Etiopathogenesis of systemic lupus erythematosus

Systemic Lupus Erythematosus (SLE) is a chronic disease of heterogeneous clinical presentation characterised by the production of autoantibodies directed against nuclear antigens. Its occurrence is the result of exposure to a favorable environment and stochastic events in a lupus-prone genetic background. Both the innate and adaptive immune systems are involved. The main source of autoantigens appears to be abnormal efferocytosis. Abnormally available nuclear material initiates the immune response through activation of intra-and extracytosolic nucleic acid receptors. Interactions between dendritic cells, B cells and T cells result in the production of cytokines, antibodies and cytotoxic cells that are deleterious. Interferons, especially type I and B Lymphocyte stimulator (BLyS), have a key role in the pathogenesis of SLE. Many new drugs are in development. More directly targeted on the immunological actors involved in SLE than the corticoids and immunosuppressants currently used, these new molecules should improve the efficacy and tolerance of treatments. (c) 2021 l'Academie nationale de medecine. Published by Elsevier Masson SAS. All rights reserved.