Precision medicine in systemic lupus erythematosus.

Autor: Fasano S; Rheumatology Unit, Department of Precision Medicine, Università Degli Studi Della Campania 'Luigi Vanvitelli', Naples, Italy. serena.fasano@unicampania.it., Milone A; Rheumatology Unit, Department of Precision Medicine, Università Degli Studi Della Campania 'Luigi Vanvitelli', Naples, Italy., Nicoletti GF; Multidisciplinary Department of Medical-Surgical and Dental Specialties, Università Degli Studi Della Campania 'Luigi Vanvitelli', Naples, Italy., Isenberg DA; Department of Rheumatology, Division of Medicine, University College London, London, UK., Ciccia F; Rheumatology Unit, Department of Precision Medicine, Università Degli Studi Della Campania 'Luigi Vanvitelli', Naples, Italy. Francesco.ciccia@unicampania.it.
Jazyk: angličtina
Zdroj: Nature reviews. Rheumatology [Nat Rev Rheumatol] 2023 Jun; Vol. 19 (6), pp. 331-342. Date of Electronic Publication: 2023 Apr 11.
DOI: 10.1038/s41584-023-00948-y
Abstrakt: Systemic lupus erythematosus (SLE) is an autoimmune disease that has diverse clinical manifestations, ranging from restricted cutaneous involvement to life-threatening systemic organ involvement. The heterogeneity of pathomechanisms that lead to SLE contributes to between-patient variation in clinical phenotype and treatment response. Ongoing efforts to dissect cellular and molecular heterogeneity in SLE could facilitate the future development of stratified treatment recommendations and precision medicine, which is a considerable challenge for SLE. In particular, some genes involved in the clinical heterogeneity of SLE and some phenotype-related loci (STAT4, IRF5, PDGF genes, HAS2, ITGAM and SLC5A11) have an association with clinical features of the disease. An important part is also played by epigenetic varation (in DNA methylation, histone modifications and microRNAs) that influences gene expression and affects cell function without modifying the genome sequence. Immune profiling can help to identify an individual's specific response to a therapy and can potentially predict outcomes, using techniques such as flow cytometry, mass cytometry, transcriptomics, microarray analysis and single-cell RNA sequencing. Furthermore, the identification of novel serum and urinary biomarkers would enable the stratification of patients according to predictions of long-term outcomes and assessments of potential response to therapy.
(© 2023. Springer Nature Limited.)
Databáze: MEDLINE
Externí odkaz: