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哲学性且独特的系统性红斑狼疮缩影:与证据相冲突的教条以及既定病理生理模型之间的认知失调。

Philosophical and distinct SLE epitomes: dogmas in conflict with evidences and an intellectual dissonance between established pathophysiological models.

作者信息

Rekvig Ole Petter

机构信息

Section for autoimmunity, Fürst Medical Laboratory, Oslo, Norway.

Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.

出版信息

Front Immunol. 2025 Jul 24;16:1580664. doi: 10.3389/fimmu.2025.1580664. eCollection 2025.

Abstract

This study centers around dogmas, their identifications and definitions, and their impact on our understanding of what Systemic lupus erythematosus (SLE) is. A focus is centered on description of how we investigate this enigmatic syndrome, and how we try to describe processual elements that can be targeted by experimental therapy modalities. Mostly, this study deals with definitions and critical insight into how dogmas hinder our understanding of SLE. When we start to investigate apparently convincing statements related to SLE, it is surprising how many of them are uncovered as authoritative, but not founded by concrete evidence! This problem refers to a definition of a dogma: For example, several central statements/criteria are revealed as dogmas that challenge our insight into SLE as a complex syndrome. Critical in this context is the immense impact of "SLE classification criteria" versions in relation to evidence-based basic SLE processes. The SLE classification criteria will, as described in this study, most probably not identify SLE as "a one disease entity," but more likely as a "poly-causal, poly-etiological, and poly-phenotypic "theoretical template SLE," "SLE-like," or "SLE-like non-SLE" syndromes. This is problematic as SLE may, in context of definitions described here, not be rationally structured by classification criteria. This prevents SLE cohorts from being suitable and ideal as study objects aimed to investigate experimental therapy modalities, genetics, etiology, and pathophysiology. However, this pessimistic view may turn into optimism if dogmas described in this study are identified and subjected to causal studies based on critical hypotheses. Today's interpretative use of SLE classification criteria tentatively maintains a narrative that describes scientific studies of the SLE syndrome as not optimal and not ideal.

摘要

本研究围绕教条、它们的识别与定义以及它们对我们理解系统性红斑狼疮(SLE)的影响展开。重点在于描述我们如何研究这一神秘综合征,以及我们如何试图描述可被实验性治疗方式靶向的过程性要素。总体而言,本研究探讨了教条的定义以及对其如何阻碍我们对SLE理解的批判性见解。当我们开始研究与SLE相关的看似令人信服的陈述时,令人惊讶的是,其中有多少被发现是权威性的,但却没有具体证据支持!这个问题涉及到教条的定义:例如,一些核心陈述/标准被揭示为教条,它们挑战了我们对SLE作为一种复杂综合征的理解。在这种情况下,“SLE分类标准”版本相对于基于证据的SLE基本过程的巨大影响至关重要。正如本研究中所描述的,SLE分类标准很可能不会将SLE识别为“单一疾病实体”,而更可能是“多因果、多病因和多表型的”理论模板SLE、“SLE样”或“SLE样非SLE”综合征。这是个问题,因为按照这里所描述的定义,SLE可能无法通过分类标准进行合理构建。这使得SLE队列不适宜且不理想作为旨在研究实验性治疗方式、遗传学、病因学和病理生理学的研究对象。然而,如果本研究中描述的教条能够被识别并基于关键假设进行因果研究,这种悲观观点可能会转变为乐观。当今对SLE分类标准的解释性使用暂时维持了一种说法,即描述对SLE综合征的科学研究并非最优且不理想。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/12328356/ccd013026277/fimmu-16-1580664-g001.jpg

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