Lupus Science & Medicine最新文献

{"title":"Comparison of cardiac MRI features of fibrosis and strain for early cardiac dysfunction assessment in patients with systemic lupus erythematosus and Sjögren's syndrome.","authors":"Zhi Yang, Ling-Li Wang, Xue Meng, Yong Zhu, Liang-Chao Gao, Ling Wu, Bing Fu, Shu-Yue Pan","doi":"10.1136/lupus-2026-002066","DOIUrl":"10.1136/lupus-2026-002066","url":null,"abstract":"<p><strong>Objectives: </strong>The additional impact of coexisting Sjögren's syndrome (SS) on cardiac involvement in patients with systemic lupus erythematosus (SLE) remains insufficiently understood. This study aimed to investigate the association of coexisting SS with cardiac function and left ventricular (LV) remodelling in patients with SLE using cardiac magnetic resonance (CMR) imaging.</p><p><strong>Methods: </strong>The study included 36 consecutive patients with SLE and coexisting SS, 36 patients with SLE without SS and 20 age- and sex-matched healthy controls who underwent CMR. LV global strain parameters, native T1 and T2 values, extracellular volume fraction(ECV) and late gadolinium enhancement (LGE) were compared among the three groups. Univariable and multivariable linear regression analyses were performed to investigate the associations of coexisting SS with LV global strain and myocardial mapping parameters.</p><p><strong>Results: </strong>Patients with SLE and coexisting SS had the lowest global longitudinal strain (GLS) between the three groups (-14.21% (-16.74, -12.81) vs -16.38% (-17.73, -14.25) vs -17.09% (-17.63, -12.97), p=0.030). However, there were similar global circumferential strain and global radial strain between those three groups (p>0.05). Native T1 values were highest in patients with SLE and coexisting SS (1302 ms (1266, 1338) vs 1265 ms (1216, 1289) in patients with SLE without SS and 1262 ms (1241, 1314) in healthy controls, p=0.016). Similarly, ECV was highest in the SLE-with-SS group (29.00% (27.00, 31.00) vs 27.50% (25.25, 29.00) and 27.00% (25.00, 29.00), respectively, p=0.019). Native T2 values did not differ significantly among the three groups (p>0.05). LGE was detected in 30.56% of patients with SLE and coexisting SS and 25.00% of patients with SLE without SS, with no significant between-group difference (p=0.792). Among all patients with SLE, coexisting SS was independently associated with impaired GLS (β = -0.211, p=0.041), higher native T1 (β=0.227, p=0.048) and higher ECV (β=0.268, p=0.009).</p><p><strong>Conclusion: </strong>Coexisting SS was independently associated with greater subclinical LV dysfunction and more pronounced myocardial tissue abnormalities in patients with SLE. These findings suggest that SS may contribute additional cardiac involvement in SLE, although prospective longitudinal studies are required to determine its clinical and prognostic significance.</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/PMC13599852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017151","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":"Measurement properties of the FATIGUE-PRO in patients with SLE in real-world settings.","authors":"Caroline Gordon, Matthias Schneider, Gamal Chehab, Stefan Cano, Antoine Regnault, Christian Stach, Christine de la Loge, Sophie Cleanthous, Thomas Morel","doi":"10.1136/lupus-2026-002071","DOIUrl":"10.1136/lupus-2026-002071","url":null,"abstract":"<p><strong>Objective: </strong>Fatigue is a common, multifaceted symptom in SLE which is difficult to treat. There has been a lack of broadly accepted SLE-specific assessment tools for fatigue. This study assessed the psychometric properties of the FATIGUE-PRO, a new patient-reported outcome measure, in patients with SLE in real-world clinical outpatient settings (Birmingham, UK, and Düsseldorf, Germany).</p><p><strong>Methods: </strong>Patients with SLE aged ≥18 years from cross-sectional, observational studies in Birmingham and Düsseldorf completed the three FATIGUE-PRO domains (physical fatigue, mental and cognitive fatigue and susceptibility to fatigue). Psychometric evaluation was completed using Rasch Measurement Theory and classical test theory methods. Association between the FATIGUE-PRO and other clinical outcome assessments was evaluated using Spearman's rank order correlations.