Lupus Science & Medicine最新文献

{"title":"Balancing automation and expertise: real-world evaluation of AI-assisted whole-exome sequencing in lupus-causing genes.","authors":"Anastasia-Vasiliki Madenidou, Gillian I Rice, Terence Garner, Sarah Dyball, Ben Parker, Alice Chieng, Adam Stevens, Ian N Bruce, Tracy A Briggs","doi":"10.1136/lupus-2026-002049","DOIUrl":"https://doi.org/10.1136/lupus-2026-002049","url":null,"abstract":"<p><strong>Objective: </strong>Whole-exome sequencing (WES) is increasingly used to investigate patients with suspected monogenic forms of systemic lupus erythematosus (SLE) and other systemic autoimmune rheumatic diseases (SARDs). With the increasing use of artificial intelligence (AI)-assisted variant interpretation tools, there is a need to evaluate their real-world utility. In a SARD cohort, we compared the performance of AI-assisted and expert-guided WES analysis strategies in identifying disease-relevant variants within lupus-causing genes.</p><p><strong>Methods: </strong>We analysed WES data from 120 SARD patients using the same platform, Emedgene. For the AI-assisted analysis, a fully automated phenotype-based variant analysis produced a list of prioritised potentially disease-causing variants for each case, labelled as 'most likely'. For the expert-guided approach, expert-informed filtering criteria were applied. Both the 'most likely' AI-assisted and the expert-informed filtered variants then underwent further manual analysis.</p><p><strong>Results: </strong>Before manual analysis, a total of 2906 variants potentially likely to be causative were identified with the Emedgene AI tool (mean 20.8 variants per case), approximately three times fewer than the 8391 variants identified by the expert-guided method (mean 59.9 per case). A comparable number of variants (78 vs 56) in lupus-causing genes were identified at the end of the manual analysis with both methods, including two monogenic cases <i>PEPD</i> (c.819-1G>A protein change, homozygous) and <i>CYBB</i> (c.1314+1G>A protein change, hemizygous).</p><p><strong>Conclusions: </strong>AI-assisted WES analysis substantially reduced the number of variants requiring manual review without missing the two monogenic cases. These findings support the integration of AI-assisted pipelines into genomic workflows for SLE and other SARDs which has the potential to improve efficiency and scalability of WES.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111665","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":"Interleukin-22 reflects adverse cardiometabolic features in SLE.","authors":"Iván Ferraz-Amaro, Juan Carlos Quevedo-Abeledo, Beatriz Tejera Segura, Enrique García-Barrera, Luisa María Villar, Javier Gonzalo Ocejo-Vinyals, Raquel Largo, Miguel Ángel Gonzalez-Gay","doi":"10.1136/lupus-2026-002217","DOIUrl":"10.1136/lupus-2026-002217","url":null,"abstract":"<p><strong>Introduction: </strong>Interleukin-22 (IL-22), a member of the IL-10 cytokine family, primarily targets non-haematopoietic epithelial and stromal cells, contributing to maintenance of epithelial barrier integrity, antimicrobial immunity and tissue regeneration. In this study, we sought to evaluate the association between serum levels of IL-22, measured by an ultrasensitive assay, and disease characteristics in patients with SLE.</p><p><strong>Methods: </strong>In this cross-sectional study, we thoroughly assessed 313 patients with SLE, collecting data on autoantibody status as well as disease activity indices (SLE Disease Activity Index-2000 and Lupus Low Disease Activity State), damage accrual (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC-DI)) and remission status (Definitions of Remission in SLE). The cohort was also characterised in terms of haematological parameters, lipid profile, insulin resistance markers and measures of subclinical carotid atherosclerosis and arterial stiffness. Serum IL-22 concentrations were quantified using the Simoa (Single Molecule Array) platform. We then used multivariable linear regression to explore the associations between these clinical characteristics and circulating IL-22 levels.