Comprehensive Insights into Neuropsychiatric Systemic Lupus Erythematosus
Diagnostic Advances and Therapeutic Approaches
DOI:
https://doi.org/10.12775/QS.2024.18.53423Keywords
Neuropsychiatric systemic lupus erythematosus, cognitive dysfunction, antinuclear antibodiesAbstract
Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, often affecting women of childbearing age, with periods of exacerbations and remissions. SLE can impact multiple organs, causing a range of clinical symptoms. Neuropsychiatric systemic lupus erythematosus (NPSLE) includes symptoms like headaches, seizures, anxiety disorders, cognitive dysfunctions, psychosis, and neuropathies. Its diagnosis is challenging, and treatment is complex.
Purpose: This study aims to explain the pathophysiology of NPSLE, describe diagnostic methods, and summarize current treatment methods based on recent research.
Methods: Databases such as PubMed, Medline, and ResearchGate were used.
State of current knowledge: Early and accurate diagnosis of SLE is crucial for optimal patient management. The 2019 EULAR/ACR classification criteria have improved diagnostic precision with a weighted scoring system for diverse disease manifestations. Therapy of neuropsychiatric lupus focuses on symptom control and causal treatment, considering anti-inflammatory action or counteracting ischemic incidents. It involves immunosuppressive agents and antiplatelet or anticoagulant substances. Non-pharmacological interventions and lifestyle modifications are also important. The dynamic criteria reflect ongoing advancements in understanding SLE, emphasizing continuous research and collaboration.
Conclusions: The diagnosis of NPSLE requires excluding other causes of neuropsychiatric symptoms, such as infections, endocrine disorders, or drug reactions. Diagnostic methods vary based on symptoms, including lumbar puncture, CSF analysis, EEG, cognitive function assessment, and MRI. The treatment of NPSLE focuses on symptom control and causal treatment, with therapy individualized based on symptom severity and patient burden.
References
Maidhof W, Hilas O. Lupus: an overview of the disease and management options. P T. 2012 Apr;37(4):240-9. PMID: 22593636; PMCID: PMC3351863.
Alhammadi NA, Alqahtani H, Al Hamdan SA, Al Hamdan JA, Hadhir Alalyani RT, Asiri SAA, Alqahtani RS, Aljari AAM, Asiri GBM. Dermatological Manifestation of SLE Patients, Living in Aseer Region. J Family Med Prim Care. 2024 Apr;13(4):1249-1253. doi: 10.4103/jfmpc.jfmpc_1234_23. Epub 2024 Apr 22. PMID: 38827701; PMCID: PMC11142007.
Kosałka-Węgiel J, Dziedzic R, Siwiec-Koźlik A, Spałkowska M, Milewski M, Żuk-Kuwik J, Zaręba L, Bazan-Socha S, Korkosz M. Clinical and laboratory characteristics of early-onset and delayed-onset lupus nephritis patients: A single-center retrospective study. Rheumatol Int. 2024 Jul;44(7):1283-1294. doi: 10.1007/s00296-024-05579-4. Epub 2024 Mar 28. PMID: 38546745; PMCID: PMC11178551.
Justiz-Vaillant AA, Gopaul D, Soodeen S, Arozarena-Fundora R, Barbosa OA, Unakal C, Thompson R, Pandit B, Umakanthan S, Akpaka PE. Neuropsychiatric Systemic Lupus Erythematosus: Molecules Involved in Its Imunopathogenesis, Clinical Features, and Treatment. Molecules. 2024 Feb 6;29(4):747. doi: 10.3390/molecules29040747. PMID: 38398500; PMCID: PMC10892692.
Barbhaiya M, Costenbader KH. Environmental exposures and the development of systemic lupus erythematosus. Curr Opin Rheumatol. 2016 Sep;28(5):497-505. doi: 10.1097/BOR.0000000000000318. PMID: 27428889; PMCID: PMC4965307.
