Lupus最新文献

{"title":"Analysis of the serum 25(OH)D3 level and its correlation with immunological indexes in patients with systemic lupus erythematosus.","authors":"Shasha Xu, Xiaoheng Guo, Yan Wu, Changgeng Zhang","doi":"10.1177/09612033251380872","DOIUrl":"https://doi.org/10.1177/09612033251380872","url":null,"abstract":"<p><p>ObjectiveTo analysis the impact of 25(OH)D3 on immune function in patients with Systemic lupus erythematosus (SLE) and elucidate its correlation with immunological indexes.MethodsA total of 158 newly diagnosed SLE patients admitted to the Rheumatology and Immunology Department of the hospital from January 2022 to January 2024 were collected. 25(OH)D3, immunoglobulin IgA, IgG, IgM, complement C3 and C4,CD3⁺T cells, CD4⁺T cells, CD8⁺T cells and CD4⁺/CD8⁺ were detected. Antinuclear antibody (ANA) and ENA antibody spectrum were identified; Clinical data of patients were collected. We separated the SLE group into three groups based on the levels of 25(OH)D3: deficient, insufficient, and sufficient. The clinical symptoms, immunological indexes, and autoantibodies of SLE patients across several groups were compared, and the association between the levels of 25(OH)D3 and immunological indexes was investigated.ResultsThe levels of IgA, IgG, and CD8⁺T lymphocytes in patients with SLE were higher compared to those in the healthy control group. The incidence of lupus nephritis, anemia, and arthritis, as well as the positive rate of anti-Sm antibody, was greater in the 25(OH) D3-deficient group compared to the 25(OH) D3-insufficient and sufficient groups. In individuals with SLE, 25(OH)D3 had a positive cor- relation with C3、while showing a negative correlation with IgG, CD8⁺T cells.Conclusion25(OH)D3 is typically insufficient in patients with SLE. Deficiency of 25(OH)D3 impacts the immune system of patients with SLE; such as lupus nephritis, anemia, and arthritis signify an elevated risk of vitamin D deficiency, requiring clinical consideration.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251380872"},"PeriodicalIF":1.9,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and initial content validation of a new version of the damage index in thrombotic antiphospholipid syndrome (DIAPSV2).","authors":"María Victoria Goycochea Robles, Gabriela Medina García, Claudia Mendoza Pinto, Claudia Meléndez Mercado, Laura Aline Martínez Martínez, Pamela Medina San Millán, Silvia Guzmán Vázquez, Angélica Aurora Pérez Ruiz, Mary-Carmen Amigo","doi":"10.1177/09612033251379310","DOIUrl":"https://doi.org/10.1177/09612033251379310","url":null,"abstract":"<p><p>BackgroundAntiphospholipid syndrome (APS) is the most common acquired hypercoagulable disorder characterized mainly by thrombotic events and obstetric morbidity. Quantifying chronic damage caused by APS is crucial for patient management. The original Damage Index for Thrombotic APS (DIAPS) was developed to address this need, but required updates to improve its comprehensiveness and specificity.ObjectiveTo report the initial content validation process of a new version of the damage index: DIAPSv2.MethodsA modified Delphi panel was conducted in two stages. Stage 1 involved a systematic scoping review of DIAPS studies, with data extracted from questionnaires and confirmed by the leading committee. These questionnaires identified items from the original instrument that needed modification, elimination, or replacement with new candidate items. Stage 2 employed the modified Delphi method over three rounds, considering expert panelists' opinions to select concepts for inclusion in DIAPSv2.ResultsIn Stage 1, evidence supported the validity of the original DIAPS but highlighted missing conditions reflecting chronic damage, such as alveolar hemorrhage and significant bleeding due to anticoagulation therapy. In Stage 2, participants from different working groups reached a consensus to evaluate 41 of the 67 items that the leading committee proposed for accurately measuring chronic damage in APS. A final consensus included 32 items. Definitions of all items were updated according to specialists' input and international recommendations for each domain.ConclusionsA collaborative and multidisciplinary consensus-based approach developed a new version of the damage index, comprising 11 domains and 32 items (an update from 10 domains and 38 items in the original version). DIAPSv2 offers a more specific tool for evaluating irreversible damage in patients with thrombotic APS.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251379310"},"PeriodicalIF":1.