Title:Autoimmune Responses and Therapeutic Interventions for Systemic
Lupus Erythematosus: A Comprehensive Review
Volume: 24
Issue: 5
Author(s): Surya Prakash Pandey, Rakesh Bhaskar, Sung Soo Han*Kannan Badri Narayanan*
Affiliation:
- School of Chemical Engineering, Yeungnam University, Gyeongsan, 38541, South Korea
- Research Institute of Cell Culture, Yeungnam University, Gyeongsan, Gyeongbuk, 38541, South Korea
- School of Chemical Engineering, Yeungnam University, Gyeongsan, 38541, South Korea
- Research Institute of Cell Culture, Yeungnam University, Gyeongsan, Gyeongbuk, 38541, South Korea
Keywords:
Lupus, autoantibodies, cytokine, immunosuppressants, pathogenesis, rheumatoid arthritis.
Abstract: Systemic Lupus Erythematosus (SLE) or Lupus is a multifactorial autoimmune disease
of multiorgan malfunctioning of extremely heterogeneous and unclear etiology that affects multiple
organs and physiological systems. Some racial groups and women of childbearing age are
more susceptible to SLE pathogenesis. Impressive progress has been made towards a better understanding
of different immune components contributing to SLE pathogenesis. Recent investigations
have uncovered the detailed mechanisms of inflammatory responses and organ damage. Various
environmental factors, pathogens, and toxicants, including ultraviolet light, drugs, viral pathogens,
gut microbiome metabolites, and sex hormones trigger the onset of SLE pathogenesis in genetically
susceptible individuals and result in the disruption of immune homeostasis of cytokines, macrophages,
T cells, and B cells. Diagnosis and clinical investigations of SLE remain challenging due
to its clinical heterogeneity and hitherto only a few approved antimalarials, glucocorticoids, immunosuppressants,
and some nonsteroidal anti-inflammatory drugs (NSAIDs) are available for
treatment. However, the adverse effects of renal and neuropsychiatric lupus and late diagnosis
make therapy challenging. Additionally, SLE is also linked to an increased risk of cardiovascular
diseases due to inflammatory responses and the risk of infection from immunosuppressive treatment.
Due to the diversity of symptoms and treatment-resistant diseases, SLE management remains
a challenging issue. Nevertheless, the use of next-generation therapeutics with stem cell and
gene therapy may bring better outcomes to SLE treatment in the future. This review highlights the
autoimmune responses as well as potential therapeutic interventions for SLE particularly focusing
on the recent therapeutic advancements and challenges.