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Review
. 2022 May 22;23(10):5804.
doi: 10.3390/ijms23105804.

Bone Involvement in Systemic Lupus Erythematosus

Valeria Rella  1 , Cinzia Rotondo  1 , Alberto Altomare  1 , Francesco Paolo Cantatore  1 , Addolorata Corrado  1
Affiliations
Review

Bone Involvement in Systemic Lupus Erythematosus

Valeria Rella et al. Int J Mol Sci. .

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by a wide variability of clinical manifestations due to the potential involvement of several tissues and internal organs, with a relapsing and remitting course. Dysregulation of innate and adaptive immune systems, due to genetic, hormonal and environmental factors, may be responsible for a broad spectrum of clinical manifestations, affecting quality of life, morbidity and mortality. Bone involvement represents one of the most common cause of morbidity and disability in SLE. Particularly, an increased incidence of osteoporosis, avascular necrosis of bone and osteomyelitis has been observed in SLE patients compared to the general population. Moreover, due to the improvement in diagnosis and therapy, the survival of SLE patient has improved, increasing long-term morbidities, including osteoporosis and related fractures. This review aims to highlight bone manifestations in SLE patients, deepening underlying etiopathogenetic mechanisms, diagnostic tools and available treatment.

Keywords: avascular necrosis; osteomyelitis; osteoporosis; systemic lupus erythematosus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Osteoimmunology: the tight interplay between immune system and bone metabolism in SLE. Immune cells interplay affecting bone metabolism, mainly by means of a proinflammatory cytokine network that impairs the balance between osteoclast and osteoblast function. ACPA: anti-citrullinated protein antibody. Anti-CarbP: anti-carbamylated protein. BMP: bone morphogenetic protein. IFNβ: interferon β. IL-1: interleukin 1. IL-6: interleukin 6. IL-17: interleukin 17. OPG: osteoprotegerin. RANK: receptor activator of nuclear factor-kB. RANKL: receptor activator of nuclear factor-kB ligand. SLE: systemic lupus erythematous. Smad: small mother against decapentaplegic. Th1 cells: T helper 1 cells. Th2 cells: T helper 2 cells. Th17 cells: T helper 17 cells. TNFα: tumor necrosis factor α. Treg cells: T regulatory cells. Wnt: wingless-related integration site. Original figure.
See this image and copyright information in PMC

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