Liu Y, Tu Z, Zhang X, Du K, Xie Z, Lin Z. Pathogenesis and treatment of neuropsychiatric systemic lupus erythematosus: A review. Front Cell Dev Biol. 2022 Sep 5;10:998328. doi: 10.3389/fcell.2022.998328. PMID: 36133921; PMCID: PMC9484581.
Wang X, Ma L, Luo Y, Yang Y, Upreti B, Cheng Y, Cui R, Liu S, Xu J. Increasing of Blood Brain Barrier Permeability and the Association With Depression and Anxiety in Systemic Lupus Erythematosus Patients. Front Med (Lausanne). 2022 Mar 29;9:852835. doi: 10.3389/fmed.2022.852835. PMID: 35425773; PMCID: PMC9001971.
Sato S, Temmoku J, Fujita Y, Yashiro-Furuya M, Matsuoka N, Asano T, Kobayashi H, Watanabe H, Migita K. Autoantibodies associated with neuropsychiatric systemic lupus erythematosus: the quest for symptom-specific biomarkers. Fukushima J Med Sci. 2020 Apr 22;66(1):1-9. doi: 10.5387/fms.2020-02. Epub 2020 Mar 13. PMID: 32173681; PMCID: PMC7269884.
Matus S, Burgos PV, Bravo-Zehnder M, Kraft R, Porras OH, Farías P, Barros LF, Torrealba F, Massardo L, Jacobelli S, González A. Antiribosomal-P autoantibodies from psychiatric lupus target a novel neuronal surface protein causing calcium influx and apoptosis. J Exp Med. 2007 Dec 24;204(13):3221-34. doi: 10.1084/jem.20071285. Epub 2007 Dec 3. PMID: 18056288; PMCID: PMC2150977.
Sun J, Li X, Zhou H, Liu X, Jia J, Xie Q, Peng S, Sun X, Wang Q, Yi L. Anti-GAPDH Autoantibody Is Associated with Increased Disease Activity and Intracranial Pressure in Systemic Lupus Erythematosus. J Immunol Res. 2019 Mar 31;2019:7430780. doi: 10.1155/2019/7430780. PMID: 31049359; PMCID: PMC6462327.
Guo Y, Li X, Li R, Li Y, Wang Z, Liu H, Cao S, Li R, Zhao Y, Wang Q, Sun X. Utility of autoantibody against an UCH-L1 epitope as a serum diagnostic marker for neuropsychiatric systemic lupus erythematosus. Clin Exp Rheumatol. 2022 Nov;40(11):2078-2087. doi: 10.55563/clinexprheumatol/0bjstd. Epub 2022 Jan 25. PMID: 35084329.
Hirohata S, Kikuchi H. Role of Serum IL-6 in Neuropsychiatric Systemic lupus Erythematosus. ACR Open Rheumatol. 2021 Jan;3(1):42-49. doi: 10.1002/acr2.11217. Epub 2021 Jan 3. PMID: 33393227; PMCID: PMC7811696.
Santer DM, Yoshio T, Minota S, Möller T, Elkon KB. Potent induction of IFN-alpha and chemokines by autoantibodies in the cerebrospinal fluid of patients with neuropsychiatric lupus. J Immunol. 2009 Jan 15;182(2):1192-201. doi: 10.4049/jimmunol.182.2.1192. PMID: 19124763; PMCID: PMC2745922.
Fanouriakis A, Tziolos N, Bertsias G, Boumpas DT. Update on the diagnosis and management of systemic lupus erythematosus. Ann Rheum Dis. 2021 Jan;80(1):14-25. doi: 10.1136/annrheumdis-2020-218272. Epub 2020 Oct 13. PMID: 33051219.
Rahman A, Isenberg DA. Systemic lupus erythematosus. N Engl J Med. 2008 Feb 28;358(9):929-39. doi: 10.1056/NEJMra071297. PMID: 18305268.