</p><p><strong>Results: </strong>Overall, 200 patients were recruited from Birmingham and 234 from Düsseldorf. The FATIGUE-PRO demonstrated consistently adequate measurement properties. Items demonstrated high levels of targeting (82-95%) and the response scale functioned as intended for most items across all domains (82-100% ordered thresholds). Domains were cohesive overall, with minimal item misfit, and demonstrated little local dependency. Principal component analysis of residuals was supportive of unidimensionality of all three domains. All domain scores were reliable and demonstrated high internal consistency reliability (0.90-0.97). Moderate-to-high correlations, supportive of construct validity, were observed between the FATIGUE-PRO scores and other patient-reported outcomes, including Lupus Quality of Life. Low correlations were seen with outcome measures such as Brief Index of Lupus Damage and clinician-reported SLE Disease Activity Index-2000.</p><p><strong>Conclusions: </strong>The FATIGUE-PRO was demonstrated to be fit-for-purpose in real-world clinical outpatient settings, with strong measurement properties, supporting its use in the assessment of fatigue in SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990566","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":"Global author collaborations in lupus research and publications: a meta-research and network analysis.","authors":"Laurent Arnaud, Francois Chasset, Thierry Martin, Guillermo J Pons-Estel, Matteo Piga","doi":"10.1136/lupus-2026-002169","DOIUrl":"10.1136/lupus-2026-002169","url":null,"abstract":"<p><strong>Background: </strong>Global collaboration is a key driver of advances in complex diseases such as lupus, yet its distribution and structure remain insufficiently characterised. This study aimed to analyse global authorship, productivity and collaboration patterns in lupus publications over the last 10 years.</p><p><strong>Methods: </strong>A bibliometric analysis of lupus-related publications indexed in PubMed between April 2016 and 2026 was conducted. Author affiliations were disambiguated and mapped to countries. Productivity indicators (number of authors and publications), population-standardised metrics and collaboration measures, including coauthorship patterns and the International Collaborative Index (ICI), were calculated. Network visualisation was performed using VOSviewer.</p><p><strong>Results: </strong>A total of 22 813 publications involving 76 536 authors across 142 countries were identified, with a 74% increase in annual output over the study period. China and the USA had the highest numbers of authors and publications, while smaller countries such as Iceland and Greece ranked highest when adjusted per capita. Most publications (83.1%) were single-country studies. The USA was the central hub of international collaboration, with the highest number of links (n=115) and total link strength. The most frequent collaborations involved the USA, particularly with the UK and China. Countries such as Iceland and Uruguay showed high ICI values, whereas China and Japan had lower international collaboration levels. Network analysis revealed a core-periphery structure dominated by North America and Western Europe.</p><p><strong>Conclusions: </strong>Lupus research is expanding but remains concentrated within a limited number of countries. International collaboration is uneven, highlighting the need for more inclusive global research partnerships.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990646","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":"Risk of stroke in SLE: a systematic review and meta-analysis.","authors":"Jingya Zhang, Weiman Shi, Yaling Xu, Dianming Li, Wu Chen, Lin Huang, Xuanlin Li, Qiao Wang","doi":"10.1136/lupus-2026-002161","DOIUrl":"10.1136/lupus-2026-002161","url":null,"abstract":"<p><p>The association between SLE and composite stroke, ischaemic stroke and haemorrhagic stroke remains incompletely understood. This meta-analysis aims to assess the risk of stroke in patients with SLE.</p><p><strong>Methods: </strong>Data sources included PubMed, Embase, the Cochrane Library and reference lists of included studies. This meta-analysis included cohort studies evaluating whether stroke risk is associated with SLE. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Risk ratios (RRs) with 95% CIs were pooled using a random-effects model, and publication bias was assessed with funnel plots and Egger's test.