Lupus Science & Medicine最新文献

{"title":"Impact of body weight on mycophenolic acid population pharmacokinetics in paediatric lupus nephritis: a pharmacogenomic integration study.","authors":"Chen Ye, Baojing Liu, Lizhi Chen, Lu Zhang, Yifan Zheng, Kejing Tang, Xiaoyun Jiang, Pan Chen","doi":"10.1136/lupus-2025-001535","DOIUrl":"10.1136/lupus-2025-001535","url":null,"abstract":"<p><strong>Background: </strong>Mycophenolic acid (MPA) is recommended for the treatment of lupus nephritis (LN). However, the high pharmacokinetic (PK) variability of MPA contributes to its suboptimal efficacy and an increased incidence of adverse reactions. Rare data reported the impacts of genetic and clinical characteristics on MPA clearance in the paediatric patients with LN.</p><p><strong>Methods: </strong>Paediatric patients with LN receiving mycophenolate mofetil (MMF) were prospectively enrolled. MPA PK parameters were calculated on reaching steady state (defined as at least 7 days), based on plasma concentrations measured before and after administration at intervals of 0.5, 1.5, 2.5, 4, 6, 9 and 12 hours post-MMF treatment. Genetic variants associated with the MPA PK process were identified. The population PKs (PPKs) model was constructed using Phoenix NLME software and validated internally as well as externally.</p><p><strong>Results: </strong>A total of 51 patients were included in the study, resulting in the acquisition of 146 area under the concentration-time curve (AUC) values. PK analysis revealed that the mean AUC value was 31.05 μg×hour/mL. The mean clearance value was 11.10 L/hour. We screened 29 single nucleotide polymorphisms across 13 candidate genes and identified that eight genetic variants within the <i>UGT1A9</i>, <i>ABCC2</i> and <i>CES1</i> genes significantly impacted the AUC of MPA. Furthermore, our data were adequately represented by a two-compartment model incorporating lag time and linear elimination kinetics. However, when combined with clinical variables, only body weight emerged as a critical covariate significantly associated with MPA peripheral volume of distribution. External validation involving nine patients demonstrated strong predictive performance.</p><p><strong>Conclusion: </strong>Body weight emerges as the primary covariate over pharmacogenetic variants in PPK modelling of MPA in paediatric LN. We suggest that an individualised initial dose and adjustment based on body weight can be given in the paediatric population.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540760","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":"Relationship between hydroxychloroquine blood levels and lupus activity through the lens of the type 1 and type 2 lupus model: a cross-sectional study.","authors":"Kai Sun, Amanda M Eudy, Megan E B Clowse, Stephen J Balevic, Tyler O'Malley, Roberta Vezza Alexander, Rebecca E Sadun, Mithu Maheswaranathan, Jayanth Doss, Lisa G Criscione-Schreiber, Jennifer L Rogers","doi":"10.1136/lupus-2025-001531","DOIUrl":"10.1136/lupus-2025-001531","url":null,"abstract":"<p><strong>Introduction: </strong>In the type 1 and 2 SLE model, inflammation mediates type 1 manifestations, but its role in type 2 manifestations (eg, fatigue, myalgias, mood disturbance, cognitive dysfunction) is less clear. Therapeutic hydroxychloroquine (HCQ) levels reduce type 1 activity, but their relationship with type 2 activity is unknown. Exploring this relationship may illuminate type 2 SLE pathophysiology.</p><p><strong>Methods: </strong>We measured whole blood HCQ levels using liquid chromatography-mass spectrometry, categorising them as underexposure (<200 ng/mL), subtherapeutic (200 to <750 ng/mL) or therapeutic (≥750 ng/mL). We measured type 1 SLE activity using the type 1 Physician Global Assessment (PGA) and Systemic Lupus Erythematosus Disease Activity Index and type 2 SLE activity using the type 2 PGA and patient-reported polysymptomatic distress scores. Patients were categorised into <i>minimal</i> (low type 1 and type 2), <i>type 1</i> (high type 1 and low type 2), <i>type 2</i> (low type 1 and high type 2) and <i>mixed activity</i> (high type 1 and type 2) groups. We analysed relationships between HCQ levels and type 1 and type 2 SLE activities.