Recent developments in systemic lupus erythematosus pathogenesis and applications for therapy

Abstract

Purpose of review: Systemic lupus erythematosus (SLE) pathogenesis is complex. Aberrancies of immune function that previously were described but not well understood are now becoming better characterized, in part through recognition of monogenic cases of lupus-like disease.

Recent findings: We highlight here recent descriptions of metabolic dysfunction, cytokine dysregulation, signaling defects, and DNA damage pathways in SLE. Specifically, we review the effects of signaling abnormalities in mammalian target of rapamycin, Rho kinase, Bruton's tyrosine kinase, and Ras pathways. The importance of DNA damage sensing and repair pathways, and their influence on the overproduction of type I interferon in SLE are also reviewed.

Summary: Recent findings in SLE pathogenesis expand on previous understandings of broad immune dysfunction. These findings have clinical applications, as the dysregulated pathways described here can be targeted by existing and preclinical therapies.

Figure

Schematic of immune abnormalities known to contribute to SLE pathophysiology. This diagram greatly underestimates the complexity of interactions that are dysregulated in SLE in order to highlight recent findings described here.