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hopes and concerns of CAR-T cell regimens in systemic lupus erythematosus and other immune mediated diseases.","authors":"Dario Roccatello","doi":"10.1177/09612033251379322","DOIUrl":"https://doi.org/10.1177/09612033251379322","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251379322"},"PeriodicalIF":1.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of systemic lupus erythematosus in Peru and its association with environmental and healthcare factors: An ecological study.","authors":"Paul J Tejada-Llacsa, Graciela S Alarcón, Manuel F Ugarte-Gil","doi":"10.1177/09612033251379313","DOIUrl":"https://doi.org/10.1177/09612033251379313","url":null,"abstract":"<p><p>ObjectiveTo estimate the prevalence of Systemic Lupus Erythematosus (SLE) in Peru in 2017 and its association with altitude, environmental temperature, and physician density.MethodsThis ecological study was performed using population data from the 2017 Peruvian census. The number of SLE cases for each department was obtained from the National Health Registries using the ICD-10 code M32. Altitude, environmental temperature and physician density were obtained for each department from the National Institute of Statistics and Informatic (<i>Instituto Nacional de Estadística e Informática)</i> registries. The prevalence for each department was calculated adjusting for age and sex. Then a negative binomial regression was performed to estimate the prevalence ratio (PR) and evaluate factors associated with the prevalence of SLE.ResultsThe national prevalence of SLE was 40.2 per 100,000 people. Two age groups had the highest prevalence: 12-17 years and 30-59 years. Females exhibited a higher prevalence than males, particularly in the 30-59 age group (113.9 vs 16.1 per 100,000, respectively). An inverse relationship was observed between the age- and sex-adjusted prevalence in each department and altitude (PR 0.97; 95% CI: 0.94-0.99). On the other hand, there was a direct relationship with physician density (PR: 1.04; 95% CI: 1.01-1.07). No association was found between the adjusted prevalence and environmental temperature or latitude.ConclusionThe prevalence of SLE in Peru aligns with global estimates. The inverse relationship with altitude and the direct association with physician density suggest that environmental and healthcare access factors may influence disease distribution. Further research is needed to explore the underlying mechanisms driving these associations.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251379313"},"PeriodicalIF":1.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"KRAS-associated pediatric lupus: Expanding the genomic landscape of monogenic lupus.","authors":"Riju Bhattacharjee, Sramana Das, Mrinal Kanti Das, Suprit Basu","doi":"10.1177/09612033251378398","DOIUrl":"https://doi.org/10.1177/09612033251378398","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251378398"},"PeriodicalIF":1.9,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of Belimumab, Rituximab and Voclosporin in the treatment of lupus nephritis based on registered clinical trials: A systematic review and network meta-analysis.","authors":"Feigao Li, Xizhe Liu, Xinhui Zhang, Menghao Li, Xiuju Liu","doi":"10.1177/09612033251378388","DOIUrl":"https://doi.org/10.1177/09612033251378388","url":null,"abstract":"<p><p>ObjectiveTo systematically compare the clinical effectiveness and safety of Belimumab, Rituximab and Voclosporin in the treatment of lupus nephritis based on network meta-analysis method.MethodsSystematic search of registered clinical trials in four major databases (Pubmed, Embase, Web of Science, The Cochrane Register of Clinical Trials) and ClinicalTrials.gov. According to the inclusion and exclusion criteria of the protocol, Screening of registered randomized controlled clinical trials of Belimumab, Rituximab and Voclosporin in the treatment of lupus nephritis.ResultsThis study included a total of five registered randomized controlled clinical trials involving 1212 subjects. In terms of complete renal remission, Voclosporin -1 year, High-Voclosporin-1 year, Voclosporin-2 years and Belimumab-2 years were all significantly better than placebo; At the same time, the effect of Voclosporin-1 year on complete renal remission rate was significantly better than that of Rituximab-1 year [OR = 3.2, 95% CI (1.41,7.24)]. In terms of safety, placebo was significantly better than High-Voclosporin-1 year [OR = 0.23, 95% CI (0.07,0.82)], and the difference was statistically significant; There was no significant difference in the incidence of serious adverse events.ConclusionVoclosporin and Belimumab showed significant clinical efficacy in the treatment of lupus nephritis, and the safety was not statistically different from placebo. Voclosporin had significantly better clinical efficacy than Rituximab during 1-year treatment period. Increasing the dose of Voclosporin did not significantly improve the efficacy, but it will increase the safety risk of adverse events.