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系统性红斑狼疮:新的诊断与治疗方法

Systemic Lupus Erythematosus: New Diagnostic and Therapeutic Approaches.

作者信息

Lazar Stephanie, Kahlenberg J Michelle

机构信息

Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA; email:

出版信息

Annu Rev Med. 2023 Jan 27;74:339-352. doi: 10.1146/annurev-med-043021-032611. Epub 2022 Jul 8.

Abstract

Systemic lupus erythematosus (SLE) is a devastating autoimmune disease that can result in substantial morbidity and mortality. Diagnosis and treatment of SLE are clinical challenges. Patient presentation and response to therapy are heterogeneous because of the complex immune dysregulation that results in SLE disease pathogenesis. An intricate interplay between genetic risk and skewing of adaptive and innate immune system responses leads to overproduction of type I interferons and other cytokines, complement activation, immune-complex deposition, and ultimately inflammation and tissue damage. Here, we review the classification criteria as well as standard and emerging diagnostic tools available to identify patients with SLE. We then focus on medical management, including novel therapeutics, nonpharmacologic interventions, and comorbidity management.

摘要

系统性红斑狼疮(SLE)是一种严重的自身免疫性疾病,可导致严重的发病和死亡。SLE的诊断和治疗是临床面临的挑战。由于导致SLE发病机制的复杂免疫失调,患者的临床表现和对治疗的反应存在异质性。遗传风险与适应性和先天性免疫系统反应的偏差之间的复杂相互作用导致I型干扰素和其他细胞因子的过度产生、补体激活、免疫复合物沉积,最终导致炎症和组织损伤。在这里,我们回顾了用于识别SLE患者的分类标准以及现有的标准和新兴诊断工具。然后,我们将重点关注医疗管理,包括新型治疗方法、非药物干预和合并症管理。

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