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1.
Autoimmun Rev ; 14(11): 1005-18, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26164648

ABSTRACT

Autoimmune diseases, such as rheumatoid arthritis, multiple sclerosis, autoimmune hepatitis and inflammatory bowel disease, have complex pathogeneses and the factors which cause these disorders are not well understood. But all have in common that they arise from a dysfunction of the immune system, interpreting self components as foreign antigens. Systemic lupus erythematosus (SLE) is one of these complex inflammatory disorders that mainly affects women and can lead to inflammation and severe damage of virtually any tissue and organ. Recently, the application of advanced techniques of genome-wide scanning revealed more genetic information about SLE than previously possible. These case-control or family-based studies have provided evidence that SLE susceptibility is based (with a few exceptions) on an individual accumulation of various risk alleles triggered by environmental factors and also help to explain the discrepancies in SLE susceptibility between different populations or ethnicities. Moreover, during the past years new therapies (autologous stem cell transplantation, B cell depletion) and improved conventional treatment options (corticosteroids, traditional and new immune-suppressants like mycophenolate mofetile) changed the perspective in SLE therapeutic approaches. Thus, this article reviews genetic aspects of this autoimmune disease, summarizes clinical aspects of SLE and provides a general overview of conventional and new therapeutic approaches in SLE.


Subject(s)
Lupus Erythematosus, Systemic/genetics , Lupus Erythematosus, Systemic/immunology , Animals , Genetic Predisposition to Disease , Genome-Wide Association Study , Histocompatibility Antigens/immunology , Humans , Immunosuppressive Agents/therapeutic use , Lupus Erythematosus, Systemic/therapy , Treatment Outcome
2.
Biomed Res Int ; 2013: 759760, 2013.
Article in English | MEDLINE | ID: mdl-24205507

ABSTRACT

Interstitial lung disease (ILD) is a relevant extra-articular manifestation of rheumatoid arthritis (RA) that may occur either in early stages or as a complication of long-standing disease. RA related ILD (RA-ILD) significantly influences the quoad vitam prognosis of these patients. Several histopathological patterns of RA-ILD have been described: usual interstitial pneumonia (UIP) is the most frequent one, followed by nonspecific interstitial pneumonia (NSIP); other patterns are less commonly observed. Several factors have been associated with an increased risk of developing RA-ILD. The genetic background plays a fundamental but not sufficient role; smoking is an independent predictor of ILD, and a correlation with the presence of rheumatoid factor and anti-cyclic citrullinated peptide antibodies has also been reported. Moreover, both exnovo occurrence and progression of ILD have been related to drug therapies that are commonly prescribed in RA, such as methotrexate, leflunomide, anti-TNF alpha agents, and rituximab. A greater understanding of the disease process is necessary in order to improve the therapeutic approach to ILD and RA itself and to reduce the burden of this severe extra-articular manifestation.


Subject(s)
Arthritis, Rheumatoid , Lung Diseases, Interstitial , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/drug therapy , Arthritis, Rheumatoid/genetics , Arthritis, Rheumatoid/metabolism , Arthritis, Rheumatoid/physiopathology , Female , Genetic Predisposition to Disease , Humans , Lung Diseases, Interstitial/drug therapy , Lung Diseases, Interstitial/etiology , Lung Diseases, Interstitial/genetics , Lung Diseases, Interstitial/metabolism , Lung Diseases, Interstitial/physiopathology , Male , Risk Factors , Smoking/adverse effects , Smoking/genetics
3.
G Ital Nefrol ; 30(4)2013.
Article in Italian | MEDLINE | ID: mdl-24403199

ABSTRACT

Systemic lupus erythematosus (SLE) is an autoimmune condition with a wide range of manifestations. Among the various targets of the disease, the kidney holds a very important place. In fact, renal involvement is one of the most important and frequent features of the disease, deeply affecting a patient's prognosis and influencing the therapeutic approach. In the last few years, some progress has been achieved in terms of both disease classification and treatment. In 2012, the Systemic Lupus International Collaborating Clinics (SLICC) published the new classification criteria for SLE and the American College of Rheumatology established recommendations for the screening, treatment, and management of SLE nephritis. These new points of view derived from the recent evolution of medical knowledge, technology, and practice in the field of SLE in general, and lupus nephritis in particular. Moreover, it is important to remember that SLE still remains a systemic disorder and that a multi-disciplinary approach is the optimal way to manage these patients.


Subject(s)
Lupus Erythematosus, Systemic/classification , Lupus Erythematosus, Systemic/therapy , Lupus Nephritis/therapy , Decision Trees , Humans , Lupus Erythematosus, Systemic/complications , Lupus Nephritis/etiology , Practice Guidelines as Topic
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