Lupus Science & Medicine最新文献

{"title":"Comparison of TLR4, NF-κB and IRF3 expression in kidney tissue between lupus nephritis (LN) and systemic lupus erythematosus (SLE): a pristane-induced lupus mice model study.","authors":"Yuswanto Setyawan, Hani Susianti, Nur Samsu, Loeki Enggar Fitri","doi":"10.1136/lupus-2024-001445","DOIUrl":"https://doi.org/10.1136/lupus-2024-001445","url":null,"abstract":"<p><strong>Introduction and purpose: </strong>Lupus nephritis (LN) is a major cause of morbidity and mortality in patients with SLE, a complex autoimmune disease characterised by loss of tolerance to self-nuclear antigens. Toll-like receptor 4 (TLR4), the first line of defence in the innate immune system, has been linked to the pathogenesis of autoimmune diseases and LN by activating nuclear factor-κB (NF-κB) or interferon regulatory transcription factor 3 (IRF3). Local expression of those biomarkers in pristane-induced lupus mice is still unknown. Therefore, this study aimed to prove the role of TLR4, NF-κB and IRF3 in pristane-induced lupus mice.</p><p><strong>Subjects and methods: </strong>The study subjects were female Balb/c pristane-induced lupus mice model, 8-12 weeks of age, n=30, divided into two groups, nephritis (LN group) and non-nephritis (SLE group). The control group were age-matched healthy female Balb/c mice, n=11. All mice were euthanised at weeks 16. Kidney tissue was taken for histopathology examination and TLR4, NF-κB, IRF3 immunofluorescence assay. The diagnosis of LN was based on proteinuria and histopathology examination according to the ISN/RPS 2004 classification of LN. Statistical analysis was performed using IBM SPSS Statistics V.25. P value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>There were significant differences in the expressions of TLR4, NF-κB and IRF3 among the LN, SLE and healthy control groups (p=0.000), with the highest expression found in the LN group for all markers. The linear regression between TLR4 and NF-κB resulted in p value=0.000; R²=0.817; β=0.904. Linear regression between TLR4 and IRF3 showed p value=0.000; R²=0.896; β=0.947, which means TLR4 had an 81.7% effect on NF-κB and 89.6% on IRF3 expression.</p><p><strong>Conclusion: </strong>TLR4, NF-κB and IRF3 expression were increased in lupus, with the highest expression found in the LN group, suggesting that these biomarkers may be responsible for the development of nephritis in SLE, with TLR4 likely playing a dominant role in this pathway. Increased expression of these biomarkers in lupus without nephritis may indicate progression towards nephritis, which still needs to be proven with further research.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IgG glycosylation profiling of systemic lupus erythematosus using lectin microarray.","authors":"Yang Wu, Minhui Wang, Chaojun Hu, Shangzhu Zhang, Jiuliang Zhao, Qian Wang, Dong Xu, Xinping Tian, Yan Zhao, Xiaofeng Zeng, Mengtao Li","doi":"10.1136/lupus-2024-001413","DOIUrl":"10.1136/lupus-2024-001413","url":null,"abstract":"<p><strong>Objectives: </strong>Research on the specific role of immunoglobulin G (IgG) glycosylation in SLE development and progression is limited, especially regarding changes in IgG glycosylation profiles among different SLE subtypes. In this study, we aimed to characterise the glycosylation profile of serum IgG in patients with SLE.</p><p><strong>Methods: </strong>Lectin microarrays with 56 lectins were used to analyse serum IgG glycosylation in 194 patients with SLE, 100 disease controls (40 primary Sjögren's syndrome (pSS), 60 rheumatoid arthritis (RA)) and 100 healthy controls (HCs). Differences between SLE and control groups, as well as SLE subgroups, were validated by lectin blotting. Altered IgG glycosylation patterns were identified and further confirmed. Receiver operating characteristic (ROC) analysis evaluated the diagnostic value of these glycosylation changes in SLE and its subgroups, including neuropsychiatric SLE (NPSLE), lupus nephritis (LN), pulmonary arterial hypertension, immune thrombocytopaenia and SLE without major organ involvement (WMOI).