</p><p><strong>Results: </strong>Among 154 patients (median age 43, 90% women, 63% Black race, 7% Hispanic ethnicity) across 297 visits, HCQ levels were underexposed at 41 (14%) visits, subtherapeutic at 76 (26%) and therapeutic at 180 (61%) visits. Patients had <i>minimal activity</i> at 102 visits (34%), <i>type 1 activity</i> at 33 (11%), <i>type 2 activity</i> at 85 (29%) and <i>mixed activity</i> at 77 (26%) visits.Underexposed HCQ levels were independently associated with higher type 1 (OR 2.33, 95% CI 1.23 to 4.44) and type 2 activities (OR 1.80, 95% CI 1.07 to 3.04). <i>Mixed activity</i> most strongly associated with Underexposed HCQ levels (OR 3.4-10.3, p<0.05).</p><p><strong>Conclusions: </strong>Low HCQ levels are associated with increased type 1 and type 2 SLE activities, particularly for the <i>mixed activity</i> group, suggesting that immunologic activity may contribute to type 2 symptoms in some patients.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528630","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":"Serum glutathione reductase level as a disease activity biomarker in systemic lupus erythematosus: a single-centre preliminary study.","authors":"Mengxue Yan, Yan Sun, Siping Li, Zhichun Liu, Leixi Xue","doi":"10.1136/lupus-2025-001593","DOIUrl":"10.1136/lupus-2025-001593","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate serum glutathione reductase (GR) levels in patients with SLE and to assess its association with disease activity.</p><p><strong>Methods: </strong>The retrospective study collected clinical data, including serum GR, complement (C) 3 and C4 levels, among patients with SLE. The SLE Disease Activity Index 2000 (SLEDAI 2000) and SLE Disease Activity Score (SLE-DAS) were calculated, and C3 and C4 were used as controls to assess the importance of serum GR levels in evaluating SLE disease activity.</p><p><strong>Results: </strong>Serum GR levels were significantly higher in patients with SLE (n=142) than in healthy controls (n=100). Serum GR levels were positively correlated with SLEDAI 2000 (ρ=0.335) and SLE-DAS (ρ=0.454) values in patients with SLE. Further, C3 and C4 were negatively correlated with SLEDAI 2000 (ρ = -0.544 and -0.418) and with SLE-DAS (ρ = -0.290 and -0.242). Fisher's Z test showed that GR was inferior to C3; however, similar to C4 in the correlation with SLEDAI 2000, whereas GR was comparable to C3 but superior to C4 in the correlation with SLE-DAS. The identification of moderate-to-severe disease activity based on SLEDAI 2000 of >6 revealed a receiver operating characteristic curve area under the curve (AUC) for GR of 0.700 (95% CI: 0.617 to 0.774), which was comparable to the AUC for C3 (0.784, 95% CI: 0.707 to 0.848) and C4 (0.697, 95% CI: 0.615 to 0.771); in determining moderate-to-severe disease activity as defined by SLE-DAS of >7.64, GR (0.767, 95% CI: 0.689 to 0.834) was equal to C3 (0.661, 95% CI: 0.576 to 0.738) but superior to C4 (0.617, 95% CI: 0.532 to 0.698).</p><p><strong>Conclusion: </strong>Serum GR levels are positively correlated with SLE disease activity and exhibit clinical value in identifying moderate-to-severe disease activity in SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484887","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":"Total Tubulointerstitial Score: a simple and effective predictor of long-term mortality and adverse renal outcomes in lupus nephritis.","authors":"Xinxin Zhang, Manhuai Zhang, Xiaolei Shi, Wang Xiang, Yuewen Lu, Jiaqing Tan, Jianwen Yu, Hongjian Ye, Zhong Zhong, Jiang Lanping, Ruihan Tang, Xi Xia, Wei Chen","doi":"10.1136/lupus-2025-001578","DOIUrl":"10.1136/lupus-2025-001578","url":null,"abstract":"<p><strong>Objective: </strong>Most studies focused on glomerular lesions in lupus nephritis (LN). However, the predictive value for tubulointerstitial lesions remains less well understood and controversial. Here, we assessed the impact of tubulointerstitial lesions, quantified by Total Tubulointerstitial Lesions Score (TTS), on long-term renal outcomes and mortality in LN.