-
Seminars in Arthritis and Rheumatism Dec 2021Malignancy is a potential comorbidity in patients with systemic lupus erythematosus (SLE). However, risk by malignancy type remains to be fully elucidated. We evaluated... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Malignancy is a potential comorbidity in patients with systemic lupus erythematosus (SLE). However, risk by malignancy type remains to be fully elucidated. We evaluated the risk of malignancy type in SLE patients in a systematic review and meta-analysis.
METHODS
MEDLINE and EMBASE were searched from inception to July 2018 to identify observational studies that evaluated malignancy risk in adult SLE patients compared with the general population. Random-effects models were used to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs). Heterogeneity was quantified using the I test.
FINDINGS
Forty-one studies reporting on 40 malignancies (one overall, 39 site-specific) were included in the meta-analysis. The pooled RR for all malignancies from 3694 events across 80 833 patients was 1.18 (95% CI: 1.00-1.38). The risk of 24 site-specific malignancies (62%) was increased in SLE patients. For malignancies with ≥6 studies, non-Hodgkin lymphoma and Hodgkin lymphoma risk was increased >3-fold; myeloma and liver >2-fold; cervical, lung, bladder, and thyroid ≥1.5-fold; stomach and brain >1.3-fold. The risk of four malignancies (breast, uterine, melanoma, prostate) was decreased, whereas risk of 11 other malignancies did not differ between SLE patients and the general population. Heterogeneity ranged between 0% and 96%, and 63% were non-significant.
INTERPRETATION
The risk of overall and some site-specific malignancies is increased in SLE compared with the general population. However, the risk for some site-specific malignancies is decreased or did not differ. Further examination of risk profiles and SLE patient phenotypes may support guidelines aimed at reducing malignancy risk.
FUNDING
AstraZeneca.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO number: CRD42018110433.
Topics: Humans; Lupus Erythematosus, Systemic; Male; Neoplasms; Odds Ratio; Risk; Risk Factors
PubMed: 34710720
DOI: 10.1016/j.semarthrit.2021.09.009 -
Frontiers in Immunology 2020Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that involves multiple organs and disproportionality affects females, especially African Americans... (Review)
Review
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that involves multiple organs and disproportionality affects females, especially African Americans from 15 to 44 years of age. SLE can lead to end organ damage including kidneys, lungs, cardiovascular and neuropsychiatric systems, with cardiovascular complications being the primary cause of death. Usually, SLE is diagnosed and its activity is assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), Systemic Lupus International Collaborating Clinics Damage Index (SLICC/ACR), and British Isles Lupus Assessment Group (BILAG) Scales, which unfortunately often occurs after a certain degree of systemic involvements, disease activity or organ damage already exists. There is certainly a need for the identification of early biomarkers to diagnose and assess disease activity as well as to evaluate disease prognosis and response to treatment earlier in the course of the disease. Here we review advancements made in the area of sphingolipidomics as a diagnostic/prognostic tool for SLE and its co-morbidities. We also discuss recent reports on differential sphingolipid metabolism and blood sphingolipid profiles in SLE-prone animal models as well as in diverse cohorts of SLE patients. In addition, we address targeting sphingolipids and their metabolism as a method of treating SLE and some of its complications. Although such treatments have already shown promise in preventing organ-specific pathology caused by SLE, further investigational studies and clinical trials are warranted.
Topics: Animals; Biomarkers; Humans; Lupus Erythematosus, Systemic; Prognosis; Sphingolipids
PubMed: 33101319
DOI: 10.3389/fimmu.2020.586737 -
Proceedings of the National Academy of... Mar 2003Systemic lupus erythematosus (SLE) is a complex, inflammatory autoimmune disease that affects multiple organ systems. We used global gene expression profiling of...
