Immunogenetic studies on systemic lupus erythematosus

Lupus ◽  
2009 ◽  
Vol 18 (10) ◽  
pp. 878-883 ◽  
Author(s):  
GD Sebastiani ◽  
M Galeazzi

Understanding the pathogenesis of systemic lupus erythematosus (SLE) remains a considerable challenge. Multiple abnormalities of both the innate and adaptive immune system have been described and, furthermore, immunological dysfunction precedes clinical presentation by many years. There is a strong genetic basis to SLE, which means that genetic studies can play a key role in furthering our understanding of this disease. Because susceptibility variants are present from birth and are unaffected by the course of the disease, or by its treatment, genetic analysis is, perhaps uniquely, capable of identifying fundamental, causative, disease mechanisms. In this article, we review our SLE immunogenetic studies performed in collaboration with the European Working Party on Systemic Lupus Erythematosus. By considering the results of our research and the recent advances obtained by genome-wide associations’ studies, we can begin to understand how dysregulation at a number of key immunological steps may predispose to the development of SLE.

Lupus ◽  
2001 ◽  
Vol 10 (12) ◽  
pp. 892-894 ◽  
Author(s):  
R Cervera ◽  
M A Khamashta ◽  
J Font ◽  
G RV Hughes ◽  

Lupus ◽  
2009 ◽  
Vol 18 (10) ◽  
pp. 884-888 ◽  
Author(s):  
G Zandman-Goddard ◽  
M Blank ◽  
Y Shoenfeld

This article is an update on the clinical and research data available on systemic lupus erythematosus (SLE) and intravenous immunoglobulin (IVIg) therapy that includes some studies performed under the umbrella of the European Working Party on SLE. Various mechanisms of IVIg may play a role, some synergistically, in the modulation of SLE. Recently it has been suggested that IVIg also suppresses the expansion of autoreactive B lymphocytes through signalling of the FcgRIIB, idiotype-mediated inhibition of B cell receptors and neutralisation of cytokines such as the B cell survival factors (B cell activation factor (BAFF and APRIL). In case reports and in open trials, high-dose IVIg (2 g/kg over a 5-day period) has consistently been shown to be a beneficial and safe adjunct therapeutic agent for over 20 manifestations in patients with SLE. It can be given as a first choice of therapy in some cases, for example, in neurological involvement and in those patients who refuse certain immunosuppressive agents such as cyclophosphamide, or in patients who have concomitant infections. Furthermore, IVIg may have a steroid-sparing effect although this characteristic needs further investigation. Specific IVIg (an anti-idiotype to anti-DNA, phosphorylcholine and antiphospholipids) has been shown to be effective in experimental murine models. Hence, extractable IVIg that is directed to the specific pathogenic immunoglobulins will enable the more specific therapy for patients with lupus.


Author(s):  
Peter Lloyd ◽  
Sarah Doaty ◽  
Bevra H. Hahn

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the presence of immune dysregulation, autoreactive B and T cells, and the production of a broad, heterogeneous group of autoantibodies (autoAb). The pathogenesis of lupus can be divided into three stages: 1) genetic predisposition and environmental exposures, 2) loss of tolerance, and 3) immune activation. In this chapter we will discuss the aetiopathogenesis of systemic lupus erythematosus with emphasis placed on key autoantibodies, cytokines, the innate and adaptive immune system, tolerance, NETosis, genetics and epigenetics, environmental triggers and the role of gender.


Lupus ◽  
2009 ◽  
Vol 18 (10) ◽  
pp. 930-932 ◽  
Author(s):  
C Vasconcelos ◽  
R Cervera

The studies developed by the European Working Party on Systemic Lupus Erythematosus and the European Forum on Antiphospholipid Antibodies stress the importance of the creation of international networks devoted to the study of autoimmune diseases and the need for centres of excellence in the management of these conditions. This article analyses the importance of such centres and networks in Europe.


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