</p><p><strong>Methods: </strong>We conducted a cohort study of 832 patients with LN diagnosed from 1996 to 2018 at the First Affiliated Hospital of Sun Yat-sen University. Patients were stratified by the median of TTS (TTS ≤2 vs TTS >2 groups), which included the total score of tubulointerstitial inflammation, tubular atrophy and interstitial fibrosis by the 2018 ISN/RPS (International Society of Nephrology and Renal Pathology Society) classification semi-score. We used Kaplan-Meier survival curves and Cox regression models to analyse the associations between TTS and patient outcomes.</p><p><strong>Results: </strong>Pearson's correlation analysis revealed that TTS was negatively correlated with estimated glomerular filtration rate, haemoglobin and serum albumin levels, while positively correlated with proteinuria levels. TTS was significantly higher in patients with proliferative LN. Kaplan-Meier analysis showed that patients with higher TTS had a higher risk of all-cause mortality and adverse renal outcomes. Multivariate Cox analysis identified TTS >2 (HR=1.50, 95% CI=1.02 to 2.22, p=0.039) and higher tubulointerstitial inflammation and tubular atrophy as the independent predictor of all-cause mortality, and TTS >2 (HR=1.63, 95% CI=1.05 to 2.52, p=0.030) and severer tubulointerstitial inflammation, tubular atrophy and interstitial fibrosis were independently associated with adverse renal outcomes.</p><p><strong>Conclusions: </strong>TTS provides a comprehensive assessment of renal tubulointerstitial lesions and is a simple and effective predictor of long-term mortality and adverse renal outcomes in LN.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336633","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":"Expression pattern and clinical significance of MerTK on circulating NK cells in systemic lupus erythematosus.","authors":"Renge Liang, Ranran Yao, Ziye Wang, Wenwen Pei, Ruyu Liang, Xiao Han, Haojie Xu, Yin Zhu, Jianping Guo, Yin Su","doi":"10.1136/lupus-2024-001407","DOIUrl":"10.1136/lupus-2024-001407","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the clinical significance of Mer receptor tyrosine kinase (MerTK) on circulating natural killer (NK) cells in systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>63 patients with SLE and 36 healthy controls (HCs) were recruited in this study. Peripheral blood samples were collected from all participants. MerTK expression on circulating NK cells (CD3^-CD56⁺) was detected by flow cytometry. MerTK expression was compared between patients with SLE and HCs or lupus nephritis (LN) and non-LN subgroups, and its correlation with clinical or laboratory features was also investigated. Bioinformatic analysis was conducted to explore the potential function of <i>MERTK</i> in NK cells in SLE.</p><p><strong>Results: </strong>MerTK expression on circulating NK cells was significantly higher in patients with SLE than that in HCs. In patients with SLE, NK-cell specific MerTK expression was positively correlated with Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), anti-double-stranded DNA antibody levels, proportions and absolute count of B lymphocytes, but negatively correlated with complement C3, complement C4, proportions and absolute count of NK cells. Moreover, NK-cell specific MerTK expression was significantly higher in the LN group than that in the non-LN group. Bioinformatics analysis revealed that <i>MERTK</i> was one of the dysregulated NK-cell related genes in SLE, and the differentially expressed genes related to <i>MERTK</i> were associated with biological pathways including NK cell activation and response to type I interferon (IFN-I). In vitro study showed that MerTK expression on NK cells was increased after IFN-I treatment.