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Dolor en el lupus eritematoso sistémico: ideas y paradigmas emergentes
David S Pisetsky1,2, Amanda M Eudy3, Jennifer L Rogers3
1Division of Rheumatology and Immunology, Department of Integrative Immunobiology, Duke University Medical Center, Durham, NC, USA. david.pisetsky@duke.edu.
Nature reviews. Rheumatology
|August 26, 2025
Resumen
El lupus eritematoso sistémico (LES) causa dolor generalizado y síntomas relacionados debido a la desregulación del sistema inmunológico. Estos síntomas pueden deberse a cambios en el sistema nervioso, no solo a la inflamación, que afectan a la calidad de vida del paciente.
Área de la Ciencia:
- Inmunología
- Neurología
- Reumatología
Sus antecedentes:
- El lupus eritematoso sistémico (LES) es una enfermedad autoinmune crónica con diversas características clínicas impulsadas por la desregulación inmune.
- El dolor y los síntomas asociados como la fatiga, los trastornos del estado de ánimo y el deterioro cognitivo son comunes en los pacientes con LES, lo que afecta significativamente la calidad de vida.
Objetivo del estudio:
- Revisar los orígenes del dolor en el LES y sus implicaciones clínicas.
- Explorar el vínculo entre los mecanismos inmunes y el dolor en el LES.
- Comprender el papel de la sensibilización del sistema nervioso en el dolor relacionado con el LES.
Principales métodos:
- Revisión de la literatura centrada en la fisiopatología del dolor en el LES.
- Análisis de la relación entre los marcadores inflamatorios y los niveles de dolor informados.
- Examen de la evidencia de la sensibilización del sistema nervioso central y periférico en el LES.
Principales resultados:
- Si bien la inflamación contribuye al dolor nociceptivo en el LES, los pacientes a menudo experimentan dolor desproporcionado a los signos inflamatorios.
- La nociplasticidad, que implica la sensibilización del sistema nervioso y el procesamiento alterado del cerebro, parece ser un factor significativo en el dolor del LES.
- El dolor generalizado y los síntomas asociados en el LES pueden compartir vías patógenas con otras afecciones de dolor autoinmunes y nociplásticas.
Conclusiones:
- El dolor en el LES es complejo, involucrando mecanismos inflamatorios y nociplásticos.
- La sensibilización del sistema nervioso juega un papel crucial en la amplificación del dolor y los síntomas relacionados en pacientes con LES.
- Comprender estos mecanismos es vital para mejorar la atención al paciente y controlar eficazmente los síntomas del LES.
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