</p><p><strong>Results: </strong>Compared to DC and HC groups, the IgG glycan level of Galβ3GalNAc (binding Jacalin (11.3%) and Maclura pomifera lectin (14.4%)) was significantly increased, whereas most IgG glycan levels were significantly decreased, including core fucose, high mannose, GlcNAc, GalNAc and Galβ4GlcNAc in the SLE group (all p<0.05).The IgG glycan levels were elevated in GalNAc and galactose patterns in the NPSLE group compared to the WMOI group, as well as higher Galβ3GalNAc and galactose patterns in NPSLE and LN compared to HCs.Moreover, ROC curve analysis showed PNA levels might have moderate potential for discriminating SLE from pSS.</p><p><strong>Conclusions: </strong>Patients with SLE show disease-specific alterations in serum IgG glycosylation, and aberrant Galβ3GalNAc, galactose and GalNAc glycosylation may have diagnostic value for SLE and NPSLE. Abnormal IgG glycans may provide new insights into their roles in SLE pathogenesis and progression.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and correlates of restricted community mobility in a population-based cohort of adults with systemic lupus erythematosus.","authors":"Leila Milanfar, Christopher Barrett Bowling, Courtney Hoge, Amanda Eudy, Patricia Katz, Jinoos Yazdany, Laura Plantinga","doi":"10.1136/lupus-2024-001430","DOIUrl":"10.1136/lupus-2024-001430","url":null,"abstract":"<p><strong>Objective: </strong>Restrictions in community mobility, defined as the frequency of and help required to travel to 'life-spaces' (bedroom, home, yard, neighbourhood and town), are associated with poor outcomes among older adults. We aimed to describe and explore factors associated with community mobility among adults with SLE.</p><p><strong>Methods: </strong>We assessed community mobility cross-sectionally in a population-based SLE cohort (October 2019 to May 2022), using the University of Alabama Birmingham Study of Aging Life-Space Assessment (UAB LSA) (score range, 0-120; higher scores=greater community mobility). Community mobility was considered to be restricted if the individual reported not reaching the neighbourhood life-space or beyond at least weekly and without help. Estimated percentages (95% CIs) with restricted community mobility were assessed with multivariable logistic regression adjusting for demographics and disease activity and damage.</p><p><strong>Results: </strong>Among 447 participants (91.7% women; 82.6% Black; mean age 46.2; mean UAB LSA score 53.6), 41.6% had restricted community mobility. After adjustment, Black versus White race (43.4% (95% CI 38.5% to 48.2%) vs 24.4% (12.7% to 36.2%)), lowest versus highest educational attainment (51.1% (41.4% to 60.7%) vs 27.2% (20.7% to 33.6%)) and higher versus lower disease activity (55.2% (48.4% to 62.0%) vs 28.5% (22.9% to 34.3%)) were associated with a higher prevalence of restricted community mobility; there were no differences by age, sex or disease damage.</p><p><strong>Conclusion: </strong>Restricted community mobility was common among adults with SLE, and Black race, lower education and high disease activity were associated with more restricted community mobility. Further research to understand the association of community mobility with outcomes and implement strategies to improve community mobility in people with SLE is warranted.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using patient-reported measures to predict hospitalisation in a population-based lupus cohort.","authors":"Sung Sam Lim, Sandra Sze-Jung Wu, Ryan Ross, Gaobin Bao, Megan Richards, Liisa Palmer, Gary Bryant","doi":"10.1136/lupus-2024-001406","DOIUrl":"10.1136/lupus-2024-001406","url":null,"abstract":"<p><strong>Objective: </strong>SLE is a multisystem autoimmune disease where periods of disease activity, often difficult to predict, can cause irreversible disease damage. This study aimed to develop a patient-centric predictive model using real-world data that can identify patients with SLE at a higher risk of hospitalisation compared with the general SLE population.