Lupus最新文献

{"title":"Network meta-analysis of triple immunosuppressive therapies and standard of care for induction of remission of active lupus nephritis.","authors":"Gabriel Contreras, Vinodh Mechery, Sanjana Kota, Daniel Del Castillo Rix, Miguel Bandes, Adriana Dejman, Yiqin Zuo, Juan Camilo Duque, Jair Munoz Mendoza","doi":"10.1177/09612033261474940","DOIUrl":"10.1177/09612033261474940","url":null,"abstract":"<p><p>BackgroundIn patients with active lupus nephritis (LN), 8 different triple immunosuppressive therapies have been compared to the standard of care (SOC) of double immunosuppressive therapy in 12 induction randomized clinical trials (RCTs). The triple immunosuppressive therapies of SOC+Tacrolimus, SOC+Voclosporin, SOC+Belimumab, and SOC+Obinutuzumab compared to SOC alone demonstrated significantly higher remission of LN without excessive risk of serious adverse events (SAEs) and serious infectious events (SIEs) in RCTs. Direct or indirect comparisons among triple immunosuppressive therapies have not been studied. In this network meta-analysis (NMA), we systematically provide indirect comparisons of the relative efficacy and safety of triple immunosuppressive therapies, ranking them according to efficacy achieving primary renal remission (PRR) of LN and safety reducing the risk of SAEs and SIEs.ResultsThe NMA included predominantly women with LN. In direct pairwise comparisons, SOC+Tacrolimus (benefit ratio 1.91 [95% Credible Interval 1.45 to 2.56]), SOC+Voclosporin (1.69 [1.30 to 2.23]), SOC+Obinutuzumab (1.41 [1.09 to 1.84]), and SOC+Belimumab (1.32 [1.04 to 1.69]) had significantly higher PRR compared to SOC alone. In indirect pairwise comparisons, patients who received SOC+Tacrolimus compared to SOC+Rituximab (2.30 [1.27 to 4.20]), SOC+Anifrolumab (1.98 [1.07 to 3.52]), SOC+Ocrelizumab (1.81 [1.12 to 2.82]), and SOC+Abatacept (1.78 [1.07 to 2.91]) had significantly higher PRR. Patients who received SOC+Voclosporin compared to SOC+Rituximab (2.03 [1.14 to 2.68]) had significantly higher PRR. SOC+Belimumab, SOC+Obinutuzumab, SOC+Voclosporin and SOC+Tacrolimus ranked as effective therapies inducing PRR with SUCRA probability scores between 61.14% and 95.12%. Risk ratios of SAE and SIE were not significantly different among the immunosuppressive therapies.ConclusionIn patients with LN, induction therapies of SOC with calcineurin inhibitors had the highest relative benefit achieving remission of LN.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1257-1268"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679180","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":"Stigma, discrimination-related events, and determinants among adult people living with systemic lupus erythematosus (SLE): Systematic review and indicator-level meta-analysis.","authors":"Hebatullah M Abdulazeem, Syrine Bellakhal, Rym Abida, Saeed Soliman","doi":"10.1177/09612033261474062","DOIUrl":"10.1177/09612033261474062","url":null,"abstract":"<p><p>BackgroundSystemic lupus erythematosus (SLE) is a complex autoimmune disease with 0.4 million new cases diagnosed annually. With its wide variety of visible and invisible manifestations, people living with SLE report being exposed to stigmatization, which impacts their personal and professional lives. However, the current literature is unclear on whether healthcare management teams assess this concern during follow-up. This study aims to synthesize existing evidence on the prevalence and determinants of stigma among people living with SLE.MethodsThis systematic review and meta-analysis gathered evidence from observational studies identified from three databases on 16 July 2025. Dual independent screening, data extraction, and risk-of-bias assessment (using the Newcastle-Ottawa Scale) were performed. Results were synthesized using descriptive statistics, narrative synthesis, and indicator-level meta-analyses.ResultsWithin the past two decades, 11 studies comprising 2254 people living with SLE reported and measured stigma- and discrimination-related events using various scales. Stigma was found to be prevalent across its three constructs: interpersonal, perceived, and intrapersonal stigma. This review demonstrated that people living with SLE reported a moderate overall burden of