Cutaneous and systemic connections in lupus.
Cutaneous and systemic connections in lupus.
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DOI：
10.1097/bor.0000000000000739
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发表时间：
2020-11
影响因子：
5.1
通讯作者：
Michelle Kahlenberg J
中科院分区：
文献类型：
--
作者：
Maz MP;Michelle Kahlenberg J
系统性红斑狼疮（SLE）是一种全身性自身免疫性疾病，具有多种表现，大多数SLE患者有皮肤受累。尽管正在进行的研究，SLE和皮肤红斑狼疮（CLE）的发病机制之间的关系仍然未知。本文就SLE和CLE的病因和发病机制作一综述。最近，免疫细胞群参与SLE和CLE发病机制的机制受到质疑。研究指出，过渡性B细胞和BAFF信号传导是SLE和CLE的潜在驱动因素，贝利木单抗的临床数据支持这些假设。Ustekinumab试验和一个令人兴奋的Treg过继转移SLE患者皮肤疾病表明T细胞靶向治疗的作用。中性粒细胞NET可能是SLE自身抗原来源的理论仍有争议，而中性粒细胞已被认为是皮肤疾病的早期驱动因素。最后，浆细胞样树突状细胞（pDC）已被研究为SLE的潜在治疗靶点，抗BDCA抗体的临床试验已显示出治疗皮肤疾病的前景。虽然最近的研究结果有助于了解SLE和CLE的发病机制，这些疾病之间的机制联系仍然是一个需要进一步研究的领域。
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with multiple manifestations, with a majority of SLE patients having cutaneous involvement. Despite ongoing research, the relationship between SLE and cutaneous lupus erythematosus (CLE) pathogeneses remains unknown. This review will compare advances in understanding the etiology and pathogenesis of SLE and CLE. Recently, mechanisms by which immune cell populations contribute to the pathogenesis of SLE and CLE have been queried. Studies have pointed to transitional B cells and BAFF signaling as potential drivers of SLE and CLE, with belimumab clinical data supporting these hypotheses. Ustekinumab trials and an exciting Treg adoptive transfer in an SLE patient with cutaneous disease have suggested a role for T cell-targeted therapies. The theory that neutrophil NETs may be a source of autoantigens in SLE remains controversial, while neutrophils have been suggested as early drivers of cutaneous disease. Finally, plasmacytoid dendritic cells (pDCs) have been studied as a potential therapeutic target in SLE, and anti-BDCA antibody clinical trials have shown promise in treating cutaneous disease. While recent findings have contributed to understanding SLE and CLE pathogenesis, the mechanistic link between these diseases remains an area requiring further research.