</p><p><strong>Results: </strong>A total of 25 cohort studies involving 5 220 837 individuals were included in this meta-analysis, which were published between 2001 and 2026. The pooled analysis demonstrated a significantly increased risk of stroke in patients with SLE (RR of 2.60, 95% CI 2.21 to 3.05, <i>I</i>²=97.9%, p<0.001). The risk of composite stroke (RR of 2.83, 95% CI 2.25 to 3.57, <i>I</i>²=98.0%, p<0.001), ischaemic stroke (RR of 2.34, 95% CI 1.75 to 3.12, <i>I</i>²=97.6%, p<0.001) and haemorrhagic stroke (RR of 2.66, 95% CI 1.57 to 4.49, <i>I</i>²=96.2%, p<0.001) was also increased in SLE. Despite the large heterogeneity, the sensitivity analysis indicated that the results were robust, and there was little evidence of publication bias.</p><p><strong>Conclusion: </strong>The risk of composite stroke, ischaemic stroke and haemorrhagic stroke is increased in SLE.</p><p><strong>Prospero registration number: </strong>CRD420261294082.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977245","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":"Racial differences in cardiovascular events and adverse pregnancy outcomes among pregnant individuals with SLE.","authors":"Rashmi Dhital, Rebecca J Baer, Dilli R Poudel, Tracy M Frech, Christina Chambers","doi":"10.1136/lupus-2025-001846","DOIUrl":"10.1136/lupus-2025-001846","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to characterise differences in the occurrence of maternal cardiovascular events (CVEs) and adverse pregnancy outcomes (APOs) in each of four racial/ethnic groups compared with non-Hispanic white women with SLE and to evaluate whether the relationship between CVEs and APOs differed across or within racial/ethnic groups.</p><p><strong>Methods: </strong>Using a California population-based birth cohort (2005-2020), we identified pregnant individuals with SLE via International Classification of Diseases codes from maternal discharge records. Self-reported racial/ethnic groups were categorised as Asian, Hispanic, non-Hispanic black, non-Hispanic white and other. Individuals with reported race or ethnicity as 'unknown' or 'not stated' were excluded from the study. Log-linear regression estimated adjusted relative risks (aRRs) of CVEs and APOs in each racial/ethnic group compared with non-Hispanic white individuals, adjusting for a propensity score derived from maternal age, payer, education, comorbidities and SLE-related variables. We performed CVE-stratified analyses for racial/ethnic differences in APOs and examined associations between CVEs and APOs within each racial/ethnic group.</p><p><strong>Results: </strong>Among 8188 liveborn singletons from women with SLE, non-Hispanic black women had the highest prevalence of maternal CVEs (4.0% vs 1.6-2.0% in other groups), maternal APOs (24.6% vs 13.5-17.2%) and infant APOs (54.6% vs 34.6-49.4%). Relative to non-Hispanic white women, non-Hispanic black women had an aRR of 1.6 (95% CI 0.9 to 2.6) for maternal CVEs and 1.3 (95% CI 1.1 to 1.6) for maternal APOs, whereas infant APO risks were significantly higher across three of four racial/ethnic groups compared with non-Hispanic white women.</p><p><strong>Conclusions: </strong>Non-Hispanic black women exhibited the highest absolute burden for the adverse outcomes studied. Relative to non-Hispanic white individuals, elevated adjusted risks based on race/ethnicity were most consistent for infant APOs, whereas elevated risks for maternal APOs and CVEs were found primarily among non-Hispanic black individuals. Social drivers of health need consideration while caring for pregnant individuals with SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977262","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 association of the triglyceride-glucose index with cardiovascular involvement in systemic lupus erythematosus: a retrospective cohort study.","authors":"Zixian Deng, Jiayao Zheng, Yi Ye, Feng Chen, Huadong Liu, Xiaoyu Wang, Qiyun Liu, Chuangye Lyu, Cheng Liu, Lixiong Liu, Jie Yuan, Jianghua Li, Tangzhiming Li","doi":"10.1136/lupus-2026-002141","DOIUrl":"10.1136/lupus-2026-002141","url":null,"abstract":"<p><strong>Background: </strong>SLE is a chronic autoimmune disease associated with heightened cardiovascular risk. However, the relationship between the triglyceride-glucose (TyG) index and cardiovascular involvement remains unclear. This study aimed to evaluate the association between the TyG index and cardiovascular involvement in SLE.