Lupus Science & Medicine最新文献

{"title":"Real-world treatment patterns and clinical characteristics in patients with moderate-to-severe systemic lupus erythematosus: an analysis of the SLE Prospective Observational Cohort Study (SPOCS).","authors":"Martin Aringer, Laurent Arnaud, Richard A Furie, Eric F Morand, Christine Peschken, Alberta Hoi, Barnabas Desta, Jonatan Hedberg, Tina Grünfeld Eén, Alessandro Sorrentino, Danuta Kielar, Raj Tummala, Stephanie Chen, Bo Ding","doi":"10.1136/lupus-2024-001336","DOIUrl":"10.1136/lupus-2024-001336","url":null,"abstract":"<p><strong>Objectives: </strong>Systemic lupus erythematosus (SLE) is a disease with heterogeneous treatment patterns largely based on organ involvement and disease severity. The SLE Prospective Observational Cohort Study (SPOCS) collected data worldwide over 3 years from patients with moderate-to-severe SLE. We report real-world patterns of medication use in patients enrolled in SPOCS.</p><p><strong>Methods: </strong>Data were collected at study entry; patients were followed twice annually according to local practice. Disease activity (SLE Disease Activity Index 2000 (SLEDAI-2K)), average oral glucocorticoid dose and use of other treatments-specifically antimalarials, biologics and immunosuppressants-were measured over time. Subgroup analyses were stratified by baseline interferon gene signature (IFNGS) status and disease activity (SLEDAI-2K) status.</p><p><strong>Results: </strong>Patient demographics and baseline characteristics were similar among subgroups; the majority of patients were on antimalarials (n=670; 81.1%), followed by glucocorticoids (n=537; 65.0%), immunosuppressants (n=453; 54.8%) and biologics (n=175; 21.2%). In the overall population, median (IQR) SLEDAI-2K scores decreased within 12 months (baseline: 8.0 (6.0-12.0); 12 months: 4.0 (2.0-8.0)) and remained stable thereafter. The mean (SD) daily oral glucocorticoid dose increased by 6 months (baseline: 6.0 (7.09); 6 months: 9.8 (8.67)) and remained stable thereafter. The proportion of patients who were on glucocorticoid doses >5 mg/day ranged from ~20% to 33% throughout the study. In subgroup analyses, patients with high IFNGS and high disease activity state (HDAS) at baseline used more immunosuppressants and glucocorticoids compared with those with low IFNGS and non-HDAS at baseline.</p><p><strong>Conclusions: </strong>These findings underscore that SLE therapy is still often unable to reach goals as recommended by the European Alliance of Associations for Rheumatology, both with regard to glucocorticoid use and disease activity, suggesting that there is an unmet need for new treatment options for patients with SLE.</p><p><strong>Trial registration number: </strong>NCT03189875; 16 June 2017.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039634","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":"Factors influencing therapeutic efficacy of denosumab against osteoporosis in systemic lupus erythematosus.","authors":"Jiwon Yang, Youngjae Park, Jennifer Jooha Lee, Seung-Ki Kwok, Ji Hyeon Ju, Wan-Uk Kim, Sung-Hwan Park","doi":"10.1136/lupus-2024-001438","DOIUrl":"10.1136/lupus-2024-001438","url":null,"abstract":"<p><strong>Objective: </strong>Osteoporosis is a common comorbidity in patients with SLE, and bone loss in patients with SLE has a multifactorial aetiology. This study aimed to evaluate the therapeutic efficacy of denosumab in patients with SLE with osteoporosis and to analyse the factors influencing therapeutic efficacy.</p><p><strong>Methods: </strong>A total of 166 patients with SLE with osteoporosis who initiated denosumab between January 2016 and December 2023 were included. Changes in the T-score and areal bone mineral density (BMD) at the lumbar spine, total hip and femur neck from denosumab initiation to 12 months were measured. Correlation analysis was performed between the degree of BMD improvement and covariates including SLE-specific factors such as SLE duration, SLE Disease Activity Index 2000 (SLEDAI-2K) score, glucocorticoid dose and hydroxychloroquine use. Multiple linear regression analysis was conducted to identify predictors of the therapeutic efficacy of denosumab.</p><p><strong>Results: </strong>Denosumab significantly increased BMD and decreased bone turnover markers at 12 months compared with baseline. The degree of BMD improvement revealed a significant negative correlation with SLEDAI-2K score, hydroxychloroquine use, prior osteoporosis treatment and baseline BMD values. In contrast, body mass index and c-telopeptide of collagen type 1 levels were positively correlated with the degree of BMD improvement. Higher baseline BMD values, SLEDAI-2K scores and hydroxychloroquine use were significant predictors of attenuated BMD improvement.