Systemic lupus erythematosus (SLE) is a complex autoimmune disease that can affect virtually any organ in the body. The disease course and prognosis can vary widely from patient to patient, making diagnosis and treatment challenging. Symptoms can be mild or severe and can involve one or multiple organ systems, and may change over time. Common manifestations of SLE include skin rashes, joint pain and swelling, inflammation of the lining of the lungs or heart, hair loss, and kidney disease.
The immune dysregulation that underlies SLE is complex and multifactorial, involving intricate interactions between the innate and adaptive immune systems. This results in the upregulation of cytokines, complement activation, and the deposition of immune complexes, ultimately leading to inflammation and tissue damage.
Diagnostic tools and classification criteria are available to help clinicians diagnose SLE, but the disease remains challenging to manage. Response to treatment can be unpredictable and varies between patients, making it difficult to achieve disease control. Standard treatments for SLE have traditionally included chronic steroid use and high-dose chemotherapy, but in recent years, targeted biologic therapies have been developed and have significantly improved disease control and mortality rates.
Non-pharmacologic interventions such as lifestyle modifications and physical therapy can also be helpful in managing symptoms and improving quality of life for patients with SLE. However, there are still significant challenges that need to be addressed, including healthcare disparities, systemic racism, and lack of access to newer, more effective medications for some patients.
Moving forward, effective management of SLE will require a multifaceted approach that takes into account both precision therapies and social determinants of health. By improving access to effective treatments and addressing systemic issues that impact patient outcomes, we can make a meaningful difference in the lives of those living with SLE.
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Sources: Lazar, Stephanie, and J. Michelle Kahlenberg. “Systemic lupus erythematosus: new diagnostic and therapeutic approaches.” Annual Review of Medicine 74 (2023): 339-352.
