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Published on: May 16, 2025
Novel Insights in Systemic Lupus Erythematosus and Atherosclerosis
Vítor Teixeira1, Lai-Shan Tam2
1Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon, Portugal.
Insights
Systemic lupus erythematosus (SLE) patients face high cardiovascular event risks due to systemic inflammation. Addressing inflammation and standardizing atherosclerosis assessment are crucial for improving SLE patient longevity and cardiovascular health.
Area of Science:
- Rheumatology
- Cardiology
- Immunology
Background:
- Systemic lupus erythematosus (SLE) is characterized by systemic inflammation, increasing the risk of premature atherosclerosis and cardiovascular events (CVE).
- Managing SLE and its associated cardiovascular complications presents significant clinical challenges.
Purpose of the Study:
- To review current understanding of atherosclerosis in SLE, from pathophysiology to potential treatments.
- To explore novel molecular biomarkers and advanced imaging techniques for atherosclerosis assessment in SLE patients.
Main Methods:
- A comprehensive literature search was conducted using the PubMed database.
- A critical review of the existing research on SLE and atherosclerosis was performed.
Main Results:
- Despite advancements, cardiovascular diseases remain the leading cause of mortality and reduced life expectancy in SLE.
- Challenges persist in standardizing atherosclerosis imaging assessment and predicting cardiovascular risk due to SLE's multifactorial nature.
- Numerous molecular biomarkers for atherosclerosis have been identified, suggesting combined approaches may improve risk prediction.
Conclusions:
- Effective therapies for preventing atherosclerosis and CVE in SLE must target underlying systemic inflammation.
- Further research is needed to standardize assessment methods and develop targeted treatments for cardiovascular complications in SLE.
Introduction:
The systemic inflammatory nature of systemic lupus erythematosus (SLE) is well patent not only in the diverse clinical manifestations of the disease but also in the increased risk of premature atherosclerosis and cardiovascular events (CVE), making SLE one of the most complex diseases to study and manage in clinical practice.
Aim:
To travel from old aspects to modern insights on the physiopathology, new molecular biomarkers, imaging methods of atherosclerosis assessment, and the potential treatments of atherosclerosis in SLE.
Methods:
We conducted a literature search using PubMed database and performed a critical review.
Conclusion/Discussion:
Several developments have taken place in the understanding of the relationship between SLE and premature atherosclerosis. Nevertheless, cardiovascular diseases are still the major cause of reduced life expectancy in SLE and the main cause of death. The lack of standardization methods for the imaging assessment of atherosclerosis in SLE and the multifactorial nature of the disease are well patriated in the difficulty of achieving consistent and reproducible results among studies that focus in cardiovascular risk assessment and prediction. A raising number of molecular biomarkers of atherosclerosis have been proposed, but the combination of several biomarkers and risk factors may better estimate cardiovascular disease risk. Moreover, the development of effective therapies to prevent progression of atherosclerosis and CVE shall address systemic inflammation.
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