</p><p><strong>Conclusions: </strong>Our study suggests that denosumab is an effective treatment option for osteoporosis in patients with SLE. The therapeutic efficacy of denosumab can be predicted by baseline BMD values, SLEDAI-2K scores and hydroxychloroquine use.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023036","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":"Ultrasonographic assessment of optic nerve: does it help in lupus-induced optic neuropathy?","authors":"Amira Elsonbaty, Doaa M Mahmoud, Sara Alattar, Ahmed Hosny Shaaban, Abdallah El-Sayed Allam","doi":"10.1136/lupus-2024-001358","DOIUrl":"10.1136/lupus-2024-001358","url":null,"abstract":"<p><strong>Objective: </strong>Evaluating the potential role of neuromuscular ultrasonography (NMUS) in assessing optic nerve affection in patients with systemic lupus erythematosus (SLE), compared with healthy controls and other conventional strategies in diagnosing optic neuropathy.</p><p><strong>Methods: </strong>We conducted an observational cross-sectional study comparing patients with SLE and a healthy group. We measured the optic nerve diameter (OND) and optic nerve sheath diameter (ONSD) and calculated the OND/ONSD ratio and side-to-side difference. An ophthalmologist examined all lupus patients and visual evoked potential (VEP) was performed to help evaluate the rule of NMUS in lupus-induced optic neuropathy.</p><p><strong>Results: </strong>In this study, we include 140 subjects, 65 lupus patients and 75 controls. Significant enlargement was present among lupus patients OND and ONSD (p= 0.017, 0.004, respectively) in comparison to controls; ultrasonographic evaluation had a high specificity when compared to ophthalmological evaluation and VEP reaching 89.6% and 88.1%, respectively, but with very low sensitivity.</p><p><strong>Conclusion: </strong>Ultrasonographic evaluation of the optic nerve may add significant value to the diagnosis of optic neuropathy in patients with SLE and should be considered a complementary tool to other conventional methods.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008170","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":"CD19-directed chimeric antigen receptor T-cell therapy: what can we learn from the haematologist?","authors":"Maria Theresa Kuipers, Marie José Kersten","doi":"10.1136/lupus-2024-001157","DOIUrl":"10.1136/lupus-2024-001157","url":null,"abstract":"<p><p>CD19-directed chimeric antigen receptor (CAR) T-cell therapy, originally developed for haematological malignancies, has recently emerged as a promising therapy for patients with autoimmune diseases. By selectively depleting CD19-positive B-cells, this therapy brings a new approach in resetting immune dysregulation and potentially providing long-term remission for patients with a refractory disease. Recent reports have highlighted its effectiveness in conditions such as SLE, systemic sclerosis and myositis. However, while these early results are encouraging, questions remain regarding strategies for optimal patient selection and minimising toxicity on the short and long term. The experiences with CD19 CAR T-cell therapy in haematology may offer valuable insights for immunologists and rheumatologists. This article reviews the key principles learnt in haematology, the results and the mechanisms behind its efficacy, toxicities, and the challenges that need to be addressed for its broader application in clinical practice.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008075","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":"Longitudinal associations of flare and damage accrual in patients with systemic lupus erythematosus.","authors":"Rangi Kandane-Rathnayake, Dominique Milea, Worawit Louthrenoo, Alberta Hoi, Vera Golder, Jiacai Cho, Aisha Lateef, Shue-Fen Luo, Yeong-Jian Jan Wu, Laniyati Hamijoyo, Sargunan Sockalingam, Zhanguo Li, Sandra Navarra, Leonid Zamora, Masayoshi Harigai, Yasuhiro Katsumata, Madelynn Chan, Yanjie Hao, Zhuoli Zhang, Sean O'Neill, Fiona Goldblatt, Shereen Oon, Xiaomeng Xu, Aldo A Navarro Rojas, Sang-Cheol Bae, Chak Sing Lau, Mandana Nikpour, Eric Morand","doi":"10.1136/lupus-2024-001363","DOIUrl":"10.1136/lupus-2024-001363","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the prevalence of organ damage (damage) and flare and to examine longitudinal associations between flares and subsequent damage accrual, in patients with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>Patients enrolled in the Asia Pacific Lupus Collaboration cohort with ≥3 years of prospectively captured data were studied. Flares were assessed at routine visits, while damage ((Systemic Lupus International Collaborating Clinics/American College of Rheumatology) Damage Index) was assessed annually. Multivariable, multifailure survival analyses were carried out to quantify the association between flares and damage accrual.