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251378388"},"PeriodicalIF":1.9,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of SCORE2, QRISK3 and PREVENT equations in systemic lupus erythematosus.","authors":"Lévi-Dan Azoulay, Thomas Broussaud, Nadjia Kachenoura, Alexis Mathian, Micheline Pha, Miguel Hié, Nassim Ait Abdallah, Marc Pineton de Chambrun, Matthias Papo, Fleur Cohen-Aubart, Julien Haroche, Alban Redheuil, Zahir Amoura","doi":"10.1177/09612033251356138","DOIUrl":"10.1177/09612033251356138","url":null,"abstract":"<p><p>BackgroundAssessment of contemporary cardiovascular risk scores using clinically relevant endpoints is lacking in systemic lupus erythematosus (SLE).AimThis study aimed to assess and compare the performances of SCORE2, QRISK3 and PREVENT equations in SLE.MethodsSLE patients with no prior atherosclerotic cardiovascular disease (ASCVD) who underwent a baseline cardiovascular risk assessment including coronary artery calcium (CAC) scoring at the French national SLE reference center between 2014 and 2024 were retrospectively included. The primary outcome was incident ASCVD events defined as coronary artery disease (CAD), stroke and peripheral artery disease (PAD). The secondary outcome was CAC presence (CAC score >0). Discrimination and calibration were respectively assessed by areas under the curve (AUCs) and observed-to-predicted risk ratios.ResultsA total of 143 patients were included (91% female, median age 51 years [46-60], SLE duration 15 years [8-22]). After a median follow-up of 7 years [3-9], 12 patients (8%) had incident ASCVD events (7 CAD, 4 strokes, 1 PAD). AUCs were 0.81 for SCORE2, 0.76 for QRISK3 and 0.80 for PREVENT and did not significantly differ (all <i>p</i> > .05). Optimal thresholds for clinical events prediction were 3.9% for SCORE2, 9.4% for QRISK3 and 4.3% for PREVENT. Mean observed-to-predicted ratios were 3 for SCORE2, 0.85 for QRISK3 and 2.8 for PREVENT. Similar results were obtained when using CAC as the main outcome.ConclusionRisk scores demonstrated similar and fair discriminative performances but were poorly calibrated except for QRISK3. Application of lower thresholds and use of QRISK3 may improve cardiovascular risk stratification in SLE but requires confirmation from larger studies.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1057-1060"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prepubertal to adolescent lupus: Age-related variations in clinical, laboratory, and outcome profiles.","authors":"Lujayn Akbar, Majd S Khader, Rawan Elshaer, Samar Jaber, Abrar K Khader, Sameeha Abdulwali, Raghad Alhuthil, Sulaiman M Al-Mayouf","doi":"10.1177/09612033251357629","DOIUrl":"10.1177/09612033251357629","url":null,"abstract":"<p><p>BackgroundChildhood-onset systemic lupus erythematosus (cSLE) is a heterogeneous autoimmune disease with age-related variations. Older children often exhibit higher disease activity, whereas early-onset cSLE is associated with worse outcomes. However, most existing studies are retrospective and based on single-nation cohorts, yiedling inconsistent findings.ObjectiveTo investigate age-related variations in cSLE subgroups, namely prepubertal, peripubertal, and adolescent-onset cases.MethodsThis systematic review, registered in PROSPERO and conducted in accordance with PRISMA guidelines, searched PubMed, the Cochrane Library, and Web of Science for English-language studies pubslished between January 2000- February 2025. Eligible studies examined age-related variations in cSLE diagnosed before 18 years of age. Data were categorized into prepubertal, peri-pubertal, and adolescent-onset groups. Exclusion criteria included case reports, comments, editorials, viewpoint articles, conference abstracts, and incomplete studies. Four reviewers independently screened the articles, with discrepancies resolved by a fifth reviewer. Study quality was assessed using the NHLBI criteria.ResultsOf 16,313 studies screened, 13 met the inclusion criteria, comprising a total of 3920 cSLE cases. Among these, 464 (11.8%) were prepubertal, 1943 (49.6%) peripubertal, and 1513 (38.6%) adolescent-onset. The mean age at diagnosis was 5.8 ± 2.3, 9.4 ± 2.5, and 13.9 ± 1.1 years, respectively. The female-to-male ratio was highest in the