stigma (34.71 [95% CI 26.15, 43.27]), with average stigma scores indicating psychological impact. Additionally, nearly one in two persons (46% [95% CI 28-66%]) experienced at least one form of stigma or discrimination, most commonly social isolation and unfair treatment. Mental health associations were correlated with higher stigma burden.ConclusionThis review demonstrates that stigma and discrimination are not just social challenges but also critical determinants of health. With cautious interpretation, pooled evidence reveals a consistent high prevalence of stigma and discrimination, which act as \"toxic\" stressors, creating a vicious cycle with psychological stress and psychiatric manifestations and disease activity. There is an urgent clinical need to move beyond a mere biological approach to disease assessment and management and to begin screening for the \"invisible\" burden of invalidation and discrimination.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1269-1281"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689566","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":"Clinical phenotypes and disease outcomes of patients with systemic lupus erythematosus meeting indication for primary aldosteronism testing.","authors":"Matthew Wong, Muhammad Akram, Joanna R Kent, Peter J Fuller, Alberta Y Hoi, Jun Yang, Fabien B Vincent","doi":"10.1177/09612033261473968","DOIUrl":"10.1177/09612033261473968","url":null,"abstract":"<p><p>BackgroundHypertension is prevalent and contributes significantly to cardiovascular risk in patients with systemic lupus erythematosus (SLE). Primary aldosteronism (PA), the most common endocrine cause of hypertension, confers higher cardiovascular risk than essential hypertension and has been linked to autoimmune diseases including SLE. While the prevalence of PA in SLE is unknown, a third of patients in a tertiary lupus clinic have been demonstrated to have clinical indications for PA testing.ObjectivesTo compare SLE phenotypes and outcomes in patients attending the clinic with and without indications for PA testing.MethodsIn this retrospective study, hypertension was defined as blood pressure ≥140/90 on two clinic visits, or a documented diagnosis of hypertension. Baseline demographic and SLE disease characteristics were compared between patients with and without an indication for PA testing as determined according to the 2016 Endocrine Society guidelines, before multivariable regression analyses assessed for associations between having an indication for PA testing with disease phenotypes and outcomes specifically within the subset of patients with hypertension.ResultsOf 322 patients with SLE, 95 patients (30%) had at least one indication for PA testing. These patients were older, had longer SLE disease duration, higher body mass index, higher blood pressure, and more baseline organ damage compared to those without an indication for PA testing. Over the period of clinic attendance (median 6.8 years), these patients had greater accrual of organ damage, higher flare rates, and more frequent proteinuria. Within the subset of hypertensive patients, indications for PA testing were independently associated with reduced baseline renal function (adjusted OR 3.29, 95% CI 1.30-9.47<i>; p</i> = 0.017), higher baseline organ damage (adjusted OR 1.94, 95% CI 1.03-3.73<i>; p</i> = 0.043), and higher prevalence of flare throughout the study period (adjusted OR 2.86, 95% CI 1.04-8.60; <i>p</i> = 0.049) in multivariable modelling.ConclusionSLE patients with an indication for PA testing exhibit a phenotype characterised by impaired renal function, increased organ damage and higher prevalence of flare. Further research is needed to prospectively assess whether the increased burden is attributable to PA, other causes of hypertension, or the severe hypertension.