deep perivascular infiltrate of lymphocytes and deposits of mucin in foci in the reticular dermis. RESULTS: All four patients were young women. Ages ranged from 16 to 39 years (mean 21 years). The lesions consisted of numerous erythematous papules and plaques, some with annular configuration situated in the face and neck, trunk, and upper extremities. All four patients had concurrent lesions of classic DLE, three of them had systemic lupus erythematosus (SLE). Direct immunofluorescence test results were negative in nonexposed lesional skin of two of the patients. CONCLUSION: The clinical findings of concurrent lesions of TLE and classic DLE in the same patient, the presence of lesions of TLE in patients with SLE, and the histologic findings demonstrate that TLE is a distinct manifestation of DLE, and as such, a cutaneous expression of SLE.

Adolescent↗
PubMed1993

Chronic pancreatitis: a complication of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE), an autoimmune disease with multisystem involvement, has been reported to be associated with a number of gastrointestinal complications. Acute pancreatitis is an unusual manifestation of this disorder. This report presents two cases of patients with SLE who developed chronic pancreatitis with no other identifiable etiology.

Adult↗
PubMed1986

Systemic lupus erythematosus.

Systemic lupus erythematosus is a multisystem inflammatory disease characterized by autoantibody production. Recent investigations are providing insights into the immunoregulatory disturbances underlying this disease, and are clarifying the approach to diagnosis and treatment.

Anti-Inflammatory Agents↗
PubMed2002

Systemic lupus erythematosus.

Systemic lupus erythematosus is a pleomorphic, autoimmune disorder of unknown cause that can afflict all parts of the body. New insights into its pathogenesis, the employment of preventive measures and combinations of immunosuppressive therapy, as well as the introduction of biologics, are beginning to alter the prognosis and improve the quality of life for individuals with this serious disease.

Animals↗
PubMed2001

Prospects for autoimmune disease: Research advances in systemic lupus erythematosus.

Systemic lupus erythematosus is an autoimmune disease with a significant genetic component to susceptibility. Some environmental risks are known, and identification of specific genetic factors promises to define new molecular targets for therapy. Broad immunosuppression will be replaced by early, selective, and individualized intervention. Mortality rates will decline, and insights into therapy may apply to other autoimmune conditions.

Allergy and Immunology↗