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Targeting of the immune system in systemic lupus erythematosus

Published online by Cambridge University Press:  21 January 2008

Meera Ramanujam
Affiliation:
Feinstein Institute for Medical Research, NS-LIJHS, Manhasset, NY 11030, USA.
Anne Davidson*
Affiliation:
Feinstein Institute for Medical Research, NS-LIJHS, Manhasset, NY 11030, USA.
*
*Corresponding author: Anne Davidson, Feinstein Institute for Medical Research, NS-LIJHS, Autoimmune Laboratory, 350 Community Drive, Manhasset, NY 11030, USA. Tel: +1 516 562 3840; Fax: +1 516 562 2953; E-mail: adavidson1@nshs.edu

Abstract

Systemic lupus erythematosus (SLE) is a complex immune disorder in which loss of tolerance to nucleic acid antigens and other crossreactive antigens is associated with the development of pathogenic autoantibodies that damage target organs, including the skin, joints, brain and kidney. New drugs based on modulation of the immune system are currently being developed for the treatment of SLE. Many of these new therapies do not globally suppress the immune system but target specific activation pathways relevant to SLE pathogenesis. Immune modulation in SLE is complicated by differences in the immune defects between patients and at different disease stages. Since both deficiency and hyperactivity of the immune system can give rise to SLE, the ultimate goal for SLE therapy is to restore homeostasis without affecting protective immune responses to pathogens. Here we review recent immunological advances that have enhanced our understanding of SLE pathogenesis and discuss how they may lead to the development of new treatment regimens.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2008

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References

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Further reading, resources and contacts

A list of current clinical trials in SLE can be found at:

Wiesendanger, M. et al. (2006) Novel therapeutics for systemic lupus erythematosus. Curr Opin Rheumatol 18, 227-235CrossRefGoogle ScholarPubMed
Furie, R. (2006) Abetimus sodium (riquent) for the prevention of nephritic flares in patients with systemic lupus erythematosus. Rheum Dis Clin North Am 32, 149-156CrossRefGoogle ScholarPubMed
Fairhurst, A.M., Wandstrat, A.E. and Wakeland, E.K. (2006) Systemic lupus erythematosus: multiple immunological phenotypes in a complex genetic disease. Adv Immunol 92, 1-69CrossRefGoogle Scholar
Davidson, A. and Aranow, C. (2006) Pathogenesis and treatment of systemic lupus erythematosus nephritis. Curr Opin Rheumatol 18, 468-475Google ScholarPubMed
Wiesendanger, M. et al. (2006) Novel therapeutics for systemic lupus erythematosus. Curr Opin Rheumatol 18, 227-235CrossRefGoogle ScholarPubMed
Furie, R. (2006) Abetimus sodium (riquent) for the prevention of nephritic flares in patients with systemic lupus erythematosus. Rheum Dis Clin North Am 32, 149-156CrossRefGoogle ScholarPubMed
Fairhurst, A.M., Wandstrat, A.E. and Wakeland, E.K. (2006) Systemic lupus erythematosus: multiple immunological phenotypes in a complex genetic disease. Adv Immunol 92, 1-69CrossRefGoogle Scholar
Davidson, A. and Aranow, C. (2006) Pathogenesis and treatment of systemic lupus erythematosus nephritis. Curr Opin Rheumatol 18, 468-475Google ScholarPubMed