</p><p><strong>Methods: </strong>This observational, retrospective analysis used data from the Georgians Organized Against Lupus (GOAL) cohort from 2011 to 2013. The GOAL cohort is a population-based SLE cohort that collects yearly self-report surveys covering participants' sociodemographic characteristics, clinical characteristics and perceived SLE symptoms (using the Systemic Lupus Activity Questionnaire (SLAQ)). GOAL data were linked to the Georgia Hospital Discharge Database to collect participants' all-cause hospitalisation events in the 6 months following survey completion. A two-step approach was used to predict all-cause hospitalisations-logistic regressions selected a list of GOAL predictors that were subsequently included in the classification and regression tree (CART) models to generate patient subsets based on estimated hospitalisation rates.</p><p><strong>Results: </strong>There were 846 participants who completed 1486 surveys. Participants who were hospitalised within 6 months after survey completion were more likely to be younger, living in poverty and have more reported SLE symptoms than participants without a hospitalisation. CART modelling identified participants who reported any weight loss without trying, severe fatigue and Raynaud's symptoms as most likely to have an all-cause hospitalisation: one in three (34%) patients in this subset were hospitalised in the 6 months following survey completion, 2.6-fold the hospitalisation rates of the overall GOAL cohort (13%) and 6.8-fold the rate in the subset with the lowest hospitalisation rate (5%).</p><p><strong>Conclusions: </strong>This study suggests that patient-reported SLE symptoms and disease activity, specifically certain components of the SLAQ, may be of value in SLE risk management when considering hospitalisation reduction as a treatment goal.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ras-MAPK pathway in patients with lupus nephritis.","authors":"Changming Zhang, Xiaoman Jing, Yangyang Zhang, Ying Jin, Xingjian Gao, Jingxian Yu, Dandan Liang, Jiahui Zhang, Qing Zhong, Haitao Zhang, Zhihong Liu","doi":"10.1136/lupus-2024-001345","DOIUrl":"10.1136/lupus-2024-001345","url":null,"abstract":"<p><strong>Background: </strong>Pathogenic mutations in genes encoding components of the Ras/mitogen-activated protein kinase (Ras-MAPK) pathway cause RASopathy. Here, we describe five unrelated patients with SLE carrying mutations associated with RASopathy and investigate the activity of the Ras-MAPK pathway.</p><p><strong>Methods: </strong>Pathogenic variants were identified by whole-exome/whole-genome sequencing. The activity of the Ras-MAPK pathway in peripheral blood mononuclear cells (PBMC) and kidneys was evaluated using RNA sequencing and datasets from the nephroseq database, respectively.</p><p><strong>Results: </strong>Five (likely) pathogenic variants in four Ras-MAPK genes were identified, including NRAS: c.G38A: p.G13D; ARAF: c.C1435T: p.R479C; KRAS: c.T341C: p.V114A; PTPN11: c.G455A: p.R152H and NRAS: c.G34A: p.G12S. Kidney injury is the main feature, presenting with nephrotic syndrome (2/5), proteinuria and haematuria (2/5). Acute kidney injury and rapidly progressive nephritic syndrome were noted in one patient each. Other clinical features included mucocutaneous lesions (5/5), cardiac involvement (4/5) and arthralgia (3/5). Laboratory abnormalities included hypocomplementaemia (5/5), presence of antiphospholipid antibodies (4/5), decreased regulatory T cells (3/3), pancytopenia (3/5) and persistent monocytosis (2/5). Kidney biopsy revealed lupus nephritis. Most patients responded well to standard therapy, with the exception of the patient with the NRAS p.G13D mutation who died. The Ras-MAPK pathway was activated in both PBMC and kidney of patients with LN as indicated by increased expression of NRAS, KRAS, RIT1, MRAS, PPP1CB, SHOC2, SOS2 and MAP2K1, as well as decreased expression of negative regulators of the Ras-MAPK pathway, CBL, LZTR1 and NF1.</p><p><strong>Conclusion: </strong>Kidney involvement may be the main feature of the clinical spectrum of RASopathy. Genetic screening should be considered for patients with early onset lupus.