</p><p><strong>Results: </strong>1556 patients with SLE with a median (IQR) of 5.7 (3.9, 7.0) years of follow-up were studied. 39.5% (n=614) of patients had damage at enrolment, and 31.9% (n=496) accrued damage during the study observation period. The incidence of damage accrual during observation was ~58/1000 person-years. Overall, 74.1% (n=1153) of patients experienced a flare of any severity (mild/moderate or severe) at least once; 56.9% (n=885) experienced recurrent (≥2) flares. The risk of subsequent damage accrual in patients who experienced mild-to-moderate flare, after controlling for confounders, was 32% greater than in patients without flares (adjusted HR) (95% CI 1.32 (1.17 to 1.72)). The risk of damage accrual was greater if patients had severe flares (HR (95% CI) 1.58 (1.18 to 2.11)). For each additional flare, the risk of damage accrual increased by 7% (HR (95% CI) 1.07 (1.02 to 1.13)).</p><p><strong>Conclusions: </strong>Flares independently increased the risk of damage accrual. Prevention of flares should be considered a necessary goal of SLE disease management to minimise permanent damage.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008114","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":"Outcomes following immunosuppressive therapy withdrawal after complete renal response in proliferative lupus nephritis.","authors":"Paola Vidal-Montal, Javier Narváez, Xavier Fulladosa, Francesca Mitjavila, Olga Capdevila, Joan Torras, Montserrat Gomà, Joan M Nolla","doi":"10.1136/lupus-2024-001375","DOIUrl":"10.1136/lupus-2024-001375","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the rate and factors influencing renal relapse (RR) in proliferative lupus nephritis (LN) patients who discontinued immunosuppressive therapy (IST), as well as the long-term renal outcomes following RR.</p><p><strong>Methods: </strong>Retrospective, single-centre study of biopsy-confirmed LN patients who had received IST for at least 36 months and maintained complete renal response (CRR) for a minimum of 12 months before therapy discontinuation.</p><p><strong>Results: </strong>Of a total of 106 patients meeting the inclusion criteria, 76 with proliferative classes were selected for analysis. The median duration of IST prior to discontinuation was 83.5 months (IQR 25th-75th: 53.5-120). Relapse occurred in 29 patients (38.2%) at a median of 26.5 months (IQR 25th-75th: 9.25-63.5 months) following IST withdrawal. Relapses were classified as severe in 9 cases (31%) and moderate in 16 cases (55.2%). Renal rebiopsy was performed in 25 of these patients (86.2%), with 80% retaining the same histological class.Discontinuation of IST at ≤34 years of age significantly increased the risk of RR (adjusted HR: 3.5). In contrast, an IST duration exceeding 48 months prior to discontinuation (HR: 0.26), maintaining CRR for at least 48 months (HR: 0.32), achieving complete remission per DORIS (definition of remission in systemic lupus erythematosus) criteria at IST withdrawal (HR: 0.21) and gradual IST tapering (HR: 0.09) were associated with a reduced risk of RR.Following reintroduction of IST, 20 out of 29 patients (68.9%) achieved CRR, 5 (17.2%) achieved a partial response and 4 (13.8%) did not respond; of these, 3 patients (10.3%) progressed to end-stage renal disease.</p><p><strong>Conclusions: </strong>Successful withdrawal of IST is possible in carefully selected patients with proliferative LN. If an RR occurs, most patients are able to remain in remission after resuming IST.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008166","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":"Elevated serum neurofilament light chain levels in patients with neuropsychiatric systemic lupus erythematosus: a cross-sectional study.","authors":"Veronika Balajková, Aneta Prokopcová, Martin Elisak, Hana Mojžišová, Karel Pavelka, Marta Olejárová","doi":"10.1136/lupus-2024-001309","DOIUrl":"10.1136/lupus-2024-001309","url":null,"abstract":"<p><strong>Background: </strong>The neurofilament light chain (NfL) in cerebrospinal fluid (CSF) and serum as a marker of neuronal damage may be a potential biomarker of neuropsychiatric involvement in SLE (NPSLE).