</p><p><strong>Results: </strong>After multivariable adjustment, serum IL-22 levels were independently linked to longer disease duration, cumulative damage (SLICC-DI >1) and inversely to methotrexate use. However, these associations did not remain significant after multiple comparison correction. Disease activity, autoantibody profile or complement and interferon levels did not show significant associations with IL-22 levels. Similarly, haematological parameters were not related to circulating IL-22. Regarding cardiovascular risk factors, IL-22 was inversely related to high-density lipoprotein-cholesterol and apolipoprotein A1 suggesting an adverse lipid profile. In addition, serum C-peptide levels were independently related to higher circulating IL-22 concentrations whereas the presence of metabolic syndrome was associated with increased IL-22 levels. Besides, carotid intima-media thickness was significantly correlated with superior IL-22 levels after adjustment for covariates although in this case this association did not withstand adjustment for multiple testing.</p><p><strong>Conclusion: </strong>In patients with SLE, IL-22 identifies a phenotype of increased cardiovascular risk despite showing little relationship with current disease activity.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081288","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":"Protein biomarkers of inflammation in women with SLE and their newborn children.","authors":"Christina Gerstner, Emma Kroon, Tilen Tršelič, Gudny Ella Thorlacius, Claudia Arasa, Sophia Björkander, Rui Da Silva Rodrigues, Eva Sverremark-Ekström, Marie Wahren-Herlenius, Malin Hedlund","doi":"10.1136/lupus-2026-002001","DOIUrl":"10.1136/lupus-2026-002001","url":null,"abstract":"<p><strong>Objectives: </strong>In utero exposure to maternal anti-Ro/Sjögren's syndrome antigen A (SSA) and anti-La/Sjögren's syndrome antigen B (SSB) autoantibodies activates the fetal type I interferon (IFN) system. Women with SLE often carry a broader range of autoantibodies beyond anti-Ro/SSA and anti-La/SSB, like for example, anti-double stranded DNA (anti-dsDNA), anti-centromere and anti-nucleosome antibodies. We aimed to assess IFN activation and the expression of other immune-related proteins in pregnant women with SLE-with or without anti-SSA/SSB or anti-dsDNA autoantibodies-and in their newborns. We also aimed to investigate the impact of maternal immunomodulatory treatment on these responses.</p><p><strong>Methods: </strong>Serum samples from 22 women with SLE and 22 healthy pregnant women, along with their newborns, were analysed using proximity extension assay technology to quantify 92 immune-related proteins.</p><p><strong>Findings: </strong>Women with SLE had differential expression of 39 out of 92 proteins compared with healthy controls. Several proinflammatory cytokines and proteins involved in SLE pathogenesis were significantly upregulated in both women and their newborns. A couple of IFN-regulated proteins were significantly increased in anti-SSA/SSB-positive and anti-dsDNA-positive mother-child pairs, respectively. Still, IFN scores were generally elevated in pregnant women with SLE regardless of their autoantibody status. However, neonatal IFN scores did not significantly differ based on maternal autoantibody status or treatment.</p><p><strong>Conclusion: </strong>Women with SLE and their newborn children had increased expression of a range of proinflammatory biomarkers irrespective of their anti-SSA/SSB or anti-dsDNA autoantibody status. Irrespective of the increased expression of several IFN-regulated proteins in anti-SSA/SSB-positive and anti-dsDNA-positive mother-child pairs, the presence of these autoantibodies alone did not significantly influence the level of IFN activation in neither the mothers nor the newborns exposed to these autoantibodies in utero.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081279","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":"Diagnostic accuracy of the Arabic composite autonomic symptom score 31 (COMPASS-31) for detecting autonomic neuropathy in SLE: a cross-sectional validation study.","authors":"Omima Ahmed El-Farra, Yasmeen Abdelhakim Abdelnaby, Hassan M H Mohammed, Rasha N Saleh, Shereen R Kamel","doi":"10.1136/lupus-2026-002287","DOIUrl":"10.1136/lupus-2026-002287","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic accuracy of the Arabic Composite Autonomic Symptom Score-31 (COMPASS-31) for detecting objectively confirmed autonomic neuropathy in patients with SLE.