Defining Biological Subsets in Systemic Lupus Erythematosus: Progress Toward Personalized Therapy

Author(s)

Sinicato, Nailu Angelica ; Postal, Mariana ; Appenzeller, Simone ; Niewold, Timothy B.

• Document type: Journal article
• Source: PHARMACEUTICAL MEDICINE; v. 31, n. 2, p. 81-88, APR 2017.
• Web of Science Citations: 5

Abstract

Systemic lupus erythematosus (SLE) is a heterogeneous disease with respect to disease severity, response to treatment, and organ damage, the pathogenesis of which includes immunological mechanisms that are driven by both genetic and environmental factors. There are clear differences in the pathogenesis of SLE between patients of different ancestral backgrounds, including differences in genetic risk factors, immunological parameters, and clinical manifestations. Patients with high and low levels of type I interferon (IFN) in circulation represent one major biological subset within SLE, and these two groups of patients are present in all ancestral backgrounds. Genetic factors, autoantibodies, and levels of other cytokines all differ between high and low IFN patients. This distinction has also been important in predicting response to treatment with anti-type I IFN therapies, providing a precedent in SLE for biological subsets predicting treatment response. This review highlights some recent developments in defining biological subsets of SLE based on disease pathophysiology, and we speculate how this improved knowledge of disease heterogeneity will inform our efforts to personalize therapy in this disease. (AU)

• FAPESP's process: 09/06049-6 - Blood and cerebrospinal fluid biomarkers associated with structural and functional central nervous system abnormalities in Systemic lupus erythematosus
• Grantee: Simone Appenzeller
• Support Opportunities: Scholarships in Brazil - Young Researchers
• FAPESP's process: 09/15286-1 - PREVALENCE AND FACTORS ASSOCIATED WITH THE METABOLIC SYNDROME IN YOUNG SYSTEMIC LUPUS ERYTEMATOSUS
• Grantee: Nailú Angélica Sinicato Martin
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 08/02917-0 - Blood and cerebrospinal fluid biomarkers associated with structural and functional central nervous system abnormalities in systemic lupus erythematosus
• Grantee: Simone Appenzeller
• Support Opportunities: Research Grants - Young Investigators Grants