Tian Jingru, Zhou Hang, Li Wei, Yao Xu, Lu Qianjin
Hospital for Skin Diseases Institute of Dermatology Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing China.
Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases Chinese Academy of Medical Sciences Nanjing China.
MedComm (2020). 2025 Jun 9;6(6):e70246. doi: 10.1002/mco2.70246. eCollection 2025 Jun.
Systemic lupus erythematosus (SLE) is a multifaceted dautoimmune disease driven by complex interactions among genetic, environmental, and sex-related factors. Central to its pathogenesis are type I interferons (IFN-I) and autoantibodies that target nucleic acids and nucleic acid-binding proteins. These mediators, often triggered by environmental stimuli in genetically susceptible individuals, promote sustained immune activation and chronic inflammation. Despite advances in understanding the immunological landscape of SLE, the precise initiating triggers and early molecular events remain incompletely defined. Recent studies have highlighted the destabilization of innate immune cells, particularly dendritic cells and monocytes, as critical early events in the pathogenesis of SLE. These alterations precede and potentially initiate the downstream activation of autoreactive lymphocytes. This review provides an updated synthesis of key epidemiological findings, emerging pathogenic mechanisms, potential therapeutic targets, and advances in translational and clinical research. Particular attention is given to recent insights into disease triggers and early pathological processes, especially the destabilization of innate immune cells. By consolidating these advances, this review aims to refine our understanding of the early immune dysregulation in SLE and to support the development of more precise, mechanism-based therapeutic strategies.
系统性红斑狼疮(SLE)是一种多方面的自身免疫性疾病,由遗传、环境和性别相关因素之间的复杂相互作用驱动。其发病机制的核心是I型干扰素(IFN-I)以及靶向核酸和核酸结合蛋白的自身抗体。这些介质通常由遗传易感个体中的环境刺激引发,促进持续的免疫激活和慢性炎症。尽管在理解SLE的免疫格局方面取得了进展,但确切的起始触发因素和早期分子事件仍未完全明确。最近的研究强调先天免疫细胞,特别是树突状细胞和单核细胞的不稳定,是SLE发病机制中的关键早期事件。这些改变先于并可能引发自身反应性淋巴细胞的下游激活。本综述提供了关键流行病学发现、新出现的致病机制、潜在治疗靶点以及转化和临床研究进展的最新综合。特别关注对疾病触发因素和早期病理过程的最新见解,尤其是先天免疫细胞的不稳定。通过整合这些进展,本综述旨在完善我们对SLE早期免疫失调的理解,并支持开发更精确的、基于机制的治疗策略。