</p><p><strong>Methods: </strong>In this cross-sectional diagnostic accuracy study, 45 patients with SLE, 23 patients with neurologically confirmed autonomic neuropathy (positive-control group), and 45 healthy controls completed the Arabic COMPASS-31 before undergoing cardiovascular autonomic reflex testing (CART) and sympathetic skin response (SSR). Objective autonomic neuropathy was defined as abnormal CART and/or absent SSR. Diagnostic accuracy analyses (receiver operating characteristic (ROC) curve analysis, optimal cut-off determination and multivariable logistic regression) were performed within the SLE cohort.</p><p><strong>Results: </strong>Objective autonomic neuropathy was present in 28 of 45 patients with SLE (62%). Total COMPASS-31 score discriminated autonomic neuropathy status with an area under the ROC curve (AUC) of 0.81 (95% CI 0.68 to 0.94) at a cut-off of ≥5 (sensitivity 89% and specificity 59%), increasing to 0.89 (95% CI 0.79 to 0.98) when restricted to definite/severe autonomic neuropathy. The orthostatic intolerance (AUC 0.78, 95% CI 0.64 to 0.91) and pupillomotor (AUC 0.77, 95% CI 0.64 to 0.90) domains performed similarly to the total score (DeLong's test, both p>0.4), while the vasomotor, secretomotor, gastrointestinal and bladder domains performed significantly worse. The COMPASS-31 total score remained independently associated with autonomic neuropathy after adjustment for age, disease duration and disease activity (adjusted OR 1.29, 95% CI 1.06 to 1.57). Internal consistency of the Arabic COMPASS-31 was good (Cronbach's α=0.83, McDonald's ω=0.857).</p><p><strong>Conclusion: </strong>The Arabic COMPASS-31 demonstrates good discrimination for objectively confirmed autonomic neuropathy in SLE, with the orthostatic intolerance and pupillomotor domains contributing most of its discriminative value. It can be used as a screening tool to identify patients who warrant confirmatory autonomic testing. Disease-specific validation should precede recommending COMPASS-31 as an autonomic neuropathy screening tool in other rheumatic diseases.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081273","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":"National trends in hospitalisation, in-hospital mortality and resource use for SLE in Spain from 2016 to 2022.","authors":"Luis Arribas-Pérez, Francisco Josué Cordero-Pérez, David Puertas-Miranda, Erik Gabriel Díaz-Avila, Leticia Salcedo-Martín, Hugo Guillermo Ternavasio-de la Vega, Jorge L Torres-Triana, Miguel Marcos, Antonio-J Chamorro","doi":"10.1136/lupus-2026-002171","DOIUrl":"10.1136/lupus-2026-002171","url":null,"abstract":"<p><strong>Objective: </strong>SLE is a complex autoimmune disease that causes significant health issues. In this study, SLE-related healthcare episodes, in-hospital mortality and resource use in Spain from 2016 to 2022 were assessed.</p><p><strong>Methods: </strong>In this retrospective, nationwide, repeated cross-sectional study, International Classification of Diseases, 10th Revision, data from Spain's National Hospital Discharge Registry were used to identify healthcare episodes with SLE (or its subtypes) coded as the principal diagnosis. Temporal trends were analysed and group comparisons were made using χ², Fisher's exact test, Student's t test and Mantel-Haenszel trend test.</p><p><strong>Results: </strong>A total of 24 151 SLE episodes were identified, with the majority occurring in women (86.9%) and individuals aged 15-65 years (88.2%). SLE episodes increased from 3002 (6.5/100 000 population) in 2016 to 4226 (8.8/100 000 population) in 2022 (p<0.001). Lupus nephritis episodes rose from 525 (1.13/100 000 population) to 956 (2.0/100 000 population; p<0.001). Relative to all other hospitalisation episodes, SLE episodes had longer hospital stays (8.7 vs 7.1 days; p<0.001) and intensive care unit (ICU) stays (8.4 vs 4.9 days; p=0.031). In-hospital mortality was low and stable. In unadjusted comparisons, mortality was lower among SLE episodes than among other hospitalisation episodes (0.3% vs 1.2%; p<0.001). A larger proportion of in-hospital deaths during SLE episodes than during all other hospitalisation episodes occurred in individuals aged 15-65 years (42.5% vs 15.1%; p<0.001). Although more deaths occurred in women, mortality was higher among men in unadjusted comparisons (0.7% vs 0.3%; p<0.001).</p><p><strong>Conclusions: </strong>SLE-related healthcare episodes increased in Spain from 2016 to 2022, but in-hospital mortality remained stable. SLE episodes involved longer hospital and ICU stays than other episodes. These results reflect healthcare utilisation patterns, not disease severity or patient outcomes.