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 991 patients with SLE admitted between 2000 and 2021, spanning 21 years with extended follow-up. Kaplan-Meier curves were used to compare event-free survival across TyG quartiles, and differences between curves were assessed using the log-rank test. Time-to-event analyses were performed using Cox proportional hazards regression models. The proportional hazards assumption was assessed using scaled Schoenfeld residuals. Restricted cubic spline analyses based on Cox models were performed to evaluate the dose-response association between TyG and cardiovascular outcomes.</p><p><strong>Results: </strong>Cardiovascular involvement occurred in 251 patients (25.3%), consisting of 210 inflammatory or lupus-related manifestations and 41 major adverse cardiovascular events (MACE). Elevated TyG correlated with progressively lower event-free survival. An approximately linear association was observed between TyG and both overall cardiovascular involvement and inflammatory/lupus-related cardiovascular manifestations. Each one-unit increase in TyG remained associated with higher risk after multivariable adjustment (adjusted HR 1.36 for both outcomes, both p<0.05). These associations were materially unchanged after accounting for non-proportional covariate effects (overall cardiovascular involvement: HR 1.37, 95% CI 1.10 to 1.71; inflammatory/lupus-related manifestations: HR 1.35, 95% CI 1.06 to 1.74). For the original MACE composite, higher TyG was associated with increased risk in the adjusted analysis; however, this finding was less robust in a post hoc sensitivity analysis excluding heart failure and should be interpreted cautiously because of the limited number of events.</p><p><strong>Conclusion: </strong>These findings support the potential value of the TyG index as an accessible marker of cardiometabolic risk in SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956114","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":"Integrated metabolomics and DNA methylation signatures and their association with flare remission in SLE.","authors":"Mary Horton, Dylan Johnson, Kirsten E Overdahl, Joanne Nititham, Kimberly E Taylor, Patricia Katz, Jimmie Ye Chun, Jinoos Yazdany, Maria Dall'Era, Lisa F Barcellos, Jian-Liang Li, Alan K Jarmusch, Lindsey A Criswell, Cristina M Lanata","doi":"10.1136/lupus-2026-002017","DOIUrl":"10.1136/lupus-2026-002017","url":null,"abstract":"<p><strong>Objective: </strong>Identify whether changes in metabolite abundance are associated with SLE flare remission and changes in DNA methylation (DNAm).</p><p><strong>Methods: </strong>40 multiethnic patients with SLE were recruited during a rheumatologist-confirmed flare and returned to the clinic 3 months later. Per visit, we obtained blood samples and generated untargeted metabolomics (ultra-high performance liquid chromatography coupled to high-resolution mass spectrometry) and DNAm (Illumina EPIC array) profiles. We identified chemical features whose change between visits was associated with remission at the follow-up visit using the <i>limma</i> package and a time × remission interaction term, adjusting for follow-up time and medications. We tested for correlations between changes in significant chemical features and DNAm at 291 sites previously associated with remission.</p><p><strong>Results: </strong>16 patients with SLE were in remission at the follow-up visit. Remitters and non-remitters had similar demographics and disease activity at baseline. We identified 62 chemical features whose changes over time were associated with remission. 19 were assigned a putative consensus chemical formula. Two were confirmed with reference standards-adenosine (interaction coefficient (β): 2.29, 95% CI 1.44 to 3.14) and bilirubin (β: 2.02, 95% CI 1.09 to 2.94). We identified 23 significantly correlated chemical feature-DNAm pairs (p<0.05/62×291). This included a strong correlation between adenosine and four DNAm sites, including three within immune-related genes<i>, EBF1</i> (r=-0.77, p=1.35×10^-7), <i>IL12B</i> (r=0.69, p=1.87×10^-6) and <i>GRAMD1C</i> (r=-0.71, p=1.00×10^-6).