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1308-1319"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630820","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":"An evidence-based specialist nursing protocol for children with hypoprothrombinemia-lupus anticoagulant syndrome (HLAS) and its application research.","authors":"Shiyi Yang, Shanshan Xie, Yi Qian","doi":"10.1177/09612033261466744","DOIUrl":"10.1177/09612033261466744","url":null,"abstract":"<p><p>ObjectiveTo develop a standardized nursing protocol for pediatric hypoprothrombinemia-lupus anticoagulant syndrome (HLAS), a rare condition lacking unified clinical nursing guidelines worldwide, aiming to improve nurses' predictive, precise and whole-course care capabilities and optimize long-term clinical outcomes in affected children.MethodsEvidence-based nursing principles were integrated with clinical practice. After the admission and standardized management of a typical index case in March 2025, a multidisciplinary team composed of pediatric nephrology, rheumatology, laboratory medicine and nursing specialists conducted retrospective case analysis and collaborative protocol formulation, with its core innovation being the integration of thromboelastography (TEG) parameters to establish a quantitative bleeding risk stratification model. The systematic literature search covered all mainstream Chinese and English databases from database establishment to March 2025, consistent with the timeline of case admission and protocol development.ResultsApplication of this protocol in the index case enabled early identification of high bleeding risk, effectively avoiding severe bleeding events and nosocomial infections. The standardized health education and targeted psychological intervention significantly improved the disease cognition and family self-management ability of caregivers. It also transformed nurses from passive caregivers to proactive care managers.ConclusionThis protocol fills the gap in specialized nursing guidelines for pediatric HLAS, standardizes clinical nursing practices, and provides a replicable methodological reference for the development of standardized nursing protocols for other rare pediatric diseases.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1187-1191"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368809","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":"Association of galectin-3 in systemic lupus erythematosus: A systematic review and meta-analysis.","authors":"Shovit Ranjan, Madhavi Dubey, Aditya K Panda","doi":"10.1177/09612033261467987","DOIUrl":"10.1177/09612033261467987","url":null,"abstract":"<p><p>BackgroundSystemic lupus erythematosus (SLE) is an autoimmune condition showing persistent profiling of inflammation and damage of organs and immune system. Amongst many biomarkers for such autoimmune diseases, Galectin-3 (Gal-3) a β-galactoside-binding lectin responsible for regulation, inflammation, and fibrosis of immune repsonses, has engrossed researchers for further investigations as a potential biomarker. However, correlation has been studied between circulating Galectin-3 levels and SLE but outcomes still remain inconsistent. Therefore, this systematic review and meta-analysis evaluated the association between circulating galectin-3 levels and SLE.Materials and MethodsPubMed, Scopus, ScienceDirect, Web of Science, and Embase databases are extensively used for literature search. The last database search was conducted on September 6, 2025. Eligible studies included case control studies reporting circulating galectin-3 levels in individuals with SLE and healthy controls. Two independent reviewers performed study selection and data extraction. Study quality was evaluated using the Newcastle-Ottawa Scale. Comprehensive Meta-Analysis software was used for statistical analysis. Pooled effect sizes were calculated as mean differences with 95% confidence intervals. Heterogeneity was assessed using the Cochrane Q test and I² statistics, and publication bias was evaluated using Begg's funnel plot and Egger's regression analysis.ResultsSeven eligible studies were included in the meta-analysis. The pooled results showed that patients with SLE had significantly higher circulating Galectin-3 levels than healthy controls (mean difference = 8.48; 95% CI: 3.84-13.12; <i>p</i> < 0.0001). Substantial heterogeneity was observed across studies (Tau square: 32.57, Q = 196.03; <i>p</i> < 0.0001, I² = 96.93%). Sensitivity analysis confirmed the stability of the overall findings. Begg's funnel plot and Egger's regression analysis indicated no publication bias among studies. Subgroup analysis supports the results of the overall analysis.ConclusionThis meta-analysis depicts that galectin-3 may serve as a biomarker associated with SLE pathogenesis and inflammatory activity due to significantly elevated levels of circulating galectin-3 levels in patients with systemic lupus erythematosus.