title: The use of glucocorticoids in systemic lupus erythematosus. After 60 years still more an art than science.
abstract: Systemic Lupus Erythematosus (SLE) is a clinically diverse, chronic autoimmune disease with inflammation in several organ systems. Its pathogenesis is complex, but includes many factors that can be influenced by glucocorticoids (GCs). Indeed, GCs constitute the corner-stone in SLE-treatment. However, guidelines for GC-treatment of the different disease manifestations are lacking and not every patient responds (sufficiently). The focus of this systematic review is to evaluate the differential glucocorticoid treatment of various SLE manifestations. In addition, some relevant mechanisms of glucocorticoid action as well as resistance are discussed.
authors.affiliation: Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, The Netherlands. r.luijten@umcutrecht.nl
authors.forename: Remco K M A C
authors.initials: RK
authors.lastname: Luijten
authors.forename: Ruth D
authors.initials: RD
authors.lastname: Fritsch-Stork
authors.forename: Johannes W J
authors.initials: JW
authors.lastname: Bijlsma
authors.forename: Ronald H W M
authors.initials: RH
authors.lastname: Derksen
mesh_terms: D056704:Adaptive Immunity / Q000187:drug effects; D001323:Autoantibodies / Q000096:biosynthesis / Q000502:physiology; D001324:Autoantigens / Q000276:immunology; D004361:Drug Tolerance / Q000276:immunology; D005938:Glucocorticoids / Q000008:administration & dosage / Q000592:standards* / Q000627:therapeutic use*; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D007113:Immunity, Innate / Q000187:drug effects; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D017634:Self Tolerance / Q000187:drug effects
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D005938:Glucocorticoids