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The bm12 Inducible Model of Systemic Lupus Erythematosus (SLE) in C57BL/6 Mice
Published on: November 1, 2015
The management of pediatric systemic lupus erythematosus
Stacy P Ardoin1, Laura E Schanberg
1Division of Pediatric Rheumatology, Duke University Medical Center, Durham, NC 27710, USA.
Insights
Pediatric systemic lupus erythematosus (SLE) survivors need specialized care to prevent long-term issues like atherosclerosis. More research is crucial to understand and treat this unique childhood autoimmune disease effectively.
Area of Science:
- Pediatric Rheumatology
- Autoimmune Diseases
- Systemic Lupus Erythematosus (SLE)
Background:
- Most children and adolescents with SLE now survive into adulthood.
- Focus is shifting to preventing long-term complications such as atherosclerosis, obesity, and osteoporosis.
- Significant knowledge gaps exist regarding pediatric SLE epidemiology, outcomes, and optimal treatment.
Purpose of the Study:
- To highlight the distinct characteristics of pediatric SLE compared to adult SLE.
- To emphasize the need for specialized, multidisciplinary care for children and adolescents with SLE.
- To underscore the necessity for targeted research in pediatric SLE.
Main Methods:
- Review of current understanding and challenges in pediatric SLE management.
- Identification of key areas requiring further investigation.
- Discussion of essential components for optimizing treatment and care.
Main Results:
- Pediatric SLE differs significantly from adult SLE in disease expression, treatment, and psychosocial aspects.
- Optimizing treatment involves early recognition of flares/complications, minimizing toxicity, and addressing developmental concerns.
- Transition to adult care and research into developmental immunology are critical.
Conclusions:
- Children and adolescents with SLE require specialized, multidisciplinary care.
- Addressing developmental, psychosocial, and transition issues is vital for successful management.
- Urgent research is needed to improve understanding and treatment of pediatric SLE.
Abstract:
Most children and adolescents with systemic lupus erythematosus (SLE) now survive into adulthood, leading the pediatric rheumatology community to focus on preventing long-term complications of SLE, including atherosclerosis, obesity, and osteoporosis, and their treatment. Unfortunately, because of the paucity of data in pediatric SLE, little is known about epidemiology, long-term outcome, and optimal treatment. Most research focuses on adults with SLE, but pediatric SLE differs significantly from adult SLE in many aspects, including disease expression, approaches to pharmacologic intervention, management of treatment toxicity, and psychosocial issues. Children and adolescents with SLE require specialized, multidisciplinary care. Treatment can be optimized by early recognition of disease flares and complications, minimizing medication toxicity, educating families about prevention, promoting school performance, addressing concerns about reproductive health, and negotiating the transition to adult-centered medical care. Developmentally appropriate concerns about pain, appearance, and peers often affect treatment adherence and must be addressed by the health-care team. Research in pediatric SLE is desperately needed and provides a unique opportunity to understand how developmental immunology and the hormonal changes associated with puberty affect the pathophysiology of SLE.
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