</p><p><strong>Conclusion: </strong>Changes in chemical features, including confirmed metabolites bilirubin and adenosine, were associated with flare remission and changes in DNAm at SLE-relevant loci. Metabolites and their correlations with DNAm might serve as indicators of immune function and improve our knowledge of determinants of response to treatment. Future studies are needed to confirm the identities of metabolites and robustness of findings.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956126","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":"Identification and functional characterisation of SCO1 as a mitochondria-related biomarker in lupus nephritis.","authors":"Haiping Xie, Jianwen Liu, Juanjuan He, Yunfeng Dai, Fei Gao, Yanfang Wu, Zhihan Chen","doi":"10.1136/lupus-2026-002041","DOIUrl":"10.1136/lupus-2026-002041","url":null,"abstract":"<p><strong>Background: </strong>Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus. Mitochondrial dysfunction and inflammation are key contributors to its pathogenesis, yet the underlying mechanisms remain incompletely understood and reliable biomarkers are limited. This study investigates mitochondrial-related genes (MRGs) in LN and evaluates their potential as biomarkers.</p><p><strong>Methods: </strong>Differentially expressed genes (DEGs) were obtained from the Gene Expression Omnibus database and MRGs were derived from the MitoCarta3.0 dataset. Weighted gene co-expression network analysis identified key modules, followed by Gene Ontology and Kyoto Encyclopaedia of Genes and Genomes enrichment analyses of mitochondrial DEGs (MitoDEGs). Protein-protein interaction network analysis and random forest modelling were applied to identify hub MitoDEGs. Their diagnostic performance was evaluated using receiver operating characteristic curves. Immune cell infiltration was estimated using single-sample gene set enrichment analysis and correlations with hub MitoDEGs were analysed. Immunofluorescence staining and functional assays in HK-2 cells were performed to validate the expression and biological roles of the hub genes.</p><p><strong>Results: </strong>Among the 36 MitoDEGs, synthesis of cytochrome c oxidase 1 (SCO1) was identified. SCO1 exhibited strong discriminatory power in both the training and validation sets. After false discovery rate correction, SCO1 showed significant positive correlations with CD8+T cells, naive CD4+T cells and resting memory CD4+T cells. Immunofluorescence staining confirmed that SCO1 was predominantly expressed in renal tubules and was significantly upregulated in patients with LN compared with healthy controls. Functional validation demonstrated that SCO1 overexpression enhanced cell viability, whereas its knockdown reduced cell viability, increased mitochondrial reactive oxygen apecies and decreased mitochondrial membrane potential, without affecting ATP levels. SCO1 modulation altered P62 expression but did not significantly affect PARKIN, PINK1, or LC3B levels.</p><p><strong>Conclusion: </strong>SCO1 showed elevated expression in renal tubules and strong discriminatory ability. It may help preserve tubular cell viability and mitochondrial homeostasis under inflammatory stress, highlighting its potential as a diagnostic biomarker and a candidate for further mechanistic investigation in LN.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956130","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":"Unveiling the molecular and immune heterogeneity across distinct disease activity states of systemic lupus erythematosus through integrative bulk and single-cell transcriptomics.","authors":"Chen Shen, Mingzhe Guo, Jian Huang, Huiwen Zheng, Gang Yu","doi":"10.1136/lupus-2026-002111","DOIUrl":"10.1136/lupus-2026-002111","url":null,"abstract":"<p><strong>Objective: </strong>Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterised by substantial variability in clinical presentations and disease severity. This study aims to investigate the molecular and cellular mechanisms underlying distinct SLE Disease Activity Index (SLEDAI)-defined disease states of SLE and to identify potential prognostic biomarkers and therapeutic targets associated with heightened inflammatory activity.</p><p><strong>Methods: </strong>We analysed bulk and single-cell RNA sequencing datasets from SLE patients. Patients were stratified into clinically distinct SLEDAI-defined disease states using established SLEDAI thresholds, which served as operational surrogates of inflammatory disease burden. Differentially expressed genes and gene co-expression networks were analysed to identify severity-associated hub genes. The immune microenvironment and intercellular communication were evaluated using CIBERSORTx and CellChat algorithms, respectively.