title: Genetics and novel aspects of therapies in systemic lupus erythematosus.
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.
authors.affiliation: First Department of Medicine, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany.
authors.forename: Manfred
authors.initials: M
authors.lastname: Relle
authors.affiliation: First Department of Medicine, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Weinmann-Menke
authors.affiliation: Division of Rheumatology, IRCCS Fondazione Policlinico San Matteo, Lombardy, Pavia, Italy.
authors.forename: Eva
authors.initials: E
authors.lastname: Scorletti
authors.affiliation: Division of Rheumatology, IRCCS Fondazione Policlinico San Matteo, Lombardy, Pavia, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cavagna
authors.affiliation: First Department of Medicine, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany; Acura Centre of Rheumatology Rhineland-Palatinate, Bad Kreuznach, Germany. Electronic address: schwarting@uni-mainz.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schwarting
mesh_terms: D000818:Animals; D020022:Genetic Predisposition to Disease; D055106:Genome-Wide Association Study; D006649:Histocompatibility Antigens / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000235:genetics* / Q000276:immunology* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D006649:Histocompatibility Antigens; D007166:Immunosuppressive Agents
keywords: Environmental factors; Epistasis; GWAS; Genetics; Interferon signature; Systemic lupus erythematosus