</p><p><strong>Conclusions: </strong>The expression of MerTK on circulating NK cells was significantly elevated in patients with SLE, particularly in patients with LN, and was correlated with disease activity and autoantibody titres. <i>MERTK</i> expression may be related to regulation of NK cell activation and induced by IFN-I in SLE. Our findings indicate that circulating NK-cell specific expression of MerTK may play a role in the development and progression of SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336670","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":"Effects of environmentally-induced anxiety on autoimmunity in the MRL/lpr mouse.","authors":"Fan Zhang, Qiong Zhang, Ruo-Nan Dang, Xiao-Xue Tian, Lin-Jie Li, Quan-Min Zhou, Xiao-Ying Li, Yuan-Sheng Wu, Hui-Mei Zou","doi":"10.1136/lupus-2025-001528","DOIUrl":"10.1136/lupus-2025-001528","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the interplay between anxiety disorders and SLE using lupus-prone MRL-lpr mice and MRL/MPJ control mice exposed to predator stress, and to elucidate the potential mechanisms underlying this interaction.</p><p><strong>Methods: </strong>We conducted an experiment where 16 MRL-lpr mice and 16 MRL/MPJ control mice were randomly assigned to four groups and exposed to predator stress (cat exposure) or served as unexposed controls for 2 months. Anxiety levels were evaluated using the elevated plus maze (EPM) and open field test (OFT). Physiological responses were assessed through measurements of body weight, interleukin-6 (IL-6) levels, anti-double-stranded DNA (dsDNA) antibody titres and urine protein content. Additionally, the splenic index and the proportions of regulatory T (Treg) and T helper 17 (Th17) cells were analysed to further understand the immune responses.</p><p><strong>Results: </strong>Both mouse strains exhibited increased anxiety levels as assessed by the EPM and OFT. However, MRL-lpr mice demonstrated a heightened sensitivity to predator stress-induced anxiety compared with MRL/MPJ mice. Biochemical analyses revealed that while MRL/MPJ mice showed a typical inflammatory response to predator stress, characterised by elevated IL-6 levels, this did not exacerbate immune dysregulation or renal damage. In contrast, MRL-lpr mice exhibited markedly increased IL-6 expression, elevated anti-dsDNA antibody levels, higher urine protein content, decreased Treg proportions and increased Th17 proportions in the spleen, suggesting an accelerated progression of lupus disease.</p><p><strong>Conclusions: </strong>Our findings emphasise that lupus-prone MRL-lpr mice display a greater vulnerability to the detrimental consequences of predator stress compared with MRL/MPJ control mice.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336669","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":"Effects of dual-task exercises on cognitive status, disease activity and quality of life in childhood-onset systemic lupus erythematosus.","authors":"Eylul Pinar Kisa, Sezgin Sahin, Gokce Leblebici, İrem Yagmur Tonyali, Gulcin Balci, Şehri Dilek, Esma Aslan, Ela Tarakci, Ozgur Kasapcopur","doi":"10.1136/lupus-2024-001453","DOIUrl":"10.1136/lupus-2024-001453","url":null,"abstract":"<p><strong>Objective: </strong>Many patients with childhood-onset systemic lupus erythematosus (cSLE) suffer from cognitive dysfunction that seriously affects their quality of life, attention, visual and speech memory, motor function, reaction speed and motor perception and physical activity. This study aims to investigate the effects of dual-task (DT) exercises on cognitive status, disease activity and physical function of children with cSLE.</p><p><strong>Method: </strong>30 children with cSLE were included. During intervention sessions (2 days a week for 16 weeks), DT exercises were applied to all children having cSLE. The mental status of the patients by the Montreal Cognitive Assessment (MoCA), pain status by the McGill-Melzack Pain Questionnaire, disease activity by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2K, physical activity by the Childhood Activity Assessment Index and International Physical Activity Questionnaire (IPAQ) and steps number recorded.