Mechanisms of disease for the clinician: systemic lupus erythematosus

Abstract

Objective: To review the complex interactions and processes in systemic lupus erythematosus (SLE).

Data sources: Brief review of the important literature in peer-reviewed journals.

Study selection: Studies on the clinical and immunologic features, pathogenesis, epidemiology, laboratory evaluation, and treatment of SLE are included in this review.

Results: SLE may include a variety of disease entities, such as isolated cutaneous lupus, undifferentiated connective tissue disease, mixed connective tissue disease, and drug-induced lupus. There are many ongoing clinical trials in SLE patients of therapeutics with different mechanisms of cellular action, such as classic immunosuppression, cell depletion, antigen-specific immunomodulation, and targeting of antigen-nonspecific, immune-activating molecules. New immune cell-targeted therapies are now available that are specifically designed to block cellular pathways involved in disease pathogenesis.

Conclusion: The practicing physician should understand the immunology, pathogenesis, laboratory evaluation, and updated treatment options when diagnosing SLE in their clinic or daily practice.