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1227-1237"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412321","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":"Single-cell sequencing in systemic lupus erythematosus.","authors":"Anrui Yu, Jingyi Wu, Dehao Zhu, Xia Lin, Yuyang Ren, Chengde Yang, Zhuochao Zhou, Junna Ye","doi":"10.1177/09612033261458583","DOIUrl":"10.1177/09612033261458583","url":null,"abstract":"<p><p>BackgroundSystemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by heterogeneous clinical manifestations and multi-organ involvement. Current understanding of SLE pathogenesis remains limited, particularly due to the cellular and molecular diversity of immune cells across tissues. Therefore, a comprehensive review synthesizing recent advances in applying single-cell technologies to SLE research is urgently needed to bridge this knowledge gap.TechnologySingle-cell RNA sequencing (scRNA-seq) provides high-resolution transcriptomic profiling at the single-cell level. This technology facilitates the identification of rare cell subsets, the characterization of cellular states, and the elucidation of disease-specific gene expression patterns. This technology has been applied to various SLE sample types, including peripheral blood, kidney, skin, and bone marrow.ResultsScRNA-seq has revealed distinct immune cell subpopulations and their functional alterations in SLE, including aberrant B- and T-cell subsets, dysregulated interferon-stimulated genes, and pathogenic low-density granulocytes. Crucially, by deconvoluting this cellular heterogeneity, these high-resolution insights bridge the gap between fundamental pathogenesis and clinical application, uncovering cell-specific pathways that can be harnessed as actionable therapeutic targets and prognostic biomarkers. Integration with spatial transcriptomics and machine learning further enhances research capabilities. These tools allow for mapping disease-specific immune niches and predicting clinical outcomes. Ultimately, these findings underscore the transformative potential of scRNA-seq in decoding SLE pathogenesis and guiding future targeted therapies.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1103-1119"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150323","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":"T-bet expression in B cell subsets: Association with T peripheral helper cells and clinical activity in systemic lupus erythematosus.","authors":"Ramón Chávez-Mireles, Itzel María Borunda-Calderón, Miguel Marín Rosales, Pablo C Ortiz-Lazareno, Noemí Espinoza-García, Diana Celeste Salazar-Camarena, Aarón González-Palacios, Héctor Giancarlo Torres-Nuño, Claudia Azucena Palafox-Sánchez","doi":"10.1177/09612033261466751","DOIUrl":"10.1177/09612033261466751","url":null,"abstract":"<p><p>BackgroundSystemic lupus erythematosus (SLE) features aberrant T-B cooperation and expansion of atypical memory B cells (aMBCs) characterized by the expression of CD11c and T-bet. We investigated the relationship between IL-21/IL-21R and the activation state of cTfh and Tph, with CD11c+T-bet + B cell subsets and clinical activity.MethodsA cross-sectional study was conducted involving 40 patients with systemic lupus erythematosus (SLE) and 15 healthy subjects (HS). A multiparameter flow cytometry was used to evaluate Tph (CD4⁺CXCR5^-PD-1⁺), cTfh (CD4⁺CXCR5⁺PD-1⁺), and aMBCs (CD19⁺CXCR5^-CD11c⁺) subsets and intracellular expression of IL-17A (iIL-17A), IL-21 (iIL-21), and T-bet. The disease activity was assessed using the SLEDAI-2K.ResultsWe found an increased frequency of cTfh PD-1^vh, HLA-DR⁺, IL-21R⁺, and Tph PD-1^vh, HLA-DR⁺, and iIL-21⁺ cells in SLE patients. The aNAV T-bet⁺ cells were expanded in SLE patients. Activated T-cell states (iIL-21⁺/IL-21R⁺/PD-1^vh/HLA-DR⁺) correlated with T-bet⁺ B cells subsets. Finally, activated cTfh/Tph and aMBCs correlated with SLEDAI-2K.ConclusionsOur findings provide new insights into the cooperative expression of IL-21/IL-21R and T-bet and their potential