Aggarwal, R., Ringold, S., Khanna, D., Neogi, T., Johnson, S. R., Miller, A., Brunner, H. I., Ogawa, R., Felson, D., Ogdie, A., Aletaha, D., & Feldman, B. M. (2015). Distinctions Between Diagnostic and Classification Criteria? Arthritis Care & Research, 67(7), 891. https://doi.org/10.1002/acr.22583.
Ines L, Silva C, Galindo M, Lopez-Longo FJ, Terroso G, Romao VC et al. Classification of Systemic Lupus Erythematosus: Systemic Lupus International Collaborating Clinics Versus American College of Rheumatology Criteria. A Comparative Study of 2,055 Patients From a Real-Life, International Systemic Lupus Erythematosus Cohort. Arthritis Care Res (Hoboken ) 2015; 67: 1180–5.
Andrade RM, Alarcon GS, Gonzalez LA, Fernandez M, Apte M, Vila LM, et al. Seizures in patients with systemic lupus erythematosus: data from LUMINA, a multiethnic cohort (LUMINA LIV) Ann Rheum Dis. 2008;67(6):829-834.
Sarwar S, Mohamed AS, Rogers S, Sarmast ST, Kataria S, Mohamed KH, Khalid MZ, Saeeduddin MO, Shiza ST, Ahmad S, Awais A, Singh R. Neuropsychiatric Systemic Lupus Erythematosus: A 2021 Update on Diagnosis, Management, and Current Challenges. Cureus. 2021 Sep 14;13(9). doi: 10.7759/cureus.17969. PMID: 34667659; PMCID: PMC8516357.
The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis & Rheumatism, 42: 599-608. https://doi.org/10.1002/1529-0131(199904)42:4<599::AID-ANR2>3.0.CO;2-F
Carrión-Barberà I, Salman-Monte TC, Vílchez-Oya F, Monfort J. Neuropsychiatric involvement in systemic lupus erythematosus: A review. Autoimmun Rev. 2021 Apr;20(4):102780. doi: 10.1016/j.autrev.2021.102780. Epub 2021 Feb 18. PMID: 33609799.
Bertsias GK, Ioannidis JP, Aringer M, Bollen E, Bombardieri S, Bruce IN, Cervera R, Dalakas M, Doria A, Hanly JG, Huizinga TW, Isenberg D, Kallenberg C, Piette JC, Schneider M, Scolding N, Smolen J, Stara A, Tassiulas I, Tektonidou M, Tincani A, van Buchem MA, van Vollenhoven R, Ward M, Gordon C, Boumpas DT. EULAR recommendations for the management of systemic lupus erythematosus with neuropsychiatric manifestations: report of a task force of the EULAR standing committee for clinical affairs. Ann Rheum Dis. 2010 Dec;69(12):2074-82. doi: 10.1136/ard.2010.130476. Epub 2010 Aug 19. PMID: 20724309.
Zirkzee EJ, Steup-Beekman GM, van der Mast RC, Bollen EL, van der Wee NJ, Baptist E, et al. Prospective study of clinical phenotypes in neuropsychiatric systemic lupus erythematosus; multidisciplinary approach to diagnosis and therapy. J Rheumatol. 2012;39(11):2118–2126. PMID: 22766025.
Magro-Checa C, Zirkzee EJ, Huizinga TW, Steup-Beekman GM. Management of Neuropsychiatric Systemic Lupus Erythematosus: Current Approaches and Future Perspectives. Drugs. 2016 Mar;76(4):459-83. doi: 10.1007/s40265-015-0534-3. PMID: 26809245; PMCID: PMC4791452.
Liu CC, Ahearn JM. The search for lupus biomarkers. Best Pract Res Clin Rheumatol. 2009 Aug;23(4):507-23. doi: 10.1016/j.berh.2009.01.008. PMID: 19591781; PMCID: PMC2727983.