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Levels of physical activity in a large international cohort of patients with systemic lupus erythematosus.","authors":"Timothée Mischler, Lou Kawka, Juan C Sarmiento-Monroy, Philippe Mertz, Luc Pijnenburg, Marina Rinagel, Manuel Francisco Ugarte-Gil, Sophie Geneton, Julien Blaess, Matteo Piga, Christelle Sordet, Laurent Arnaud","doi":"10.1136/lupus-2024-001443","DOIUrl":"10.1136/lupus-2024-001443","url":null,"abstract":"<p><strong>Introduction: </strong>Physical activity (PA) holds a pivotal role in the improvement of mental health or depressive symptoms, as well as in the prevention of cardiovascular diseases (CVDs). Patients with SLE are exposed to an increased risk of CVDs and suffer from deteriorated quality of life compared with the general population. The aim of this study was to assess PA level and characteristics in a large international cohort of patients with SLE.</p><p><strong>Methods: </strong>PA was assessed in metabolic equivalent of tasks (METs) using the International Physical Activity Questionnaire (IPAQ) and classified into three levels: low, moderate and high PA. Other data such as fatigue, disease activity, pain, insomnia, anxiety, depression, stress and fibromyalgia were collected using validated patient-reported instruments, using the Lupus Expert system for the Assessment of Fatigue (LEAF) digital tool.</p><p><strong>Results: </strong>1029 LEAF participants with SLE (986 (95.8%) women) with a median age of 43 years were analysed. The median physical expenditure was 936 METs/week (IQR: 297-2622). 456 (44.3%) participants were classified as having low PA levels. Increased fatigue according to the Functional Assessment of Chronic Illness Therapy-Fatigue Scale (p<0.0001), the Multidimensional Fatigue Inventory (p<0.0001), Visual Analogue Scale for fatigue (p=0.02), pain (p=0.009), depression (p=0.02) and stress (p<0.0001) were significantly more prevalent in less active patients, in IPAQ classification.</p><p><strong>Conclusion: </strong>In this large international study, more than 40% of patients with SLE were not active enough. We found an inverse association between PA levels and fatigue, pain, stress or depression. This points out the necessity to better assess PA in patients with SLE, as well as the aforementioned comorbidities to improve quality of life and reduce cardiovascular risk.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolomic analysis suggests thiamine monophosphate as a potential marker for mesenchymal stem cell transplantation outcomes in patients with SLE.","authors":"Xiaoman Jiang, Zhuoyang Jia, Bin Yang, Xiaojun Tang, Xuebing Feng, Lingyun Sun","doi":"10.1136/lupus-2024-001197","DOIUrl":"10.1136/lupus-2024-001197","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this research is to identify metabolic markers associated with successful treatment by evaluating the effect of mesenchymal stem cell transplantation (MSCT) on the metabolic profiles of patients with SLE.</p><p><strong>Methods: </strong>Plasma samples were collected from 20 patients with SLE before and after MSCT. Principal component analysis (PCA) was used to distinguish pretreatment and post-treatment groups and pathway analysis for identifying involved metabolic pathways. Clinical variables were monitored with a median follow-up time of 180 days. Pearson correlation and receiver operating characteristics (ROC) analysis were employed to associate metabolite changes with clinical outcomes and to predict treatment success.</p><p><strong>Results: </strong>We detected 18 121 metabolites, with 1152 showing significant changes post-treatment, which could be clearly distinguished between pretreatment and post-treatment groups through PCA. Pathway analysis indicated involvement in riboflavin and thiamine metabolism. Clinical improvements were observed at a median follow-up time of 180 days after MSCT, including decreased SLE Disease Activity Index scores, urine protein/creatinine ratios, and erythrocyte sedimentation rates, along with increased levels of complement C3 and C4, haemoglobin, and platelets. Pearson correlation indicated that specific metabolite changes were associated with clinical improvements, particularly increases in thiamine monophosphate (TMP) and asiaticoside levels. ROC analysis identified TMP level changes as the most predictive of treatment success, with a 35% increase indicating a good response to MSCT.