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分子谱分析和治疗定制以解决系统性红斑狼疮的疾病异质性。

Molecular profiling and therapeutic tailoring to address disease heterogeneity in systemic lupus erythematosus.

机构信息

Department of General Medicine, Kasturba Medical College, Manipal, Manipal Academy Higher Education, Manipal, India.

Department of Rheumatology, All India Institute of Medical Sciences New Delhi, New Delhi, India.

出版信息

Clin Exp Med. 2024 Sep 19;24(1):223. doi: 10.1007/s10238-024-01484-z.

Abstract

Systemic lupus erythematosus (SLE) is a chronic, heterogeneous, systemic autoimmune disease characterized by autoantibody production, complement activation, and immune complex deposition. SLE predominantly affects young, middle-aged, and child-bearing women with episodes of flare-up and remission, although it affects males at a much lower frequency (female: male; 7:1 to 15:1). Technological and molecular advancements have helped in patient stratification and improved patient prognosis, morbidity, and treatment regimens overall, impacting quality of life. Despite several attempts to comprehend the pathogenesis of SLE, knowledge about the precise molecular mechanisms underlying this disease is still lacking. The current treatment options for SLE are pragmatic and aim to develop composite biomarkers for daily practice, which necessitates the robust development of novel treatment strategies and drugs targeting specific responsive pathways. In this communication, we review and aim to explore emerging therapeutic modalities, including multiomics-based approaches, rational drug design, and CAR-T-cell-based immunotherapy, for the management of SLE.

摘要

系统性红斑狼疮(SLE)是一种慢性、异质性、系统性自身免疫性疾病,其特征为自身抗体产生、补体激活和免疫复合物沉积。SLE 主要影响年轻、中年和育龄妇女,有发作和缓解期,尽管男性的发病率要低得多(女性:男性为 7:1 至 15:1)。技术和分子进步有助于患者分层,改善了整体患者预后、发病率和治疗方案,从而提高了生活质量。尽管人们多次试图了解 SLE 的发病机制,但对该病的确切分子机制仍知之甚少。目前 SLE 的治疗选择是务实的,旨在为日常实践开发综合生物标志物,这需要强有力地开发针对特定反应途径的新型治疗策略和药物。在本次交流中,我们回顾并探讨了新兴的治疗方式,包括基于多组学的方法、合理药物设计和 CAR-T 细胞免疫疗法,用于 SLE 的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fa/11410857/2220fe86c6a9/10238_2024_1484_Fig1_HTML.jpg

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