adolescent-onset group (<i>p</i> = .002). Clinical manifestations showed no significant age-related differences; however, musculoskeletal involvement increased with age, while neuropsychiatric symptoms and fever decreased. Lymphopenia was more frequent in the adolescent-onset group (60% vs 25.6%, <i>p</i> = .016). Although disease activity and damage did not differ significantly across age groups, mortality was signficantly higher in the prepubertal group (16.5%) compared to the adolescent-onset group (2.9%) (<i>p</i> = .014).ConclusionThis review underscores both similarities and differences in cSLE across age groups. Prepubertal onset was associated with higher mortality, emphasizing the need for timely diagnosis and early intervention in this subgroup.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1049-1056"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of retention in care by visits or lupus-specific labs with acute care among young adults: A medicare cohort study.","authors":"Maria Schletzbaum Bowler, Ang Yu, Brad C Astor, W Ryan Powell, Shivani Garg, Andrea Gilmore-Bykovskyi, Joseph Kramer, Amy J Kind, Christie M Bartels","doi":"10.1177/09612033251360289","DOIUrl":"10.1177/09612033251360289","url":null,"abstract":"<p><p>ObjectiveWhile quality lupus care is associated with lower lupus-related damage, the impact of access and process quality measures on other lupus outcomes remains unclear. Given high acute care in young adults, our objective was to evaluate two process quality measures, visit-based retention in lupus care and receipt of lupus-specific serologic testing, and associations with subsequent acute care use.MethodsThis cohort study used a 20% national sample of young adult (ages 18-35) Medicare beneficiaries with lupus to first measure visit-based retention in rheumatology care and receipt of ≥1 complement or dsDNA test over 1 year. Acute care use (Emergency Department visits and hospitalizations) was then assessed in the subsequent 6 months. Associations of visit-based retention and serologic testing with acute care were evaluated with Cox regressions.ResultsAmong 1036 young adults with lupus, acute care use was very high - nearly 60% at 6 months. Observed acute care-free survival time was longer in patients who had visit-based retention (154 vs 104 days, <i>p</i> = 0.02) or serologic testing (166 vs 101 days, <i>p</i> = 0.002). Only 28% of beneficiaries had serologic testing, but this was associated with 21% lower incidence of acute care (aHR 0.79, 95% CI 0.65, 0.97) after adjustment; visit-based retention was not associated with acute care after adjustment.ConclusionReceipt of complement or dsDNA antibody testing, a lupus-specific care quality indicator, was associated with reduced acute care use in young adults. Improving lupus care quality measures, like complement or dsDNA testing, may improve lupus outcomes including reduced acute care use.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1013-1023"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From innate immunity to autoimmunity: Neutrophils in systemic lupus erythematosus pathogenesis.","authors":"Ehsan Dehdashtian, Roberto Caricchio","doi":"10.1177/09612033251352734","DOIUrl":"10.1177/09612033251352734","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is a complex autoimmune disease primarily affecting women of childbearing age. Historically, SLE was attributed to adaptive immune dysfunction. However, recent research highlights the critical role of innate immunity, particularly neutrophils, in disease pathogenesis. Neutrophils contribute through mechanisms such as neutrophil extracellular trap (NET) formation, excessive ROS production, and impaired NET clearance. These processes lead to tissue damage by driving inflammation, promoting autoantibody formation, and causing immune complex deposition. Within this inflammatory milieu, ROS primes and NETs activate the NLRP3 inflammasome in various immune cells, leading to the release of IL-1β and IL-18. These cytokines further amplify ROS accumulation and NETosis, establishing a feed-forward inflammatory loop. In this review, we discuss the role of innate immunity in SLE, with a focus on the interplay between neutrophils, NETosis, oxidative stress and NLRP3 inflammasome activation. Understanding these mechanisms may reveal therapeutic strategies targeting excessive NETosis, enhancing NET clearance mechanisms, and modulating inflammasome or ROS activity to mitigate inflammation and tissue damage in SLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"989-1002"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}