</p><p><strong>Results: </strong>McGill-Melzack pain scores and MoCA scores (42.70±16.85 and 20.86±3.89, respectively) were significantly improved after the intervention (36.53±16.55 and 23.73±2.72, respectively) (p<0.05). Additionally, IPAQ median metabolic equivalent scores (3171.73±3185.69) were significantly increased after the intervention (5592.40±6228.61; p=0.01). Lupus disease activity score (SLEDAI-2K) decreased from 2.79±3.20 to 2.18±2.23 with the implementation of DT; however, this was not statistically significant (p>0.05).</p><p><strong>Conclusions: </strong>DT exercises can play a crucial role in enhancing cognitive status and physical function of patients with cSLE. There is limited research examining the effects of DT exercises on cognitive status, particularly in patients with cSLE.</p><p><strong>Trial registration number: </strong>NCT05984316.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336668","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":"Failing maternal-fetal tolerance in SLE (FaMaLE): a prospective cohort study for finding the molecular mechanisms behind pregnancy complications.","authors":"Wendy Dankers, Jikke F van Ruitenbeek, Serife Asya Germe, Agner R Parra Sánchez, Mirte F H M van Gaal, Marjolein Hortensius, Kyra Cramer, Daphne C Rohrich-Heldens, Marjon de Boer, Lisa G M van Baarsen, Irene E M Bultink","doi":"10.1136/lupus-2025-001668","DOIUrl":"10.1136/lupus-2025-001668","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnant women with SLE have an increased risk of maternal complications and adverse fetal outcomes. These include pre-eclampsia, preterm birth and fetal growth restriction. Interestingly, this increased risk persists in subsequent pregnancies, whereas it decreases in healthy women due to the development of maternal-fetal tolerance. As maternal-fetal tolerance is crucial for a healthy pregnancy, we hypothesise that its failure contributes to the increased risk of pregnancy complications in women with SLE. Therefore, we initiated the failing maternal-fetal tolerance in SLE (FaMaLE) study to investigate the failure of maternal-fetal tolerance in pregnant women with SLE.</p><p><strong>Methods and analysis: </strong>In the FaMaLE study, women with SLE and healthy women are included in their first trimester of pregnancy (<14 weeks gestational age) at Amsterdam UMC. Throughout the pregnancy, data on SLE disease activity, pregnancy course and medication use are collected. Peripheral blood is collected once per trimester, within 48 hours before delivery and 5-12 weeks post partum. In addition, the placenta is collected after delivery. Whole blood, peripheral blood mononuclear cells and placenta samples are freshly analysed by flow cytometry to assess immune cell composition. The resulting data are analysed in relation to SLE disease course, pregnancy course and pregnancy outcomes.</p><p><strong>Ethics and dissemination: </strong>The study has been approved by the Amsterdam UMC Medical Ethics Committee and all participating women will be asked to provide informed consent. The findings will be disseminated through peer-reviewed publications, presentations at scientific meetings and via patient organisations.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336631","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":"Impact of antiphospholipid antibodies on heart valve involvements in systemic lupus erythematosus: based on CSTAR cohort.","authors":"Siyun Chen, Can Huang, Hui Jiang, Yangzhong Zhou, Liying Peng, Ziqian Wang, Junyan Qian, Wei Bai, Shangzhu Zhang, Chuhan Wang, Yuan Zhao, Xiaoxiao Guo, Mengtao Li, Xiaofeng Zeng, Jiuliang Zhao, Yan Zhao","doi":"10.1136/lupus-2025-001674","DOIUrl":"10.1136/lupus-2025-001674","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the role of antiphospholipid antibodies (aPLs) in patients with SLE with heart valve diseases (HVDs).