Recommendations for Systemic Lupus Erythematosus

Βertsias, George

doi:10.1016/j.rdc.2022.05.001

Cited by 8 publications

(5 citation statements)

References 61 publications

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“…5 Multiple factors including genetics, epigenetics, sex hormones, and environmental triggers contribute to the complex nature of this disease. 6 Epigenetics refers to the regulation of gene expression without altering the actual DNA sequence. One important aspect of epigenetics is DNA methylation, which primarily influences gene transcription by targeting CpG islands in promoters.…”

Section: Introductionmentioning

confidence: 99%

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Significant heightened methylation levels of RUNX3 gene promoter in patients with systemic lupus erythematosus

Ehtesham,

Alesaeidi,

Mohammad Zadeh

et al. 2024

Lupus

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Objective Researchers are actively investigating new diagnostic and prognostic biomarkers that offer improved sensitivity and specificity for systemic lupus erythematosus (SLE). One area of interest is DNA methylation changes. Previous studies have shown a connection between the RUNX3 gene dysfunction and SLE. In this study, the focus was on examining the methylation level of the RUNX3 promoter in peripheral blood mononuclear cells (PBMCs) of SLE patients and healthy individuals. Methods A total of 80 individuals diagnosed with SLE from Iran, along with 77 healthy individuals, were included. The methylation levels of the RUNX3 gene in the extracted DNA were evaluated using the MethyQESD method. To determine the diagnostic effectiveness of the RUNX3 promoter methylation level, a receiver operating characteristic (ROC) curve was generated. Results The methylation of the RUNX3 promoter was found to be significantly higher in patients with SLE compared to healthy individuals ( p < .001). This difference in methylation levels was observed between SLE patients and healthy individuals and between SLE patients with renal involvement and those without renal involvement (86.29 ± 10.30 vs 40.28 ± 24.21, p < .001). ROC analyses revealed that the methylation level of the RUNX3 promoter had a diagnostic power of 0.769 [95% CI (0.681–0.814)] for SLE. Additionally, there was a positive correlation between the RUNX3 methylation level and levels of creatinine and C4. Conclusion The findings of this study emphasize the potential use of RUNX3 methylation levels in PBMCs of SLE patients as biomarkers for diagnosing the disease, predicting renal damage, and assessing disease activity.

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Section: Introductionmentioning

confidence: 99%

“…5 Multiple factors including genetics, epigenetics, sex hormones, and environmental triggers contribute to the complex nature of this disease. 6…”

Section: Introductionmentioning

confidence: 99%

Significant heightened methylation levels of RUNX3 gene promoter in patients with systemic lupus erythematosus

Ehtesham,

Alesaeidi,

Mohammad Zadeh

et al. 2024

Lupus

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“…6 In this regard, the combinatorial involvement of various factors containing genetic, epigenetic, sex hormones, and environmental stimuli consisting of viral infection and ultraviolet B (UVB) radiation leads to the development of this complex disease. 7 There remains much to be resolved about the etiopathology of SLE.…”

Section: Introductionmentioning

confidence: 99%

Significant hypomethylation of MMP9 gene promoter in patients with systemic lupus erythematosus

Ehtesham

Mosallaei

Mahdiabadi

et al. 2023

Lupus

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Objective Scholars are exploring novel diagnostic and prognostic biomarkers with higher sensitivity and specificity for systemic lupus erythematosus (SLE). In this regard, DNA methylation alterations have aroused attention. The association between the dysfunction of MMP9 and TNFAIP3 genes and SLE has been previously demonstrated. Therefore, in this study, we investigated the methylation level of MMP9 and TNFAIP3 promoters in peripheral blood mononuclear cells (PBMCs) of SLE patients and healthy controls. Methods Eighty Iranian SLE patients and 77 healthy individuals were enrolled. The methylation quantification endonuclease-resistant DNA (MethyQESD) method was used to assess methylation levels of MMP9 and TNFAIP3 in extracted DNA of PBMCs. To quantify the diagnostic utility of the promoter methylation level of these genes, the receiver operating characteristic (ROC) curve was constructed. Results MMP9 promoter was significantly hypomethylated in SLE patients compared with healthy people ( p < 0.001), while there was no significant difference in terms of TNFAIP3 promoter methylation levels ( p = 0.167). Also, this differential MMP9 methylation was observed in patients with renal involvement and patients without renal involvement (42.07 ± 25.73 vs 56.74 ± 29.71, p = 0.007). ROC analyses indicated that the diagnostic power of the MMP9 promoter methylation level for SLE was 0.839 [95% CI (0.781–0.911)]. Moreover, MMP9 methylation level was negatively correlated with creatinine and anti-dsDNA concentration and positively correlated with C3 and C4 levels. Conclusion The results of this study highlight the application of MMP9 methylation level in PBMCs of SLE patients as a diagnostic biomarker.

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“…Despite significant advances in LN including the publication of high-quality management recommendations, the definition of treatment goals associated with improved outcomes, and the approval of novel therapies [5][6][7][8], SLE patients with kidney involvement are still burdened with increased morbidity and mortality [9]. Moreover, it is worrisome that rates of lupus-associated end-stage kidney disease (ESKD) are stable, non-improving during the last 2 decades [10,11].…”

Section: Introductionmentioning

confidence: 99%

Flares in Lupus Nephritis: Risk Factors and Strategies for Their Prevention

Banos

Βertsias

2023

Curr Rheumatol Rep

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Purpose of Review Discuss the prognostic significance of kidney flares in patients with lupus nephritis, associated risk factors, and possible preventative strategies. Recent Findings Recently performed clinical trials and observational cohort studies underscore the high frequency of relapses of kidney disease, following initial response, in patients with proliferative and/or membranous lupus nephritis. Analysis of hard disease outcomes such as progression to chronic kidney disease or end-stage kidney disease, coupled with histological findings from repeat kidney biopsy studies, have drawn attention to the importance of renal function preservation that should be pursued as early as lupus nephritis is diagnosed. In this respect, non-randomized and randomized evidence have suggested a number of factors associated with reduced risk of renal flares such as attaining a very low level of proteinuria (< 700–800 mg/24 h by 12 months), using mycophenolate over azathioprine, adding belimumab to standard therapy, maintaining immunosuppressive/biological treatment for at least 3 to 5 years, and using hydroxychloroquine. Other factors that warrant further clarification include serological activity and the use of repeat kidney biopsy to guide the intensity and duration of treatment in selected cases. Summary The results from ongoing innovative studies integrating kidney histological and clinical outcomes, together with an expanding spectrum of therapies in lupus nephritis, are expected to facilitate individual medical care and long-term disease and patient prognosis.

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Recommendations for Systemic Lupus Erythematosus

Cited by 8 publications

References 61 publications

Significant heightened methylation levels of RUNX3 gene promoter in patients with systemic lupus erythematosus

Significant heightened methylation levels of RUNX3 gene promoter in patients with systemic lupus erythematosus

Significant hypomethylation of MMP9 gene promoter in patients with systemic lupus erythematosus

Flares in Lupus Nephritis: Risk Factors and Strategies for Their Prevention

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