Immunological pathogenesis and treatment of systemic lupus erythematosus

World J Pediatr. 2020 Feb;16(1):19-30. doi: 10.1007/s12519-019-00229-3. Epub 2019 Feb 22.

Abstract

Background: Systemic lupus erythematosis (SLE) is a complex and clinically heterogeneous autoimmune disease. A variety of immunological defects contribute to SLE, including dysregulated innate and adaptive immune response. A clearer understanding of the mechanisms driving disease pathogenesis combined with recent advances in medical science is predicted to enable accelerated progress towards improved SLE-personalized approaches to treatment. The aim of this review was to clarify the immunological pathogenesis and treatment of SLE.

Data sources: Literature reviews and original research articles were collected from database, including PubMed and Wanfang. Relevant articles about SLE were included.

Results: Breakdown of self-tolerance is the main pathogenesis of SLE. The innate and adaptive immune networks are interlinked with each other through cytokines, complements, immune complexes and kinases of the intracellular machinery. Treatments targeted at possible targets of immunity have been assessed in clinical trials. Most of them did not show better safety and efficacy than traditional treatments. However, novel targeting treatments are still being explored.

Conclusions: Dysregulated immune response plays a critical role in SLE, including innate immunity and adaptive immunity. Biologic agents that aim to specifically target abnormal immune processes were assessing and may bring new hope to SLE patients.

Keywords: Immunological pathogenesis; Systemic lupus erythematosis; Treatment.

Publication types

  • Review

MeSH terms

  • Adaptive Immunity
  • Antirheumatic Agents / therapeutic use*
  • Child
  • Humans
  • Immunity, Innate
  • Immunosuppressive Agents / therapeutic use*
  • Lupus Erythematosus, Systemic / drug therapy*
  • Lupus Erythematosus, Systemic / immunology*

Substances

  • Antirheumatic Agents
  • Immunosuppressive Agents