Clinical disease activity and flare in SLE: Current concepts and novel biomarkers

Thanou, Aikaterini; Jupe, Eldon R.; Purushothaman, Mohan; Niewold, Timothy B.; Munroe, Melissa E.

doi:10.1016/j.jaut.2021.102615

Cited by 53 publications

(58 citation statements)

References 83 publications

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“…The adaptive immune system is dysregulated in SLE, resulting in a variety of abnormalities including as autoantibody production, activation of auto aggressive T effector cells and B cells, and a reduction in regulatory T cells (Tregs). SLE treatment includes glucocorticoids (GCs), antimalarial medicines, nonsteroidal anti-inflammatory drugs (NSAIDs), immunosuppressive agents, and B cell–targeting biologics and Chinese herbal medicine ( 6 ). However, the side effects such as gastrointestinal reaction, metabolic disorders and infections enable the doctors and scientists to seek new therapies.…”

Section: Introductionmentioning

confidence: 99%

Lactobacillus: Friend or Foe for Systemic Lupus Erythematosus?

2022

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The cause of Systemic Lupus Erythematosus (SLE) remains largely unknown, despite the fact that it is well understood that a complex interaction between genes and environment is required for disease development. Microbiota serve as activators and are essential to immune homeostasis. Lactobacillus is thought to be an environmental agent affecting the development of SLE. However, beneficial therapeutic and anti-inflammatory effects of Lactobacillus on SLE were also explored. The discovery of Lactobacillus involvement in SLE will shed light on how SLE develops, as well as finding microbiota-targeted biomarkers and novel therapies. In this review, we attempt to describe the two sides of Lactobacillus in the occurrence, development, treatment and prognosis of SLE. We also discuss the effect of different strains Lactobacillus on immune cells, murine lupus, and patients. Finally, we try to illustrate the potential immunological mechanisms of Lactobacillus on SLE and provide evidence for further microbiota-targeted therapies.

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Section: Introductionmentioning

confidence: 99%

Lactobacillus: Friend or Foe for Systemic Lupus Erythematosus?

2022

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“…Predicting active SLE using reliablemarkers is of particular importance when it comes to implementing useful preventive strategies in clinical practice [21]. As we known, SLEDAI is the most commonly used to calculate disease activity.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of patients who are prone to develop disease are has become a major challenge for the prevention and control of SLE activity, which will improve the long-term outcome. Predicting changes in SLE disease activity could allow for closer monitoring and preemptive treatment, but existing clinical, and serologic markers have been only modestly predictive [4]. Novel, proactive serologic markers to predicting disease activity are thus critically needed.…”

Section: Introductionmentioning

confidence: 99%

Using AFR+PNI Model for Predicting Disease Activity in Patients With Systemic Lupus Erythematosus

Luo

Zhao

et al. 2022

Preprint

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Background: Systemic lupus erythematosus (SLE) is chronic autoimmune disease with multiple organ damage and is associated with poor prognosis and high mortality. Identification of universal biomarkers to predict SLE activity is challenging due to the heterogeneity of the disease. This study aimed to identify the indicators that are sensitive and specific to predict activity of SLE. Methods: We retrospectively analyzed 108 patients with SLE. Patients were categorized into SLE with activity and without activity groups on the basis of SLE disease activity index. We analyzed the potential of routine and novel indicators in predicting the SLE activity using receiver operating characteristic curves and multivariate logistic regression. The Spearman method was used to understand the correlation between albumin to fibrinogen ratio (AFR), prognostic nutritional index (PNI), AFR+PNI model and disease activity.Results: SLE with activity group had elevatory C3, ESR, CRP, D-dimer, fibrinogen, CRP to albumin ratio, positive rate of anti-dsDNA and ANUA, lower TBIL, TP, albumin, albumin/globulin, creatinine, HDL-C, hemoglobin, hematocrit, lymphocyte count, AFR, PNI. A further established model based on combination of AFR and PNI (AFR-PNI model) showed prominent value in distinguishing SLE with activity patients from SLE without activity patients. In addition, the sensitivity and specificity of AFR-PNI model +anti-dsDNA combination model were superior to AFR-PNI model. AFR and PNI were risk factors for SLE activity. Moreocer, AFR, PNI and AFR+PNI model correlated with disease activity. Furthermore, AFR, PNI, and AFR-PNI model were associated with fever, pleurisy, pericarditis, renal involvement. Conclusion: These findings suggest that predictive model based on combination of AFR and PNI may be useful markers to identify active SLE in clinical practice.

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“…Однако в большинстве случаев течение заболевания характеризуется чередующимися ремиссиями и обострениями [43]. Повторные обострения СКВ, особенно тяжелые, с одной стороны, служат причиной частых госпитализаций и, соответственно, увеличения затрат для системы здравоохранения, а, с другой стороны, приводят к накоплению повреждения внутренних органов [44]. Ежегодно обострения СКВ наблюдаются у 65-70% больных.…”

Section: риск обострений и повреждения органов и частота госпитализаций у пациентов с сквunclassified

Systemic lupus erythematosus: epidemiology, outcomes and burden

Moiseev¹,

Новиков²,

Bulanov³

2021

CPT

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The estimates of incidence and prevalence of systemic lupus erythematosus (SLE) in Europe are 1.5-4.9 per 100 000 persons-years and 30-70 per 100 000 people, respectively. Over the last 50 years, survival in SLE patients has improved significantly. Moreover, immunosuppressive treatment resulted in a decreased risk of death from active disease, whereas infections and cardiovascular disease have become the main causes of death in SLE populations. Almost 70% of SLE patients have recurrent course of disease, although long-term remissions or persistent disease activity also occur in a proportion of patients. Annually, every third SLE patient develops moderately severe or severe flares. Recurrent flares, complications of immunosuppressive treatment and comorbidity are associated with accrual of organ damage that increases the risk of death. SLE patients have impaired health-related quality of life correlating with both disease activity and organ damage. Being on remission of SLE or on low disease activity is associated with better outcomes, including lower mortality and risk of damage or flares, improved quality of life, lower hospitalisation rates and costs. Glucocorticoids remain the mainstay of SLE treatment, although their use should be limited, e.g. by proper administration of immunosuppressive or antiinflammatory agents that have steroid-sparing activity. Treatment and prevention of infections and cardiovascular outcomes are also essential for further improvement of survival of SLE patients.

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Clinical disease activity and flare in SLE: Current concepts and novel biomarkers

Cited by 53 publications

References 83 publications

Lactobacillus: Friend or Foe for Systemic Lupus Erythematosus?

Lactobacillus: Friend or Foe for Systemic Lupus Erythematosus?

Using AFR+PNI Model for Predicting Disease Activity in Patients With Systemic Lupus Erythematosus

Systemic lupus erythematosus: epidemiology, outcomes and burden

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