The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
Clin Rheumatol. 2024 Aug;43(8):2403-2416. doi: 10.1007/s10067-024-07046-8. Epub 2024 Jul 4.
Systemic lupus erythematosus (SLE) is a common autoimmune disease with a polymorphic clinical presentation involving multisystem damages with significant differences in prevalence and disease severity among different ethnic groups. Although genetic, hormonal, and environmental factors have been demonstrated to contribute a lot to SLE, the pathogenesis of SLE is still unknown. Numerous evidence revealed that gene variants within the type I interferons (IFN) signaling pathway performed the great genetic associations with autoimmune diseases including SLE. To date, through genome-wide association studies (GWAS), genetic association studies showed that more than 100 susceptibility genes have been linked to the pathogenesis of SLE, among which TYK2, STAT1, STAT4, and IRF5 are important molecules directly connected to the type I interferon signaling system. The review summarized the genetic associations and the detailed risk loci of STAT4 and IRF5 with Asian SLE patients, explored the genotype distributions associated with the main clinical manifestations of SLE, and sorted out the potential reasons for the differences in susceptibility in Asia and Europe. Moreover, the therapies targeting STAT4 and IRF5 were also evaluated in order to propose more personalized and targeted treatment plans in SLE.
系统性红斑狼疮(SLE)是一种常见的自身免疫性疾病,其临床表现多样,涉及多系统损害,在不同种族中的患病率和疾病严重程度存在显著差异。尽管遗传、激素和环境因素已被证明对 SLE 有很大的贡献,但 SLE 的发病机制仍不清楚。大量证据表明,I 型干扰素(IFN)信号通路内的基因变异与包括 SLE 在内的自身免疫性疾病具有很强的遗传关联。迄今为止,通过全基因组关联研究(GWAS),遗传关联研究表明,已有 100 多个易感基因与 SLE 的发病机制有关,其中 TYK2、STAT1、STAT4 和 IRF5 是与 I 型干扰素信号系统直接相关的重要分子。本综述总结了 STAT4 和 IRF5 与亚洲 SLE 患者的遗传关联和详细风险位点,探讨了与 SLE 主要临床表现相关的基因型分布,并梳理了亚洲和欧洲易感性差异的潜在原因。此外,还评估了针对 STAT4 和 IRF5 的治疗方法,以期为 SLE 提出更个性化和针对性的治疗方案。
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