</p><p><strong>Methods: </strong>This prospective study included consecutive patients with SLE who visited Peking Union Medical College Hospital between April 1999 and December 2024. Echocardiography was performed based on clinical indications. Clinical characteristics, aPL profiles and echocardiographic findings were collected. Logistic regression was used to evaluate associations between aPLs and HVD.</p><p><strong>Results: </strong>Among 508 patients with SLE, 27.4% had HVD. The most frequently affected valves were aortic (17.3%) and mitral (11.2%) valves, with thickening (19.5%) and regurgitation (15.9%) as the leading lesion types. aPLs positive patients with SLE had higher rates of HVD (35.1% vs 24.0%, p=0.010), including valve thickening (25.3% vs 16.9%, p=0.028), regurgitation (24.7% vs 12.1%, p<0.001), vegetations (9.1% vs 0.8%, p<0.001) and stenosis (1.9% vs 0.0%, p=0.008). Anticardiolipin-IgG was associated with HVD (OR=2.484, p=0.003), mitral lesions (OR=4.156, p<0.001), valve thickening (OR=2.255, p=0.011) and regurgitation (OR=2.121, p=0.014). Anti-β2 glycoprotein I-IgG showed similar associations and was also linked to valve stenosis (OR=11.209, p=0.022). Lupus anticoagulant (LA) was associated with valve vegetations (OR=8.659, p<0.001) and interventional/surgical indications (OR=6.868, p=0.005).</p><p><strong>Conclusion: </strong>aPLs, especially IgG isotype and LA, are independently associated with diverse HVD in SLE. Echocardiographic monitoring is warranted in aPL-positive patients.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336632","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 MRI-based brain oxygen extraction fraction mapping in patients with systemic lupus erythematosus.","authors":"Shuoqi Zhang, Jiayi Ma, Shaolong Wu, Ziwei Hu, Su Yan, Junghun Cho, Yi Wang, Lingli Dong, Shun Zhang, Wenzhen Zhu","doi":"10.1136/lupus-2025-001522","DOIUrl":"10.1136/lupus-2025-001522","url":null,"abstract":"<p><strong>Objective: </strong>We aim to assess the cerebral oxygen extraction fraction (OEF) changes in patients with systemic lupus erythematosus (SLE) and neuropsychiatric SLE (NPSLE) by using an MRI-based technique and examine the relationship between OEF and cognition.</p><p><strong>Methods: </strong>43 SLE patients (18 NPSLE and 25 non-NPSLE) and 26 healthy controls (HC) were recruited. Cognitive function was assessed via the Montreal Cognitive Assessment (MoCA). OEF was calculated by quantitative susceptibility mapping plus quantitative blood oxygen level-dependent model (QQ). Whole-brain voxel-wise analysis of OEF was performed. In subcortical grey matter structures, regional OEF values were measured, and their relationship with MoCA scores was explored.</p><p><strong>Results: </strong>Whole-brain voxel-wise analysis revealed significant changes of OEF primarily in the limbic system, including the orbitofrontal cortex and bilateral insular lobes, among HC, non-NPSLE and NPSLE groups. Regional analysis indicated reduced OEF values in subregions of the amygdala, hippocampus and caudate nucleus in non-NPSLE compared with HC, with decreasing trends observed in all selected regions of subcortical grey matter structures. In the right hippocampus, OEF values were increased in NPSLE patients compared with non-NPSLE patients. Considering all subjects in the study, OEF values in the bilateral medial amygdalae, right lateral amygdala, left rostral hippocampus and right dorsal caudate nucleus were positively correlated with MoCA scores.</p><p><strong>Conclusion: </strong>Cerebral OEF mapping in patients with SLE is readily available using the MRI-based QQ method, which has the potential to serve as an adjunctive tool for diagnosing NPSLE and monitoring cognitive impairment in SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317348","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}