</p><p><strong>Conclusion: </strong>This study concludes that TMP is a potential biomarker that can predict the efficacy of MSCT in treating SLE, providing valuable insights for clinical practice and further research.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of flares in 85 patients with SLE who maintained, discontinued or reduced dose of hydroxychloroquine during a prospective study of ophthalmological screening for retinopathy (PERFOCTAPS Study).","authors":"Joana Isabel Marques Dias, Kevin Chevalier, Vivien Vasseur, Elsa Laumonier, Sabine Derrien, Nathalie Morel, Véronique Le Guern, Alexis Mathian, Luc Mouthon, Martine Mauget Faÿsse, Yann Nguyen, Nathalie Costedoat-Chalumeau","doi":"10.1136/lupus-2024-001434","DOIUrl":"10.1136/lupus-2024-001434","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about the risk of SLE flares associated with hydroxychloroquine (HCQ) reduction or cessation, especially after ophthalmological screening. We analysed the risk of SLE flares after HCQ reduction or discontinuation after detection of early ophthalmological toxicity.</p><p><strong>Methods: </strong>This study includes all patients with SLE among the 109 included in the prospective PERFOCTAPS Study and treated with HCQ for at least 5 years. Patients were divided into 3 groups: HCQ maintenance, reduction and discontinuation after intensive ophthalmological screening. Flare occurrence (SELENA-SLEDAI Flare Index) was assessed for 2 years after HCQ reduction or discontinuation or after inclusion in the maintenance group.</p><p><strong>Results: </strong>This study included 85 patients (98% women, mean age 40.0 years, and mean durations of SLE and HCQ treatment 14.4±7.7 years and 12.9±7.2 years, respectively). The PERFOCTAPS Study identified ophthalmological abnormalities in 25 patients (29.4%); these led to dose reduction in 20 patients and discontinuation in 5. Flares occurred in 29 patients (34.1%): 17 (28.3%) in the maintenance group, 10 (50%) in the reduction group and 2 (40%) in the discontinuation group. After adjustment for potential confounders, HCQ reduction was independently associated with the risk of flare (adjusted HR 2.26; 95% CI 1.03 to 4.97). The same trend was observed in the discontinuation group, but was no longer statistically significant (adjusted HR 2.13; 95% CI 0.44 to 10.27).</p><p><strong>Conclusion: </strong>In this prospective study, HCQ reduction due to early suspicion of retinal toxicity was associated with a statistically significantly increased risk of disease flare.</p><p><strong>Trial registration number: </strong>NCT02719002.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effects of pre-exposure treatment with hydroxychloroquine on the risk of COVID-19 infection and on the efficacy of anti-COVID-19 vaccination during lupus or Gougerot-Sjögren's disease: Prepcov multicentre trial.","authors":"Laurent Alric, Clara Brusq, Marion Migueres, Stephanie Faure, Pascal Lebray, Jean François Viallard, Dominique Chauveau, Laurent Sailler, Emilie Bérard, Grégory Pugnet, Patrice Cacoub","doi":"10.1136/lupus-2024-001435","DOIUrl":"10.1136/lupus-2024-001435","url":null,"abstract":"<p><strong>Objectives: </strong>Some patients with SLE or Gougerot-Sjögren's disease (GSD) receive long-term treatment with hydroxychloroquine (HCQ), sometimes combined with immunosuppressive therapy (IS). This study sought to assess whether long-term HCQ therapy that had been initiated long before the COVID-19 pandemic had a protective or adverse effect on COVID-19 risk, severity of infection or immunity protection.