An Overview of Systemic Lupus Erythematosus (SLE) Pathogenesis, Classification, and Management

Systemic lupus erythematosus (SLE) is a complex autoimmune disease with multisystem involvement. It is multifactorial and involves epigenetic, genetic, ecological, and environmental factors. Primarily it leads to activation of both innate and adaptive immunity, which consequently leads to autoreactive B cell activation by T cells and leads to immune complexes deposition in tissues leading to an autoimmune cascade that may be limited to the single organ or can cause a widespread systemic involvement. SLE is heterogeneous in presentation, with a broad spectrum of clinical manifestations ranging from clinically mild self-resolving symptoms to severe life-threatening organ involvement. Clinical and serological heterogeneity are critical features in SLE, posing a significant challenge in its diagnosis. Antinuclear antibodies (ANA) are the telltale serological marker in more than 95% of SLE patients. The improved set of European Alliance of Associations for Rheumatology (EULAR) classification enabled accurate diagnosis of SLE. The treatment focuses on remission, preventing organ damage, and improving the overall quality of life.

Automated summary

Systemic lupus erythematosus (SLE) is a complex autoimmune disease that involves multiple systems and is influenced by epigenetic, genetic, ecological, and environmental factors. It primarily activates both innate and adaptive immunity, leading to autoreactive B cell activation by T cells and immune complex deposition in tissues. SLE can present with a wide range of clinical manifestations, from mild self-resolving symptoms to severe life-threatening organ involvement. Clinical and serological heterogeneity poses a significant challenge in diagnosing SLE, with antinuclear antibodies (ANA) being a common serological marker. The improved classification by the European Alliance of Associations for Rheumatology (EULAR) enables accurate diagnosis of SLE, and treatment focuses on achieving remission, preventing organ damage, and improving quality of life.