</p><p><strong>Methods: </strong>80 patients with SLE were included.We obtained paired serum and CSF samples from 48 patients (NPSLE n=32, non-NPSLE n=16) and 31 controls. The serum and CSF levels of NfL were determined using ELISA.</p><p><strong>Results: </strong>Patients with NPSLE demonstrated significantly higher levels of serum NfL compared with the non-NPSLE group (mean 31.68±36.63 pg/mL vs mean 16.75±12.48 pg/mL, respectively, p<0.05) and with controls (mean 10.74±4.36 pg/mL, p<0.01). Notably, CSF NfL concentrations in patients with NPSLE showed an upward trend (mean 1600±2852 pg/mL) in contrast to non-NPSLE patients (mean 393.4±191.9 pg/mL) and controls (mean 509.7±358.5 pg/mL). Furthermore, a positive correlation was observed between serum and CSF NfL levels in patients with NPSLE (R=0.8686, p<0.01). Elevated serum triacylglycerol concentrations, C reactive protein and organ damage were linked to increased serum (p=0.002; p<0.001; p=0.036) and CSF (p=0.008; p=0.007; p<0.001) NfL concentrations. In addition, we established a significant correlation between intrathecal NfL concentrations and interleukin-6 levels in the CSF of patients with NPSLE (R=0.5118, p<0.05).</p><p><strong>Conclusion: </strong>The serum NfL levels may be a readily available marker of neuropsychiatric involvement in SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008081","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 quality of life on overall work productivity impairment and activity impairment of patients with systemic lupus erythematosus: the PEONY study.","authors":"Yoshiya Tanaka, Yusuke Miyazaki, Shintaro Hirata, Katsuhide Kusaka, Shunpei Kosaka, Keisuke Nakatsuka, Kazuyoshi Saito, Shigeru Iwata, Yoshiyuki Yamaguchi, Toshiki Yabe-Wada, Masakazu Fujiwara, Yoshifumi Arita, Mitsuru Hoshino, Naoko Ozaki, Kunihiro Yamaoka, Shingo Nakayamada","doi":"10.1136/lupus-2024-001291","DOIUrl":"10.1136/lupus-2024-001291","url":null,"abstract":"<p><strong>Objectives: </strong>Even in a lupus low disease activity state (LLDAS), many patients with SLE continue to face residual symptoms and disease burden. We aimed to evaluate the quality of life, activity impairment and overall work productivity impairment among patients in LLDAS. Residual disease burden was also evaluated for patients in LLDAS.</p><p><strong>Methods: </strong>This prospective, cross-sectional study enrolled Japanese outpatients with SLE. Patients completed patient-reported outcome (PRO) questionnaires, including LupusPRO, Work Productivity and Activity Impairment-Lupus, EQ-5D-5L and Health Assessment Questionnaire-Disability Index. Disease activity and organ damage were investigator-assessed. The primary objective was to assess the residual burden in patients in LLDAS and to investigate the association of LupusPRO domains with activity impairment using multivariate regression analysis. Other objectives were to investigate the relationship between overall work productivity impairment or activity impairment and other PRO or disease activity measures.</p><p><strong>Results: </strong>The analysis set included 205 patients; 93.2% were female, mean (SD) age at index date was 52.5 (14.7) years, mean (SD) duration of morbidity was 167.2 (125.2) months and 164 were in LLDAS. The mean per cent overall work productivity impairment was 22.8% and mean per cent activity impairment was 30.0% for the LLDAS group. Among patients in LLDAS, overall work productivity impairment was significantly associated with the LupusPRO domains Desires-Goals, Body Image and Pain Vitality, and activity impairment was significantly associated with the LupusPRO domains Pain Vitality, Physical Health and Lupus Symptoms.</p><p><strong>Conclusions: </strong>Patients with SLE in LLDAS still experience symptoms associated with activity impairment. Work productivity also showed impairments. Improving their quality of life and achieving social remission will require ongoing monitoring of PROs and tailoring treatments to optimise these outcomes.</p><p><strong>Trial registration number: </strong>jRCT1030210647.