</p><p><strong>Methods: </strong>This prospective multicentre study included 547 patients with SLE, GSD, autoimmune hepatitis, primary biliary cholangitis or cured viral hepatitis C divided into four groups according to HCQ (+/-) and IS (+/-) intake prior to the pandemic: HCQ+IS+ (n=112), HCQ+IS- (n=121), HCQ-IS+ (n=115) and HCQ-IS- (n=199). When COVID-19 vaccination was possible, patients were vaccinated as recommended. Vaccination efficacy was prospectively assessed on the basis of the postvaccination antibody titre.</p><p><strong>Results: </strong>Compared with HCQ+IS+ patients, HCQ-IS+ patients had a decreased risk of COVID-19 infection (p<0.001). Compared with HCQ+IS+ patients, HCQ-IS- patients had a decreased risk of contracting COVID-19 (p<0.001). Patients in the HCQ-IS+ or HCQ-IS- group had a lower risk of symptomatic or severe infection than HCQ+IS+ patients did (p=0.001 and p<0.001, respectively). Only patients who had two or more exposures (to vaccine and/or infection) had an increased likelihood of COVID-19 immunity after the last dose (p<0.001).</p><p><strong>Conclusions: </strong>HCQ treatment that was initiated before the pandemic did not protect against COVID-19 infection. Moreover, non-exposure to HCQ treatment (combined or not with IS) was associated with decreased risk of COVID-19 infection and of developing a symptomatic or severe infection. HCQ and IS do not influence the vaccine response. Only two or more doses of vaccine result in a good vaccine response.</p><p><strong>Trial registration number: </strong>NCT04481633.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of the reporting of extrarenal manifestations in observational studies of Saudi patients with systemic lupus erythematosus.","authors":"Fahidah Alenzi, Roaa Aljohani, Aos Aboabat, Fehaid Alanazi, Haya M Almalag, Mohammed A Omair","doi":"10.1136/lupus-2024-001469","DOIUrl":"10.1136/lupus-2024-001469","url":null,"abstract":"<p><strong>Background: </strong>SLE is prevalent in Saudi Arabia, with numerous studies focusing on SLE in adult patients. However, there is a lack of comprehensive studies summarising the extrarenal manifestations of SLE in this population. This study aims to assess the variability in the prevalence rates of extrarenal manifestations of SLE across different cities in Saudi Arabia and to emphasise the need for a national registry to better understand the overall disease burden in the region.</p><p><strong>Methods: </strong>We conducted a systematic review of articles with no time restrictions, including studies from databases such as Medline, ScienceDirect, EBSCO and PubMed up to July 2024. The review process involved screening, data extraction and quality assessment in duplicate. Only observational or experimental studies focusing on extrarenal manifestations in adult patients with SLE in Saudi Arabia were included. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for systematic reviews to ensure a rigorous and comprehensive evaluation.</p><p><strong>Results: </strong>A total of 35 studies were included, primarily retrospective cohort studies. Riyadh showed the highest number of publications over time. Musculoskeletal involvement in SLE ranged from 2% to 100%, with most studies reporting 46%-85%. Mucocutaneous manifestations, including discoid rash (5%-100%), malar rash (up to 79%) and photosensitivity (6.12%-29.3%), varied widely. Raynaud's phenomenon was noted at 4.5%-15.2%. Constitutional symptoms were more common in early-onset SLE, while serositis and cardiopulmonary issues showed variability. Neuropsychiatric symptoms, especially depression, reached up to 67.6%.</p><p><strong>Conclusion: </strong>This study explores the prevalence of extrarenal manifestations of SLE among adult Saudi patients, highlighting significant regional variability in musculoskeletal, dermatological, cardiovascular and neurological symptoms. It addresses a gap in the literature for a region where autoimmune diseases are a growing public health concern. The findings emphasise the need for population-based studies to investigate environmental, genetic and lifestyle factors influencing SLE progression.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}