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039729","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":"Childhood trauma and systemic lupus erythematosus activity in Tunisian patients: exploring the mediating role of post-traumatic stress disorder.","authors":"Oumaima Chouchene, Imen Mlouki, Sondes Arfa, Marwa Ben Brahim, Rihene Melki, Amel Barhoumi, Olfa Berriche, Sana El Mhamdi","doi":"10.1136/lupus-2026-002048","DOIUrl":"10.1136/lupus-2026-002048","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease influenced by multiple factors. Growing evidence suggests that adverse childhood experiences (ACEs) and post-traumatic stress disorder (PTSD) may contribute to immune dysregulation and increased disease activity. However, these associations remain poorly explored in North Africa and the Middle East.</p><p><strong>Objective: </strong>This study aimed to investigate the mediating role of PTSD in the path from ACEs to SLE activity.</p><p><strong>Methods: </strong>This cross-sectional study involved adult patients with SLE treated at the Internal Medicine Department of Mahdia University Hospital between September 2024 and February 2025. We used the validated Arabic version of the WHO Adverse Childhood Experiences International Questionnaire, the Arabic PTSD Checklist for DSM-5. Disease activity was assessed using medical record-derived Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and British Isles Lupus Assessment Group scores. Statistical analyses included χ2 tests and Student's t-tests for group comparisons, Pearson correlation analyses and mediation analysis using the Sobel test.</p><p><strong>Results: </strong>This study included 106 Tunisian adults with SLE, predominantly women (88.7%), with a mean age of 48.6 ± 12.8 years. All participants reported at least one ACE, with intra-familial adversities being highly prevalent (96.2%). Extra-familial ACEs were reported by 67% of patients, most commonly community violence (43.4%). Probable PTSD was present in 57.5% of participants. Exposure to community violence (43.4%) was significantly associated with higher disease activity (SLEDAI and BILAG), p<0.001). Patients meeting criteria for probable PTSD also exhibited higher disease activity (SLEDAI: p < 0.001; BILAG: p = 0.044). Mediation analysis showed that PTSD partially mediated the association between childhood community violence and SLE activity, accounting for 27.7% of the total effect on SLEDAI and 41.5% on BILAG.</p><p><strong>Conclusion: </strong>PTSD appears to play a key mediating role, highlighting the need for trauma-informed and interdisciplinary approaches in SLE management.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039683","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":"Inhibition of STING modulates dendritic cell responses and ameliorates podocyte injury in SLE.","authors":"Wei Kong, Kangxing Zhou, Xin Zhang, Yue Sun, Genhong Yao, Fan Wang, Wenchao Li, Lingyun Sun","doi":"10.1136/lupus-2026-001987","DOIUrl":"10.1136/lupus-2026-001987","url":null,"abstract":"<p><strong>Background: </strong>SLE features aberrant type I interferon production, with the stimulator of interferon genes (STING) pathway acting as a key upstream driver. However, its expression patterns in patients with SLE and contributions to clinical phenotypes and tissue injury remain insufficiently defined.</p><p><strong>Methods: </strong>The proportion of STING-positive cells in peripheral blood mononuclear cells (PBMCs) from 28 patients with SLE and 15 healthy controls was analysed alongside clinical and serological features. Glomerular STING expression and podocyte injury were assessed in kidney biopsies from 39 patients with lupus nephritis (LN) and circulating and renal STING expression was compared in a paired cohort. The therapeutic effects of STING inhibitor C176 were evaluated in MRL/lpr mice by examining kidney pathology, proteinuria, function, immune cell subsets and podocyte injury. STING-mediated regulation of dendritic cell (DC) activation and plasmacytoid DC (pDC) differentiation was further investigated in vivo and in vitro.