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008071","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":"Unravelling the TCRβ repertoire: a key to unlocking the immunopathogenesis and precision medicine in SLE.","authors":"Li Zeng, Lijing Yang, Yichen Zhang, Tianzuo Lan, Yang An, Pengming He, Xueping Wen, Shaoping Deng, Zhixin Zhang, Jian Liu, Qiao Zhou","doi":"10.1136/lupus-2024-001384","DOIUrl":"10.1136/lupus-2024-001384","url":null,"abstract":"<p><strong>Objectives: </strong>SLE is a multifaceted autoimmune disorder with a complex pathogenesis involving genetic, environmental and hormonal factors, which converge on immune dysregulation. The T cell receptor (TCR) repertoire's role in SLE has garnered significant interest due to its potential in both diagnostics and therapeutics. Our study aimed to delineate the variances in the TCRβ repertoire between patients with SLE and healthy individuals, correlating these differences with the severity and subtypes of SLE.</p><p><strong>Methods: </strong>We conducted an analysis of blood samples from 50 treatment-naive patients with SLE and 50 healthy donors, employing RNA extraction, high-throughput sequencing and subsequent bioinformatics analysis.</p><p><strong>Results: </strong>Our findings revealed significant alterations in TRBV and TRBJ gene usage frequencies, indicative of a skewed TCR repertoire in patients with SLE. Notably, nine hub TRBV genes were identified as potential biomarkers for SLE with high diagnostic accuracy. Furthermore, we observed a reduction in TCR diversity, characterised by a lower diversity 50 value and increased clonal expansion, which correlated with disease severity.</p><p><strong>Conclusions: </strong>The TCRβ repertoire is significantly altered in SLE, with potential implications for diagnostics and therapeutics. The identified hub genes may serve as novel biomarkers for SLE, and the findings contribute to the understanding of the immunopathogenesis of the disease.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008183","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":"EXamining the feasibility of exerCisE to manage symptoms of Lupus (EXCEL): a protocol for a randomised controlled pilot study.","authors":"Megan Quickfall, Scott Green, Katie Hesketh, Jet Veldhuijzen Van Zanten, Matthew Cocks, John Reynolds, Alex J Wadley","doi":"10.1136/lupus-2024-001382","DOIUrl":"10.1136/lupus-2024-001382","url":null,"abstract":"<p><strong>Introduction: </strong>SLE is a chronic autoimmune disease that results in sustained hyperactivation of innate and adaptive immune cells and widespread inflammatory damage. Regular exercise reduces SLE symptoms including fatigue and joint pain and improves patient quality of life. However, most individuals with SLE are not sufficiently active to achieve these benefits, and guidance on the optimal approach to exercise is limited. EXCEL will examine the feasibility of conducting a large-scale randomised controlled trial comparing the effects of a remotely monitored, home-based, exercise programme with standard of care for individuals with SLE.</p><p><strong>Methods and analysis: </strong>30 females with SLE will be recruited, and those randomised into Exercise (SLE-Ex) will codesign a progressive training plan with support from the research team. The aim of each 12-week plan will be to complete 150 min of moderate (60-70% heart rate max, HR_max) or 90 min of vigorous exercise (>70% HR_max) per week. SLE-Ex will be encouraged to exercise independently (without support) from weeks 13-18. Participants with SLE that are randomised into Control (SLE-Con) will maintain habitual activity without support for 18 weeks. Measures of feasibility and acceptability will be reported, and peripheral blood will be collected at weeks 0, 12 and 18 to explore whether the frequency, phenotype and metabolic profile of lymphocyte subsets has changed. Biomarkers of SLE activity, and self-reported measures of fatigue, sleep quality and health-related quality of life will also be monitored at these timepoints. Blood and self-reported measures will be compared with a healthy control (HC) group (n=15, age and body mass index matched) at baseline only.</p><p><strong>Ethics and dissemination: </strong>A favourable ethical opinion was given by South East Scotland Research Ethics Committee (22/SS/0082). Findings will be disseminated at conferences and published in peer-reviewed journals.</p><p><strong>Trial registration number: </strong>ISRCTN72757645.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008086","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}