Wang M., Wang Z., Zhang S., Wu Y., Zhang L., Zhao J., Wang Q., Tian X., Li M., Zeng X. Progress in the Pathogenesis and Treatment of Neuropsychiatric Systemic Lupus Erythematosus. J. Clin. Med. Res. 2022;11:4955. doi: 10.3390/jcm11174955.
Hanly JG, Urowitz MB, Su L, Gordon C, Bae SC, Sanchez-Guerrero J, et al. Seizure disorders in systemic lupus erythematosus results from an international, prospective, inception cohort study. Ann Rheum Dis. 2012;71(9):1502–1509. doi: 10.1136/annrheumdis-2011-200957. PMID: 22492779.
Sahoo S, Kumar M, Sinha VK. Chloroquine-induced recurrent psychosis. Am J Ther. 2007;14(4):406-407. doi: 10.1097/MJT.0b013e31802e4b0e. PMID: 17667208.
Luijckx GJ, De Krom MC, Takx-Kohlen BC. Does chloroquine cause seizures? Presentation of three new cases and a review of the literature. Seizure. 1992;1(3):183-185. doi: 10.1016/1059-1311(92)90044-6. PMID: 1343777.
Govoni M., Hanly J.G. The Management of Neuropsychiatric Lupus in the 21st Century: Still so Many Unmet Needs? Rheumatology. 2020;59. doi: 10.1093/rheumatology/keaa404.
Mak A., Ho R.C.M., Lau C.S. Clinical Implications of Neuropsychiatric Systemic Lupus Erythematosus. Adv. Psychiatr. Treat. 2009;15:451-458. Mak A., Ho R.C.M., Lau C.S. Clinical Implications of Neuropsychiatric Systemic Lupus Erythematosus. Adv. Psychiatr. Treat. 2009;15:451-458.
Pamfil C., Fanouriakis A., Damian L., Rinzis M., Sidiropoulos P., Tsivgoulis G., Rednic S., Bertsias G., Boumpas D.T. EULAR Recommendations for Neuropsychiatric Systemic Lupus Erythematosus vs. Usual Care: Results from Two European Centres. Rheumatology. 2015;54:1270-1278. doi: 10.1093/rheumatology/keu482.
Wallace DJ. The history of antimalarials. Lupus. 1996 Jun;5 Suppl 1:S2-3. PMID: 8803902..
Ruiz-Irastorza G., Ramos-Casals M., Brito-Zeron P., Khamashta M.A. Clinical efficacy and side effects of antimalarials in systemic lupus erythematosus: a systematic review. Ann Rheum Dis. 2010;69(1):20-28. doi: 10.1136/ard.2008.101766. PMID: 19103632.
Fessler B.J., Alarcon G.S., McGwin G. Jr, Roseman J., Bastian H.M., Friedman A.W., et al. Systemic lupus erythematosus in three ethnic groups: XVI. Association of hydroxychloroquine use with reduced risk of damage accrual. Arthritis Rheum. 2005;52(5):1473-1480. doi: 10.1002/art.21039. PMID: 15880821.
Parker B., Urowitz M.B., Gladman D.D., Lunt M., Donn R., Bae S.C., et al. Impact of early disease factors on metabolic syndrome in systemic lupus erythematosus: data from an international inception cohort. Ann Rheum Dis. 2015;74(8):1530–1536. doi: 10.1136/annrheumdis-2013-205302. PMID: 24728326.
Wallace D.J., Metzger A.L., Stecher V.J., Turnbull B.A., Kern P.A. Cholesterol-lowering effect of hydroxychloroquine in patients with rheumatic disease: reversal of deleterious effects of steroids on lipids. Am J Med. 1990;89(3):322-326. doi: 10.1016/0002-9343(90)90322-d. PMID: 2401584.
Chen Y.M., Lin C.H., Lan T.H., Chen H.H., Chang S.N., Chen Y.H., et al. Hydroxychloroquine reduces risk of incident diabetes mellitus in lupus patients in a dose-dependent manner: a population-based cohort study. Rheumatology (Oxford). 2015;54(7):1244–1249. doi: 10.1093/rheumatology/keu409. PMID: 25264075.