</p><p><strong>Results: </strong>STING expression was significantly elevated in PBMCs from patients with SLE and kidney tissues from patients with LN, particularly in proliferative LN and correlated with glomerular proliferation and decreased synaptopodin expression, suggesting an association with podocyte injury. STING activation promoted DC activation and pDC differentiation. Furthermore, conditioned media from STING-activated DCs induced podocyte apoptosis and reduced synaptopodin expression, effects attenuated by STING inhibition, indicating that STING activation in DCs promotes podocyte injury and disrupts podocyte homeostasis in a paracrine manner. C176 treatment in MRL/lpr mice significantly alleviated splenomegaly, proteinuria, kidney inflammation and renal dysfunction, while restoring podocyte integrity and reshaping immune responses.</p><p><strong>Conclusion: </strong>Our findings suggest a potential role for STING in the interplay between immune dysregulation and podocyte injury in lupus. Pharmacological STING inhibition modulates DC responses and partially protects podocytes and renal structure, supporting STING as a promising therapeutic target for SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030771","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":"Nursing interventions for people with systemic lupus erythematosus: a systematic review.","authors":"Naomi Kabwiku, Bruno Pilote","doi":"10.1136/lupus-2026-002046","DOIUrl":"10.1136/lupus-2026-002046","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease characterised by diverse clinical manifestations that require multidisciplinary care. Across diverse care settings, nurses play a central role in supporting patients through education, psychosocial support and self-management strategies. However, evidence on nurse-led interventions and their effects on health outcomes in people with SLE remains fragmented.</p><p><strong>Objectives: </strong>This systematic review aimed to synthesise existing evidence on nurse-led interventions for adults with SLE and their effects on health outcomes.</p><p><strong>Methods: </strong>We systematically searched CINAHL, PubMed, Embase, Web of Science, Trip Database and the Cochrane Library in July 2026, with additional searches of Google Scholar. Eligible studies included adults with SLE, evaluated nurse-led interventions and reported at least one health outcome. Quantitative intervention studies published in English or French between 2016 and 2026 were included. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. Data were extracted on study characteristics, interventions and health outcomes. Due to heterogeneity in study design, interventions and outcomes, a narrative synthesis was conducted.</p><p><strong>Results: </strong>Twenty-four studies were included. Nurse-led interventions primarily focused on therapeutic education and self-management, psychological and psychoeducational support, and lifestyle and self-care interventions. Improvements were most consistently reported in SLE-related knowledge and self-management and quality of life, with additional benefits reported for fatigue, pain and psychological outcomes.</p><p><strong>Conclusion: </strong>Nurse-led interventions may improve several health outcomes in adults with SLE, particularly SLE-related knowledge, self-management and quality of life. However, heterogeneity across interventions and outcomes, together with methodological limitations and risk of bias, limits the certainty of the evidence. Further research is needed to strengthen the evidence on the effectiveness of nurse-led interventions in adults with SLE through rigorous study designs and longer follow-up.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030753","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":"Evaluating the reliability and quality of lupus nephritis educational content on TikTok and Bilibili: a cross-sectional content analysis.","authors":"Junjie Chen, Tianshu Wang, Ming Li, Shuangshuang Shang, Lili Cheng, Zhongfu Tang, Chuanbing Huang","doi":"10.1136/lupus-2025-001912","DOIUrl":"10.1136/lupus-2025-001912","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the content distribution and quality of lupus nephritis (LN)-related short videos on TikTok and Bilibili, compare differences across uploader types and examine the relationship between user engagement metrics and information reliability, thereby providing evidence to improve digital health communication strategies.