Wang Minhui, Wang Ziqian, Zhang Shangzhu, Wu Yang, Zhang Li, Zhao Jiuliang, Wang Qian, Tian Xinping, Li Mengtao, Zeng Xiaofeng
Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing 100730, China.
J Clin Med. 2022 Aug 24;11(17):4955. doi: 10.3390/jcm11174955.
Neuropsychiatric systemic lupus erythematosus (NPSLE) has a broad spectrum of subtypes with diverse severities and prognoses. Ischemic and inflammatory mechanisms, including autoantibodies and cytokine-mediated pathological processes, are key components of the pathogenesis of NPSLE. Additional brain-intrinsic elements (such as the brain barrier and resident microglia) are also important facilitators of NPSLE. An improving understanding of NPSLE may provide further options for managing this disease. The attenuation of neuropsychiatric disease in mouse models demonstrates the potential for novel targeted therapies. Conventional therapeutic algorithms include symptomatic, anti-thrombotic, and immunosuppressive agents that are only supported by observational cohort studies, therefore performing controlled clinical trials to guide further management is essential and urgent. In this review, we aimed to present the latest pathogenetic mechanisms of NPSLE and discuss the progress in its management.
神经精神性系统性红斑狼疮（NPSLE）具有广泛的亚型，严重程度和预后各不相同。缺血和炎症机制，包括自身抗体和细胞因子介导的病理过程，是NPSLE发病机制的关键组成部分。其他脑内因素（如脑屏障和常驻小胶质细胞）也是NPSLE的重要促成因素。对NPSLE的进一步了解可能为该疾病的管理提供更多选择。小鼠模型中神经精神疾病的减轻证明了新型靶向治疗的潜力。传统治疗方案包括对症治疗、抗血栓治疗和免疫抑制药物，这些仅得到观察性队列研究的支持，因此进行对照临床试验以指导进一步治疗至关重要且迫在眉睫。在本综述中，我们旨在介绍NPSLE的最新发病机制，并讨论其治疗进展。