Jung H., Bobba R., Su J., Shariati-Sarabi Z., Gladman D.D., Urowitz M., et al. The protective effect of antimalarial drugs on thrombovascular events in systemic lupus erythematosus. Arthritis Rheum. 2010;62(3):863-868. doi: 10.1002/art.27347. PMID: 20131247.
Petri M. Thrombosis and systemic lupus erythematosus: the Hopkins Lupus Cohort perspective. Scand J Rheumatol. 1996;25(4):191-193. PMID: 8792794.
Ruiz-Irastorza G, Egurbide MV, Pijoan JI, Garmendia M, Villar I, Martinez-Berriotxoa A, et al. Effect of antimalarials on thrombosis and survival in patients with systemic lupus erythematosus. Lupus. 2006;15(9):577-583. doi: 10.1191/0961203306lu2340xx. PMID: 17080916.
AlKadi HO. Antimalarial drug toxicity: a review. Chemotherapy. 2007;53(6):385-391. doi: 10.1159/000111395. PMID: 18059087.
Reiss AB, Wirkowski E. Role of HMG-CoA reductase inhibitors in neurological disorders: progress to date. Drugs. 2007;67(15):2111–2120. doi: 10.2165/00003495-200767150-00005. PMID: 17850101.
Meroni PL, Luzzana C, Ventura D. Anti-inflammatory and immunomodulating properties of statins. An additional tool for the therapeutic approach of systemic autoimmune diseases? Clin Rev Allergy Immunol. 2002;23(3):263-277. doi: 10.1385/CRIAI:23:3:263. PMID: 12443019.
Petri MA, Kiani AN, Post W, Christopher-Stine L, Magder LS. Lupus Atherosclerosis Prevention Study (LAPS). Ann Rheum Dis. 2011;70(5):760-765. doi: 10.1136/ard.2010.140426. PMID: 21345816.
Schanberg LE, Sandborg C, Barnhart HX, Ardoin SP, Yow E, Evans GW, et al. Use of atorvastatin in systemic lupus erythematosus in children and adolescents. Arthritis Rheum. 2012;64(1):285-296. doi: 10.1002/art.33317. PMID: 21904957.
Knight JS, Kaplan MJ. Cardiovascular disease in lupus: insights and updates. Curr Opin Rheumatol. 2013;25(5):597-605. doi: 10.1097/BOR.0b013e328363eb5c. PMID: 23872576.
Cain DW, Cidlowski JA. Immune Regulation by Glucocorticoids. Nat Rev Immunol. 2017;17:233-247. doi: 10.1038/nri.2017.1. PMID: 28196798.
Ahluwalia A. Topical Glucocorticoids and the Skin-Mechanisms of Action: An Update. Mediat Inflamm. 1998;7:183-193. doi: 10.1080/09629359891126. PMID: 18475825.
Monahan RC, Beaart-van de Voorde LJ, Fronczek R, de Bresser J, Eikenboom J, Kloppenburg M, Middelkoop HA, Terwindt GM, van der Wee NJ, Huizinga TW, et al. Clinical Outcome in Patients with Suspected Inflammatory Neuropsychiatric Lupus Treated with Immunosuppression: An Observational Cohort Study. Lupus Sci Med. 2023;10. doi: 10.1136/lupus-2022-000850.
Schacke H, Docke WD, Asadullah K. Mechanisms involved in the side effects of glucocorticoids. Pharmacol Ther. 2002;96(1):23-43. doi: 10.1016/S0163-7258(02)00297-8. PMID: 12441178.
Chau SY, Mok CC. Factors predictive of corticosteroid psychosis in patients with systemic lupus erythematosus. Neurology. 2003;61(1):104-107. doi: 10.1212/01.wnl.0000069927.94747.60. PMID: 12847160.