Systemic lupus erythematosus (SLE) is a complex, inflammatory autoimmune disease that affects multiple organ systems. We used global gene expression profiling of peripheral blood mononuclear cells to identify distinct patterns of gene expression that distinguish most SLE patients from healthy controls. Strikingly, about half of the patients studied showed dysregulated expression of genes in the IFN pathway. Furthermore, this IFN gene expression "signature" served as a marker for more severe disease involving the kidneys, hematopoetic cells, and/or the central nervous system. These results provide insights into the genetic pathways underlying SLE, and identify a subgroup of patients who may benefit from therapies targeting the IFN pathway.
Topics: Down-Regulation; Flow Cytometry; Gene Expression Regulation; Humans; Interferons; Leukocytes, Mononuclear; Lupus Erythematosus, Systemic; Lupus Vulgaris; Oligonucleotide Array Sequence Analysis; Up-Regulation
PubMed: 12604793
DOI: 10.1073/pnas.0337679100 -
Immunogenetics Jan 2017Systemic lupus erythematosus (SLE) is an autoimmune disorder with complex genetic underpinnings. This review attempts to assemble the myriad of genomic findings to build... (Review)
Review
Systemic lupus erythematosus (SLE) is an autoimmune disorder with complex genetic underpinnings. This review attempts to assemble the myriad of genomic findings to build a clearer picture of the pathobiology of SLE to serve as a guide for therapeutics. Over 100 genes are now known for SLE, and several more penetrant ones have led to the emergence of more defined lupus phenotypes. Also discussed here are the targeted therapies that have come up on the horizon and the specific biologic mechanisms of more traditional therapies which have only recently been explored. The diagnostic toolbox has been enhanced by the addition of new antibodies, gene expression signatures, and mutation panels. This provides an opportunity to piece together the lupus puzzle and even revisit the clinical classification of SLE.
Topics: Animals; Genomics; Humans; Lupus Erythematosus, Systemic
PubMed: 27933432
DOI: 10.1007/s00251-016-0961-7 -
Expert Review of Clinical Immunology Jun 2018Systemic lupus erythematosus (SLE) is a multi-system inflammatory autoimmune disease of incompletely understood etiology. It is thought that environmental exposures... (Review)
Review
Systemic lupus erythematosus (SLE) is a multi-system inflammatory autoimmune disease of incompletely understood etiology. It is thought that environmental exposures 'trigger' or accelerate the disease in genetically-predisposed individuals. Areas covered: Substantial epidemiological evidence exists to support the association between cigarette smoking and the risk of incident SLE. Recent evidence points to current smoking as the specific risk factor, with decreasing risk 5 years after smoking cessation, and the greatest risk for disease characterized by the presence of SLE-specific autoantibodies. Research has begun to search for possible explanations for the temporal nature of the relationship between current smoking and autoantibody positive-SLE. Here we review potential biologic mechanisms linking smoking and SLE risk, including effects upon T and B cells, inflammatory cytokines, oxidative stress, and the formation of short-lived DNA adducts. Expert commentary: The directions for future research in this field include studies of gene-environment interactions, epigenetics, metabolomics and putative biologic mechanisms.
Topics: Cigarette Smoking; Gene-Environment Interaction; Humans; Incidence; Lupus Erythematosus, Systemic
PubMed: 29724134
DOI: 10.1080/1744666X.2018.1473035 -
Frontiers in Immunology 2022
Topics: Humans; Lupus Erythematosus, Systemic; Lupus Nephritis; Biomarkers
PubMed: 36311710
DOI: 10.3389/fimmu.2022.1009038 -
Arthritis Research & Therapy May 2022To critically assess the quality and functionality of the available mobile apps for systemic lupus erythematosus and lupus nephritis patients.
OBJECTIVES
To critically assess the quality and functionality of the available mobile apps for systemic lupus erythematosus and lupus nephritis patients.
