Drug-induced lupus: Traditional and new concepts

Vaglio, Augusto; Grayson, Peter C.; Fenaroli, Paride; Gianfreda, Davide; Boccaletti, Valeria; Ghiggeri, Gian Marco; Moroni, Gabriella

doi:10.1016/j.autrev.2018.03.016

Cited by 91 publications

(93 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results extend these observations by showing that among a large number of inflammatory markers, VCAM‐1 plasma levels are associated with lack of resolution of HRS‐AKI and poor survival. These results together with findings of a similar inflammatory profile compared to that of some inflammatory diseases shed light on the potential role of VCAM‐1 and TNF‐α as therapeutic targets in patients with advanced cirrhosis …”

Section: Discussionsupporting

confidence: 54%

Characterization of inflammatory response in hepatorenal syndrome: Relationship with kidney outcome and survival

Solé

Solà

Huelín

et al. 2019

Liver International

View full text Add to dashboard Cite

Background Several lines of evidence indicate that decompensated cirrhosis is characterized by the presence of systemic inflammation. Hepatorenal syndrome (HRS‐AKI) is a unique type of renal failure that occurs at late stages of cirrhosis. However, confirmation of the presence and significance of such inflammatory response in HRS‐AKI is lacking. Aim and Methods To characterize the systemic inflammatory response, as estimated by measuring a large number of cytokines, in 161 patients hospitalized for an acute decompensation of cirrhosis: 44 patients without acute kidney injury (AKI), 63 patients with hypovolaemia‐induced AKI and 58 patients with HRS‐AKI. Results HRS‐AKI was characterized by an altered cytokine profile compared to the other two groups, particularly IL‐6, IL‐8, TNF‐α, VCAM‐1, fractalkine and MIP‐1α. The inflammatory response was not related to presence of bacterial infection, concomitant acute‐on‐chronic liver failure or severity of renal dysfunction. Patients who responded to terlipressin and albumin had only a decrease in TNF‐α and RANTES after treatment without changes in other cytokines. Interestingly, patients with persistent HRS‐AKI had higher levels of IP‐10 and VCAM‐1 compared to those with resolution of HRS‐AKI. VCAM‐1 was also an independent predictor of 3‐month mortality. A systems biology analysis approach showed that the inflammatory status of HRS‐AKI was similar to that of chronic nonhepatic inflammatory conditions, such as lupus erythematosus or inflammatory bowel disease. Conclusion Hepatorenal syndrome is characterized by a marked systemic inflammatory state, reminiscent of that of nonhepatic inflammatory diseases, that correlates with patient outcomes.

show abstract

Section: Discussionsupporting

confidence: 54%

Characterization of inflammatory response in hepatorenal syndrome: Relationship with kidney outcome and survival

Solé

Solà

Huelín

et al. 2019

Liver International

View full text Add to dashboard Cite

show abstract

“…This problem turned out to be a major concern for the development of the first TNF-α blockers (281), and it is still today a significant cause of morbidity for many immunotherapies (9,10,282,283). Moreover, in the context of obtaining an adequate immunological balance, TNF-α blockers intended for the treatment of RA have elicited SLE (284)(285)(286). Over the years, the scientific community has learned that immunotherapy products do not represent universal solutions for all patient populations and that their indiscriminate use could be detrimental for some of them.…”

Section: Safety Aspectsmentioning

confidence: 99%

The Emerging Jamboree of Transformative Therapies for Autoimmune Diseases

et al. 2020

View full text Add to dashboard Cite

Standard treatments for autoimmune and autoinflammatory disorders rely mainly on immunosuppression. These are predominantly symptomatic remedies that do not affect the root cause of the disease and are associated with multiple side effects. Immunotherapies are being developed during the last decades as more specific and safer alternatives to small molecules with broad immunosuppressive activity, but they still do not distinguish between disease-causing and protective cell targets and thus, they still have considerable risks of increasing susceptibility to infections and/or malignancy. Antigen-specific approaches inducing immune tolerance represent an emerging trend carrying the potential to be curative without inducing broad immunosuppression. These therapies are based on antigenic epitopes derived from the same proteins that are targeted by the autoreactive T and B cells, and which are administered to patients together with precise instructions to induce regulatory responses capable to restore homeostasis. They are not personalized medicines, and they do not need to be. They are precision therapies exquisitely targeting the disease-causing cells that drive pathology in defined patient populations. Immune tolerance approaches are truly transformative options for people suffering from autoimmune diseases.

show abstract

“…Methylated, acetylated and other posttranscriptional modified histones are now known to be critical in the epigenetic gene expression [52]. In addition, they are components of apoptotic bodies [52,53] and neutrophil extracellular traps (NETS) [54], which are considered to be important pathogenic phenomena in SLE [55]. As compared to antibodies to the core histones, antibodies directed to H1 and its variants are the least specific for SLE.…”

Section: Histonesmentioning

confidence: 99%

“…As compared to antibodies to the core histones, antibodies directed to H1 and its variants are the least specific for SLE. Although antibodies to histones and nucleosome have been primarily linked to drug-induced lupus (DIL) [55,56], it is important to appreciate that this association was more relevant to drugs that are no longer in wide use (e.g., hydralazine, procainamide) compared to the biological therapeutic-induced DIL that is more prevalent today. Since histones are key components of the nucleosome, antibodies to the nucleosome are considered more diagnostically relevant.…”

Section: Histonesmentioning

confidence: 99%

Challenges and Advances in SLE Autoantibody Detection and Interpretation

Choi

Fritzler

2019

Curr Treat Options in Rheum

View full text Add to dashboard Cite

Purpose of review This review is an overview of key autoantibodies used in the diagnosis and management of SLE. Questions addressed are the advantages to but limitations of ANA testing and what are the key considerations in ordering ANA tests and then interpreting the ANA results. Recent findings There is a progressive move towards • Solid-phase multi-analyte arrays with algorithmic analysis (SPMAAA) • Closing the seronegative gap in SLE • Harmonization of ANA testing Summary As an approach to limiting morbidity and rising health care costs associated with SLE, the future of ANA testing should focus on making an accurate and actionable diagnosis of very early SLE. To achieve this goal, harmonization of autoantibody testing will be important. Autoantibodies in SLE Choi and Fritzler

show abstract

Drug-induced lupus: Traditional and new concepts

Cited by 91 publications

References 57 publications

Characterization of inflammatory response in hepatorenal syndrome: Relationship with kidney outcome and survival

Characterization of inflammatory response in hepatorenal syndrome: Relationship with kidney outcome and survival

The Emerging Jamboree of Transformative Therapies for Autoimmune Diseases

Challenges and Advances in SLE Autoantibody Detection and Interpretation

Contact Info

Product

Resources

About