relationships with extrafollicular B-cell responses in SLE. These results highlight the IL-21/T-bet axis, offering potential avenues for biomarker development and targeted therapeutic intervention in SLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1175-1186"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368838","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":"Multimarker profiling of immune and vascular disregulation in antiphospholipid syndrome and systemic lupus erythematosus.","authors":"Neda Milinković, Dusica Mrdakovic, Natasa Stanisavljevic, Jelena Kotur Stevuljevic, Ljudmila Stojanovich, Dragomir Marisavljevic, Violeta Dopsaj","doi":"10.1177/09612033261495245","DOIUrl":"https://doi.org/10.1177/09612033261495245","url":null,"abstract":"<p><p>BackgroundAntiphospholipid syndrome (APS) is an autoimmune condition marked by thrombosis and pregnancy complications caused by antiphospholipid antibodies (aPL). This study evaluates immunological, inflammatory, and endothelial biomarkers in primary and secondary APS and SLE to determine their association with clinical outcomes.Material and methodsWe conducted a cross-sectional study including patients with primary (PAPS) (<i>n</i> = 79), secondary (SAPS) (<i>n</i> = 47), SLE (<i>n</i> = 36), and control group (<i>n</i> = 56). Serum and plasma samples were analyzed for aPLs, inflammatory markers (hs-CRP, IL-6), endothelial markers (endoglin), platelet activation (CD41/CD61), tissue factor, and iron metabolism markers (hepcidin, ferritin, UIBC) using ELISA and automated assays. Statistical analyses included group comparisons, correlations, multivariate logistic regression analysis and principal component analysis (PCA).ResultsNon-criteria aPLs, were significantly elevated in all patient groups compared to controls (<i>p</i> < 0.001). Patients with SAPS demonstrated significantly higher levels of aCL IgG, aCL IgA, aβ2GPI IgM, and aPS/PT (IgG and IgM) compared to PAPS. Strong correlations were identified between aPS/PT IgG and the lupus anticoagulant ratio (LAR) (r = 0.670, <i>p</i> < 0.001), as well as between aβ2GPI IgG and LAR (r = 0.625, <i>p</i> < 0.001). Multivariate logistic regression identified that endoglin and ferritin were independently associated with clinical manifestations. For fetal loss, the model was statistically significant (χ²¹ = 16.18, <i>p</i> = 0.013); an increase in endoglin raised the probability by 45.1% (OR = 1.451, <i>p</i> = 0.040), while lower ferritin levels were also independently associated (<i>p</i> = 0.004). Ferritin showed the strongest independent association with thrombosis (χ²¹ = 19.87, <i>p</i> = 0.011), with each unit increase raising the probability of a thrombotic event by 1.5% (OR = 1.015). PCA identified two main factors explaining 63% of the variance: an \"Immunological-related\" factor (42.96%) dominated by aCL IgG, aβ2GPI IgG, aPS/PT IgG, and aCL IgA, and a \"Prothrombotic and metabolic-related\" factor (20.06%) driven by aβ2GPI IgM, tissue factor, aCL IgA, and inversely by UIBC.ConclusionThe study highlights the interplay of immune, inflammatory, and endothelial dysfunction biomarkers in APS and their association with clinical manifestations. Combined assessment of conventional and non-criteria biomarkers may improve understanding of disease mechanisms and support a more comprehensive evaluation of patients with APS.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033261495245"},"PeriodicalIF":1.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111529","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":"High burden and unique pattern of cerebral small vessel disease in antiphospholipid syndrome: MRI subtypes and risk profile in a large cohort.","authors":"Yangyi Fan, Wenqiong Wang, Yu Kang, Xiangjun Liu, Qingmeng Cai, Zunjing Liu, Chun Li, Jianping Guo","doi":"10.1177/09612033261494025","DOIUrl":"https://doi.org/10.1177/09612033261494025","url":null,"abstract":"<p><p>ObjectiveTo characterize the burden and MRI subtypes of cerebral small vessel disease (cSVD) in antiphospholipid syndrome (APS) and to identify clinical factors associated with cSVD.MethodsWe retrospectively analyzed 132 patients with APS and age- and sex-matched healthy controls. MRI markers for cSVD, including lacunes, enlarged