METHODS
Two reviewers independently searched the App Store and Google Play Store for eligible mobile health (mHealth) apps. Two separate searches were done: one for systemic lupus erythematosus (SLE) and the other for lupus nephritis (LN). The Mobile App Rating Scale (MARS) was used to rate the quality of all selected apps.
RESULTS
From the systemic lupus erythematosus screening, our search yielded 841 apps. Within these 841 apps, 17 of them were ultimately included. From the lupus nephritis screening, our search returned 1152 apps. Of the 1152 apps, 2 were ultimately included. Our search strategy included apps specifically designed for patients with SLE and LN. The MARS average of all the systemic lupus erythematosus apps was 2.7 out of 5. The MARS average of the two lupus nephritis apps was 2.6 out of 5.
CONCLUSION
Mobile health apps can serve as an effective tool for telehealth, engaging patients in self-care and for increasing the quality of life of lupus patients. While several mobile health technologies exist for patients with SLE and LN, there is still a significant need for app quality improvement and expanding the comprehensiveness of offered functions.
Topics: Female; Humans; Lupus Erythematosus, Systemic; Lupus Nephritis; Male; Mobile Applications; Quality of Life; Telemedicine
PubMed: 35568874
DOI: 10.1186/s13075-022-02791-0 -
Autoimmunity Reviews Dec 2012Infection is a common problem and has become one of the leading causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE). The reasons for... (Review)
Review
Infection is a common problem and has become one of the leading causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE). The reasons for the high incidence of infection are immunosuppressive therapy and immune disturbances of lupus itself. Infections may mimic exacerbations of SLE, leading to confusion over the diagnosis and appropriate treatment. It can be notoriously difficult to differentiate between infection and disease flare in some cases. Indeed they may co-exist. Along with the conventional biomarkers of lupus flares as hypocomplementemia, anti-double-stranded-DNA antibodies and erythrocyte sedimentation rate, other biomarkers as procalcitonin, and autoantibodies against complement fraction C1q, have been investigated to distinguish infections from other inflammatory processes. Recent research has provided data about new potential biomarkers to assist clinical decision-making in the management of SLE patients (e.g. percentage of circulating CD27 high plasma cells from the peripheral blood, 2'5'-oligoadenylate synthetase isoforms, soluble triggering receptor expressed on myeloid cells-1 and pentraxin 3), but only some of them are supported by convincing evidence, such as CD 64-Fc receptor expression. We reviewed the literature on the available tests to discriminate between SLE activity and infections, focusing on conventional and upcoming biomarkers.
Topics: Biomarkers; Communicable Diseases; Humans; Lupus Erythematosus, Systemic
PubMed: 22498788
DOI: 10.1016/j.autrev.2012.03.009 -
CMAJ : Canadian Medical Association... Feb 2020
Topics: Alanine Transaminase; Antibodies, Antinuclear; Aspartate Aminotransferases; Facial Dermatoses; Female; Humans; Infant; Lupus Erythematosus, Systemic; Male; Maternal-Fetal Exchange; Pregnancy; Pregnancy Complications
PubMed: 32071108
DOI: 10.1503/cmaj.191172 -
Ugeskrift For Laeger Aug 2016Systemic lupus erythematosus (SLE) is a complex autoimmune disease which most often affects women of childbearing age. Pregnancy is therefore an important issue for the... (Review)
Review
Systemic lupus erythematosus (SLE) is a complex autoimmune disease which most often affects women of childbearing age. Pregnancy is therefore an important issue for the patient and the responsible physician. Pregnancy outcomes in women with SLE has improved significantly over the latest decades, and current research initiatives aim towards further improvement. Pregnant women with SLE are still considered being at various levels of risk. In order to achieve the best possible outcomes for mother and child, joint care in specialised multidisciplinary teams including rheumatologists and obstetricians is recommended.
Topics: Antiphospholipid Syndrome; Female; Humans; Lupus Erythematosus, Systemic; Lupus Nephritis; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Risk Factors
PubMed: 27506916
DOI: No ID Found