</p><p><strong>Results: </strong>Differential expression and network analyses identified five key hub genes (KLRK1, IL2RB, RAG1, SH2D1B and NCR1) strongly correlated with SLE disease activity states, which were used to develop a five-gene SLE severity (SLEsev) score. The SLEsev score was significantly higher in high-activity/severe SLE (sSLE) compared with low-activity/mild SLE (mSLE) (p<0.001), which showed a consistent trend in an independent validation cohort. Immune profiling revealed that mSLE was enriched in regulatory T cells (Tregs) and memory B cells, whereas sSLE exhibited elevated levels of CD8+T cells, natural killer cells and monocytes (p<0.05). Single-cell analysis demonstrated that sSLE possessed a more complex cellular communication network (311 vs 283 inferred interactions) and greater overall interaction strength than mSLE, with prominent pro-inflammatory signalling pathways such as IFN-II, GAS and CCL playing a key role in sSLE.</p><p><strong>Conclusions: </strong>This study unveils the profound immunological and transcriptomic dysregulation underlying SLE severity. The identified five-gene SLEsev score serves as a potential biomarker for disease stratification, while the hyperactive intercellular signalling networks highlight specific molecular targets for modulating immune responses in severe SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956136","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":"Efficacy and safety of telitacicept combined with standard of care in patients with proliferative lupus nephritis: a real-world retrospective study.","authors":"Ting Tian, Aifei Zhang, Xiaoxia Liu, Pengjia Wu, Na Li, Leyan Zeng, Jun Liu, Longyan Qin, Jiashun Zeng","doi":"10.1136/lupus-2026-002191","DOIUrl":"10.1136/lupus-2026-002191","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the efficacy and safety of telitacicept combined with standard of care (SoC) as induction therapy for proliferative lupus nephritis (LN) patients in a real-world setting.</p><p><strong>Methods: </strong>A total of 112 patients with biopsy-proven International Society of Nephrology/Renal Pathology Society Class III/IV (with or without Class V) LN were retrospectively enrolled. Subjects were divided into two groups: the telitacicept group (n=56) receiving telitacicept plus SoC and the control group (n=56) receiving SoC alone. The primary endpoints were the rates of complete renal response (CR) and partial renal response (PR) at week 24, while the secondary endpoints included CR and PR rates, serological profiles, disease activity markers, glucocorticoid tapering and safety assessments at weeks 12 and 52. To minimise selection bias and confounding factors, propensity score-based inverse probability of treatment weighting (IPTW) was employed. The adequacy of the covariates after IPTW was evaluated via standardised mean differences.</p><p><strong>Results: </strong>Baseline characteristics were comparable between the two groups. The telitacicept group demonstrated significant improvements in disease activity markers, including serum albumin, 24-hour urinary protein and urinary leucocyte and erythrocyte counts. At week 24, the telitacicept group achieved significantly higher CR rate (67.9% vs 39.3%, p=0.004) and PR rate (83.9% vs 67.9%, p=0.023) compared with the control group. Glucocorticoid dosages, systemic lupus erythematosus disease activity index 2000, British Isles Lupus Assessment Group and Physician's Global Assessment scores were significantly reduced in the telitacicept group. Furthermore, multivariate Cox regression analysis identified telitacicept treatment as an independent predictor for achieving CR (HR=4.43; 95% CI, 2.25 to 8.73; p<0.001).</p><p><strong>Conclusions: </strong>This real-world study demonstrates that telitacicept combined with SoC significantly improves renal response rates during the induction phase of proliferative LN while reducing glucocorticoid exposure. Consequently, telitacicept may represent a promising and effective therapeutic option for the management of proliferative LN.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956149","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}