perivascular spaces (EPVS), microbleeds, and white matter hyperintensities (WMH), were rated using validated scales. Total cSVD scores (0-4) were calculated. Logistic regression analyses adjusted for age, sex, and disease duration were used to identify risk factors.ResultsMore than half of patients with APS (51.5%) exhibited cSVD, whereas only 24.2% had a history of stroke. Lacunes were the predominant subtype (46.2%), followed by WMH (16.7%), EPVS (14.4%), and microbleeds (12.1%). Subclinical cSVD was present in 34.8% of patients with APS without neurological symptoms. Hypertension (OR 3.69, 95%CI 1.17-11.65, <i>p</i> = 0.026), prior thrombosis (OR 22.15, 95%CI 2.11-232.27, <i>p</i> = 0.010), and prior stroke (OR 10.71, 95%CI 2.47-46.36, <i>p</i> = 0.002) were independently associated with cSVD, while individual aPL profiles were not.ConclusioncSVD is a common feature in patients with APS and often occurs in the absence of neurological manifestations. The predominance of lacunes suggests a pattern of recurrent microvascular injury. Hypertension and thrombotic history are major contributors, underscoring the need for comprehensive vascular risk assessment. These findings highlight the potential value of MRI screening in selected patients with APS and call for longitudinal studies to clarify its prognostic significance.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033261494025"},"PeriodicalIF":1.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075238","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":"Association of serum levels of galectin-9 and IP-10 with disease activation in lupus nephritis.","authors":"Sibel Varelci, Suzan Cinar, Erdem Gürel, Safak Mirioglu, Omer Uludag, Ege Sinan Torun, Yasemin Yalcinkaya, Ahmet Gul, Murat Inanc, Bahar Artim-Esen","doi":"10.1177/09612033261493837","DOIUrl":"https://doi.org/10.1177/09612033261493837","url":null,"abstract":"<p><p>ObjectivesGalectin-9 and IP-10 are downstream effectors of the type I interferon (IFN) pathway and have been proposed as surrogate biomarkers of IFN signature in systemic lupus erythematosus (SLE). This study aimed to investigate the association of serum Galectin-9 and IP-10 levels with disease activity in lupus nephritis (LN) and to compare them with those in disease controls, including antiphospholipid syndrome (APS) and primary Sjögren's disease (pSD), and healthy controls.MethodsFifty-nine patients with biopsy-proven LN (31 active, 28 inactive), 36 patients with APS, 17 patients with pSD, and 61 healthy volunteers were enrolled. All SLE patients fulfilled both the SLICC and the 2019 EULAR/ACR classification criteria. Serum Galectin-9 and IP-10 levels were measured by enzyme-linked immunosorbent assay (ELISA) in samples obtained at the same visit as the disease activity assessment. In patients with active LN, kidney biopsy was performed as part of the same clinical evaluation, whereas patients with inactive LN had a previously established biopsy-proven diagnosis of LN.ResultsAmong 59 LN patients (74.6% female; mean age 37.9 ± 12 years), serum levels of both biomarkers were significantly higher in the active LN group compared with inactive LN, APS, pSD, and healthy controls (p ≤ 0.05). Biomarker levels did not differ significantly among the inactive LN, APS, and pSD groups (p > 0.05); however, all three groups showed significantly higher levels compared to healthy controls (p ≤ 0.05). Both biomarkers showed weak but statistically significant correlations with SLEDAI scores (Galectin-9: r = 0.36, p = 0.004; IP-10: r = 0.33, p = 0.009). ROC analysis demonstrated moderate discriminatory ability for distinguishing active from inactive LN (AUC: 0.695 for Galectin-9; 0.658 for IP-10).ConclusionSerum Galectin-9 and IP-10 are elevated in active LN and show weak but statistically significant correlations with SLEDAI scores. However, elevated levels are not specific to LN, as similar values are observed in inactive LN, APS, and pSD, suggesting these markers reflect a shared IFN-driven inflammatory state rather than LN-specific pathology.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033261493837"},"PeriodicalIF":1.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075235","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}