Mechanisms of disease for the clinician: systemic lupus erythematosus.
To review the complex interactions and processes in systemic lupus erythematosus (SLE). Brief review of the important literature in peer-reviewed journals. Studies on the clinical and immunologic features, pathogenesis, epidemiology, laboratory evaluation, and treatment of SLE are included in this review. SLE may include a variety of disease entities, such as isolated cutaneous lupus, undifferentiated connective tissue disease, mixed connective tissue disease, and drug-induced lupus. There are many ongoing clinical trials in SLE patients of therapeutics with different mechanisms of cellular action, such as classic immunosuppression, cell depletion, antigen-specific immunomodulation, and targeting of antigen-nonspecific, immune-activating molecules. New immune cell-targeted therapies are now available that are specifically designed to block cellular pathways involved in disease pathogenesis. The practicing physician should understand the immunology, pathogenesis, laboratory evaluation, and updated treatment options when diagnosing SLE in their clinic or daily practice.