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在系统性红斑狼疮的更广泛背景下,推进对皮肤红斑狼疮的认识、诊断和治疗。

Advancing understanding, diagnosis, and therapies for cutaneous lupus erythematosus within the broader context of systemic lupus erythematosus.

作者信息

Chen Kristen L, Krain Rebecca L, Werth Victoria P

机构信息

Department of Dermatology, Corporal Michael J. Crescenz VAMC, 3900 Woodland Avenue, Philadelphia, PA 19104, USA.

Department of Dermatology, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Suite 1-330A, Philadelphia, PA 19104, USA.

出版信息

F1000Res. 2019 Mar 25;8. doi: 10.12688/f1000research.17787.1. eCollection 2019.

Abstract

Cutaneous lupus erythematosus (CLE) is an autoimmune disease that can be associated with systemic lupus erythematosus (SLE) symptoms. The pathogenesis of both CLE and SLE is multifactorial, involving genetic susceptibility, environmental factors, and innate and adaptive immune responses. Despite the efficacy of current medications, many patients remain refractory, highlighting the necessity for new treatment options. Unfortunately, owing to challenges related in part to trial design and disease heterogeneity, only one new biologic in the last 50 years has been approved by the US Food and Drug Administration for the treatment of SLE. Thus, although SLE and CLE have a similar pathogenesis, patients with CLE who do not meet criteria for SLE cannot benefit from this advancement. This article discusses the recent trials and emphasizes the need to include patients with single-organ lupus, such as CLE, in SLE trials.

摘要

皮肤型红斑狼疮(CLE)是一种自身免疫性疾病,可能伴有系统性红斑狼疮(SLE)的症状。CLE和SLE的发病机制是多因素的,涉及遗传易感性、环境因素以及先天性和适应性免疫反应。尽管目前的药物有效,但许多患者仍然难治,这凸显了新治疗方案的必要性。不幸的是,由于部分与试验设计和疾病异质性相关的挑战,在过去50年里,美国食品药品监督管理局仅批准了一种新的生物制剂用于治疗SLE。因此,尽管SLE和CLE有相似的发病机制,但不符合SLE标准的CLE患者无法从这一进展中获益。本文讨论了近期的试验,并强调在SLE试验中纳入单器官狼疮患者(如CLE患者)的必要性。

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