Zhang L, Shi Y, Zhang J, Wu J, Jiang W. Cyclophosphamide-Induced Seizures in a Patient with Neuropsychiatric Systemic Lupus Erythematosus (NPSLE): A Case Report. Front Immunol. 2023;14:1122629. doi: 10.3389/fimmu.2023.1122629. PMID: 37274908.
Xiong A, Cui H, Deng R, Wei X. Cyclophosphamide in the Treatment of Systemic Lupus Erythematosus-Related Guillain-Barré Syndrome: A Systematic Review of Case Reports. J Neuroimmune Pharmacol. 2023;18:285-293. doi: 10.1007/s11481-023-10075-w. PMID: 37067288.
DiPiero J, Teng K, Hicks JK (2015). Should thiopurine methyltransferase (TPMT) activity be determined before prescribing azathioprine, mercaptopurine, or thioguanine? Cleve Clin J Med, 82(7), 409-413. doi: 10.3949/ccjm.82a.14106, PMID: 26185939.
Sanna G, Bertolaccini ML, Khamashta MA (2008). Neuropsychiatric Involvement in Systemic Lupus Erythematosus: Current Therapeutic Approach. Curr Pharm Des, 14, 1261-1269. doi: 10.2174/138161208799316401.
Sharon E, Kaplan D, Diamond HS (1973). Exacerbation of systemic lupus erythematosus after withdrawal of azathioprine therapy. N Engl J Med, 288(3), 122-124.
Fanouriakis A, Kostopoulou M, Andersen J, et al. (2023). [Title not provided]. Ann Rheum Dis Epub ahead of print. doi: 10.1136/ard-2023-224762.
Oelzner P, Abendroth K, Hein G, Stein G (1996). Predictors of flares and long-term outcome of systemic lupus erythematosus during combined treatment with azathioprine and low-dose prednisolone. Rheumatol Int, 16(4), 133-139.
Allison AC (2005). Mechanisms of action of mycophenolate mofetil. Lupus, 14(Suppl 1), s2-s8.
Pisoni CN, Sanchez FJ, Karim Y, Cuadrado MJ, D'Cruz DP, Abbs IC, et al. (2005). Mycophenolate mofetil in systemic lupus erythematosus: efficacy and tolerability in 86 patients. J Rheumatol, 32(6), 1047-1052.
Jones RB, Hiemstra TF, Ballarin J, Blockmans DE, Brogan P, Bruchfeld A, Cid MC, Dahlsveen K, de Zoysa J, Espigol-Frigolé G, et al. (2019). Mycophenolate Mofetil versus Cyclophosphamide for Remission Induction in ANCA-Associated Vasculitis: A Randomised, Non-Inferiority Trial. Ann Rheum Dis, 78, 399-405. doi: 10.1136/annrheumdis-2018-214245.
Valesini G, Priori R, Francia A, Balestrieri G, Tincani A, Airo P, et al. (1994). Central nervous system involvement in systemic lupus erythematosus: a new therapeutic approach with intrathecal dexamethasone and methotrexate. Springer Semin Immunopathol, 16(2-3), 313-321.
Zhou HQ, Zhang FC, Tian XP, Leng XM, Lu JJ, Zhao Y, et al. (2008). Clinical features and outcome of neuropsychiatric lupus in Chinese: analysis of 240 hospitalized patients. Lupus, 17(2), 93-99.
Faulds D, Goa KL, Benfield P (1993). Cyclosporin. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in immunoregulatory disorders. Drugs, 45(6), 953-1040.
Yang M, Li M, He W, Wang B, Gu Y (2014). Calcineurin inhibitors may be a reasonable alternative to cyclophosphamide in the induction treatment of active lupus nephritis: a systematic review and meta-analysis. Exp Ther Med, 7(6), 1663-1670.
Bambauer R, Schwarze U, Schiel R (2000). Cyclosporin A and therapeutic plasma exchange in the treatment of severe systemic lupus erythematosus. Artif Organs, 24(11), 852-856.