</p><p><strong>Methods: </strong>This cross-sectional study screened 250 LN-related videos from TikTok (n=143) and Bilibili (n=107). Basic video characteristics and uploader types were recorded. The Global Quality Score (GQS), modified DISCERN (mDISCERN; DISCERN, a validated instrument for evaluating the reliability of health information) and a content completeness instrument were used to assess video quality. All videos were independently evaluated by three senior rheumatology clinicians. Spearman correlation analysis was applied to evaluate associations between engagement indicators and quality scores.</p><p><strong>Results: </strong>User engagement indicators (likes, comments, shares and favourites) and the proportion of professional uploaders were significantly higher on TikTok than on Bilibili (p<0.05). Although Bilibili videos were significantly longer, TikTok videos provided more comprehensive coverage of clinical manifestations and treatment (p<0.05). No significant difference in overall GQS was found between platforms (p>0.05), whereas TikTok achieved a slightly higher mDISCERN score (p<0.05). Professional institutions significantly outperformed non-professional uploaders across all quality indicators (p<0.05). Despite strong positive correlations among engagement indicators, major popularity metrics showed limited alignment with scientific quality scores.</p><p><strong>Conclusion: </strong>The quality of LN-related information on short-video platforms varies widely, with popularity metrics poorly reflecting scientifically assessed content quality. While TikTok shows a slight advantage in information reliability, both platforms require improvement in evidentiary support and content completeness. Professional institutions consistently produced higher-quality content, underscoring the need for broader participation by authoritative medical sources. A multistakeholder governance framework emphasising professional input, content quality standards and algorithm optimisation is essential to foster a trustworthy digital health ecosystem.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024098","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":"Long-term outcomes and treatments for proliferative lupus nephritis with low-level proteinuria: a multicentre retrospective study in Japan.","authors":"Takeshi Zoshima, Misaki Yoshida, Shiori Nakagawa, Ichiro Mizushima, Yasunori Iwata","doi":"10.1136/lupus-2026-002098","DOIUrl":"10.1136/lupus-2026-002098","url":null,"abstract":"<p><strong>Objective: </strong>The long-term prognosis of patients with proliferative lupus nephritis (class III/IV) and low-level proteinuria remains unclear. Moreover, as some clinical trials have excluded them, the efficacy of some immunosuppressants for this subset of patients has not been strictly confirmed. In this study, we aimed to investigate the renal and overall survival and treatments.</p><p><strong>Methods: </strong>We conducted a retrospective study including 137 Japanese patients with biopsy-confirmed proliferative lupus nephritis from 11 hospitals. Based on previous reports, proteinuria of ≤1 g/gCr was defined as low-level proteinuria. The endpoints were kidney failure (KF) or death.</p><p><strong>Results: </strong>Compared with the high-level proteinuria group (proteinuria >1 g/gCr), the low-level proteinuria group (62 cases (45.3%)) had better baseline renal functions and histology and included more patients initially treated with glucocorticoids (GCs) alone (26 (41.9%) vs 18 (24.0%), p=0.04). Maintenance therapy was similar between groups. After a median of 93 months, the low-level proteinuria group had a lower incidence of KF or death than the high-level proteinuria group (3 (4.8%) vs 22 (29.3%), p<0.001). Kaplan-Meier analysis revealed a significant difference in the incidence of these outcomes between groups. Similarly, patients with low-level proteinuria initially treated with GCs alone exhibited a better long-term prognosis than those with high-level proteinuria. Multivariate Cox regression analyses revealed that KF or death was associated with high levels of proteinuria but not with GCs alone for the initial treatment.</p><p><strong>Conclusions: </strong>Patients with low-level proteinuria have a favourable long-term prognosis and are treated with less initial immunosuppressant use, suggesting a distinct clinical subgroup of proliferative lupus nephritis. Renal biopsy in the early phase with low-level proteinuria may lead to early diagnosis and treatment. A treatment strategy tailored to patients with low-level proteinuria may be required.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017294","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}