Autoimmune Responses and Therapeutic Interventions for Systemic Lupus Erythematosus: A Comprehensive Review.

IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Endocrine, metabolic & immune disorders drug targets Pub Date : 2024-01-01 DOI:10.2174/1871530323666230915112642
Surya Prakash Pandey, Rakesh Bhaskar, Sung Soo Han, Kannan Badri Narayanan
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Abstract

Systemic Lupus Erythematosus (SLE) or Lupus is a multifactorial autoimmune disease of multiorgan malfunctioning of extremely heterogeneous and unclear etiology that affects multiple organs and physiological systems. Some racial groups and women of childbearing age are more susceptible to SLE pathogenesis. Impressive progress has been made towards a better understanding of different immune components contributing to SLE pathogenesis. Recent investigations have uncovered the detailed mechanisms of inflammatory responses and organ damage. Various environmental factors, pathogens, and toxicants, including ultraviolet light, drugs, viral pathogens, gut microbiome metabolites, and sex hormones trigger the onset of SLE pathogenesis in genetically susceptible individuals and result in the disruption of immune homeostasis of cytokines, macrophages, T cells, and B cells. Diagnosis and clinical investigations of SLE remain challenging due to its clinical heterogeneity and hitherto only a few approved antimalarials, glucocorticoids, immunosuppressants, and some nonsteroidal anti-inflammatory drugs (NSAIDs) are available for treatment. However, the adverse effects of renal and neuropsychiatric lupus and late diagnosis make therapy challenging. Additionally, SLE is also linked to an increased risk of cardiovascular diseases due to inflammatory responses and the risk of infection from immunosuppressive treatment. Due to the diversity of symptoms and treatment-resistant diseases, SLE management remains a challenging issue. Nevertheless, the use of next-generation therapeutics with stem cell and gene therapy may bring better outcomes to SLE treatment in the future. This review highlights the autoimmune responses as well as potential therapeutic interventions for SLE particularly focusing on the recent therapeutic advancements and challenges.

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系统性红斑狼疮的自身免疫反应和治疗干预:全面回顾。
系统性红斑狼疮(SLE)或狼疮是一种影响多个器官和生理系统的多因素自身免疫性疾病,多器官功能失调,病因极为复杂且不明确。一些种族群体和育龄妇女更容易受到系统性红斑狼疮发病机制的影响。在更好地了解导致系统性红斑狼疮发病的不同免疫成分方面,已经取得了令人瞩目的进展。最近的研究发现了炎症反应和器官损伤的详细机制。各种环境因素、病原体和毒物,包括紫外线、药物、病毒病原体、肠道微生物代谢产物和性激素,都会诱发遗传易感人群的系统性红斑狼疮发病,并导致细胞因子、巨噬细胞、T 细胞和 B 细胞的免疫平衡被破坏。由于其临床异质性,系统性红斑狼疮的诊断和临床研究仍具有挑战性,迄今为止,只有少数几种经批准的抗疟药、糖皮质激素、免疫抑制剂和一些非甾体抗炎药(NSAIDs)可用于治疗。然而,肾性狼疮和神经精神性狼疮的不良反应以及诊断较晚使治疗面临挑战。此外,系统性红斑狼疮还与炎症反应导致的心血管疾病风险增加以及免疫抑制治疗带来的感染风险有关。由于系统性红斑狼疮的症状和耐药性多种多样,其治疗仍然是一个具有挑战性的问题。然而,干细胞和基因疗法等新一代疗法的使用可能会为系统性红斑狼疮的治疗带来更好的结果。本综述重点介绍系统性红斑狼疮的自身免疫反应以及潜在的治疗干预措施,尤其关注近期的治疗进展和面临的挑战。
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来源期刊
Endocrine, metabolic & immune disorders drug targets
Endocrine, metabolic & immune disorders drug targets ENDOCRINOLOGY & METABOLISMIMMUNOLOGY-IMMUNOLOGY
CiteScore
4.60
自引率
5.30%
发文量
217
期刊介绍: Aims & Scope This journal is devoted to timely reviews and original articles of experimental and clinical studies in the field of endocrine, metabolic, and immune disorders. Specific emphasis is placed on humoral and cellular targets for natural, synthetic, and genetically engineered drugs that enhance or impair endocrine, metabolic, and immune parameters and functions. Moreover, the topics related to effects of food components and/or nutraceuticals on the endocrine-metabolic-immune axis and on microbioma composition are welcome.
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