Anolik JH, Barnard J, Cappione A, Pugh-Bernard AE, Felgar RE, Looney RJ, Sanz I (2004). Rituximab Improves Peripheral B Cell Abnormalities in Human Systemic Lupus Erythematosus. Arthritis Rheum, 50, 3580-3590. doi: 10.1002/art.20592.
Parodis I, Gomez A, Frodlund M, Jönsen A, Zickert A, Sjöwall C, Bengtsson AA, Gunnarsson I (2018). Smoking Reduces the Efficacy of Belimumab in Mucocutaneous Lupus. Expert Opin Biol Ther, 18, 911-920. doi: 10.1080/14712598.2018.1494719.
Guo X, Higgs BW, Bay-Jensen AC, Karsdal MA, Yao Y, Roskos LK, White WI (2015). Suppression of T Cell Activation and Collagen Accumulation by an Anti-IFNAR1 mAb, Anifrolumab, in Adult Patients with Systemic Sclerosis. J Investig Dermatol, 135, 2402-2409. doi: 10.1038/jid.2015.188.
Tuhrim S, Rand JH, Wu XX, Weinberger J, Horowitz DR, Goldman ME, et al. (1999). Elevated anticardiolipin antibody titer is a stroke risk factor in a multiethnic population independent of isotype or degree of positivity. Stroke, 30(8), 1561-1565.
D'Cruz DP, Mellor-Pita S, Joven B, Sanna G, Allanson J, Taylor J, et al. (2007). Transverse myelitis as the first manifestation of systemic lupus erythematosus. Lupus, 16(6), 436-438. doi: 10.1177/0961203307079501.
Arnaud L., Mathian A., Ruffatti A., Erkan D., Tektonidou M., Cervera R., Forastiero R., Pengo V., Lambert M., Martinez-Zamora M.A., et al. Efficacy of Aspirin for the Primary Prevention of Thrombosis in Patients with Antiphospholipid Antibodies: An International and Collaborative Meta-Analysis. Autoimmun Rev. 2014;13:281-291. doi: 10.1016/j.autrev.2013.10.014. PMID: 24128729.
Miyachi K., Iwamoto T., Kojima S., Ida T., Suzuki J., Yamamoto T., Mimura N., Sugiyama T., Tanaka S., Furuta S., et al. Relationship of Systemic Type I Interferon Activity with Clinical Phenotypes, Disease Activity, and Damage Accrual in Systemic Lupus Erythematosus in Treatment-Naive Patients: A Retrospective Longitudinal Analysis. Arthritis Res Ther. 2023;25:26. doi: 10.1186/s13075-023-03010-0. PMID: 36796002.
Bruera S., Chavula T., Madan R., Agarwal S.K. Targeting Type I Interferons in Systemic Lupus Erythematous. Front Pharmacol. 2022;13:1046687. doi: 10.3389/fphar.2022.1046687. PMID: 36250395.
Yuan W., Guan F. Thrombosis and Anticoagulation Therapy in Systemic Lupus Erythematosus. Autoimmune Dis. 2022;2022:3208037. doi: 10.1155/2022/3208037. PMID: 35126782.
Milling T.J., Jr., Ziebell C.M. A Review of Oral Anticoagulants, Old and New, in Major Bleeding and the Need for Urgent Surgery. Trends Cardiovasc Med. 2020;30:86-90. doi: 10.1016/j.tcm.2019.03.004. PMID: 31036591.
Potpara T.S., Polovina M.M., Licina M.M., Stojanovic R.M., Prostran M.S., Lip G.Y.H. Novel Oral Anticoagulants for Stroke Prevention in Atrial Fibrillation: Focus on Apixaban. Adv Ther. 2012;29:491-507. doi: 10.1007/s12325-012-0026-8. PMID: 22825772.
Zandman-Goddard G., Levy Y., Shoenfeld Y. Intravenous Immunoglobulin Therapy and Systemic Lupus Erythematosus. Clin Rev Allergy Immunol. 2005;29:219-228. doi: 10.1385/CRIAI:29:3:219. PMID: 16373900.
Sakthiswary R., D'Cruz D. Intravenous Immunoglobulin in the Therapeutic Armamentarium of Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis. Medicine (Baltimore). 2014;93. doi: 10.1097/MD.0000000000000086. PMID: 25310521.
Mulhearn B., Bruce I.N. Indications for IVIG in Rheumatic Diseases. Rheumatology (Oxford). 2015;54:383-391. doi: 10.1093/rheumatology/keu429. PMID: 25433094.
Wessels I., Fischer H.J., Rink L. Dietary and Physiological Effects of Zinc on the Immune System. Annu Rev Nutr. 2021;41:133-175. doi: 10.1146/annurev-nutr-122019-120635. PMID: 33949573.
Weyh C., Krüger K., Peeling P., Castell L. The Role of Minerals in the Optimal Functioning of the Immune System. Nutrients. 2022;14:644. doi: 10.3390/nu14030644. PMID: 35161926.
Gohari A., Baumann B., Jen R., Ayas N. Sleep Deficiency: Epidemiology and Effects. Clin Chest Med. 2022;43:189-198. doi: 10.1016/j.ccm.2022.02.001. PMID: 35605762.
Yousfi N., Bragazzi N.L., Briki W., Zmijewski P., Chamari K. The COVID-19 Pandemic: How to Maintain a Healthy Immune System during the Lockdown-A Multidisciplinary Approach with Special Focus on Athletes. Biol Sport. 2020;37:211-216. doi: 10.5114/biolsport.2020.95125. PMID: 34150390.
Oster M., Scheel M., Muráni E., Ponsuksili S., Zebunke M., Puppe B., Wimmers K. The Fight-or-Flight Response Is Associated with PBMC Expression Profiles Related to Immune Defence and Recovery in Swine. PLoS ONE. 2015;10. doi: 10.1371/journal.pone.0120153. PMID: 25875877.
Parodis I., Gomez A., Tsoi A., Chow J.W., Pezzella D., Girard C., Stamm T.A., Boström C. Systematic literature review informing the EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis. RMD Open. 2023;9. doi: 10.1136/rmdopen-2023-003297.
Mak A., Ho R.C.M., Lau C.S. Clinical Implications of Neuropsychiatric Systemic Lupus Erythematosus. Adv Psychiatr Treat. 2009;15:451-458. doi: 10.1192/apt.bp.108.005785.
Condor D., Culcițchi C., Blum R., Baru O., Buduru S., Kui A., Țig I. A Review of CO2 Laser-Mediated Therapy for Oral Mucosal Lesions. Appl Sci (Basel). 2021;11:7744. doi: 10.3390/app11167744.
Manfredi C., Spirito L., Calace F.P., Balsamo R., Terribile M., Stizzo M., Romano L., Napolitano L., Califano G., Cirillo L., et al. Oral Preparation of Hyaluronic Acid, Chondroitin Sulfate, Curcumin, and Quercetin (Ialuril® Soft Gels) for the Prevention of LUTS after Intravesical Chemotherapy. Pathophysiology. 2022;29:365-373. doi: 10.3390/pathophysiology29030028. PMID: 36234654.
Constantin M.M., Nita I.E., Olteanu R., Constantin T., Bucur S., Matei C., Raducan A. Significance and impact of dietary factors on systemic lupus erythematosus pathogenesis. Exp Ther Med. 2019;17:1085-1090. doi: 10.3892/etm.2018.6986. PMID: 30675246.
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Copyright (c) 2024 Monika Turek, Klara Wojciechowska, Karolina Piątkowska, Aleksandra Jaroń, Katarzyna Jastrzębska, Iwona Chaberska, Aleksandra Feruś, Julia Lipska
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