Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Such developments as the introduction of whole new drug classes, as well as the general increase in pediatric drug trials, have led to a revolution in pediatric rheumatology care. For example, selective cyclooxygenase-2 inhibitors can provide the same symptomatic relief as nonselective nonsteroidal anti-inflammatory agents without the same concerns over significant gastrointestinal toxicity. Biologic agents, notably the tumor necrosis factor inhibitors, have effected dramatic improvements in many patients with severe disease who previously were often significantly disabled. New immunosuppressives, such as mycophenolate mofetil, also have promise for ameliorating systemic lupus and vasculitic conditions, perhaps with reduced toxicity compared with other agents. New strategies for the use of older agents have also been further substantiated, such as intra-articular steroid and alternate-day high-dose steroid in chronic arthritis, and broader use of sulfasalazine. Evidence for the use of these therapies is discussed, as are potential toxicities.
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PMID:New drug therapies for the pediatric rheumatic diseases. 1160 97

Differences in allelic distribution at loci surrounding the human HLA-DRB1 and tumor necrosis factor (TNF) genes have been observed in association with systemic lupus erythematosus (SLE). We investigated whether the association of HLA-DRB1*0301 (HLA-DR3) and TNF-308A with SLE could be attributed to polymorphic markers in the chromosomal region encompassed by HLA-DRB1 and HLA-C. Ninety-one consecutive Caucasian patients with SLE and 253 controls (organ donors) were typed for HLA-DRB1, microsatellites D6S1014, D6S273, TNFa, MIB, C1_2_5, and C1_3_2 and the single nucleotide polymorphism at position -308 in the promoter of TNF. The independent contribution of alleles to disease susceptibility was estimated by cross-tabulation and multivariate logistic regression. Possession of TNF-308A was associated with susceptibility to SLE (odds ratio [95% confidence interval], 3.70 [2.24-6.11]). This remained present after stratification on possession of HLA-DR3 (pooled odds ratio, 2.53 [1.37-4.70]). Stratification revealed a possible association of possession of C1_2_5*192 with protection from SLE beyond the effects of HLA-DR3 and TNF-308A. A gene dosage effect was observed for -308A only (homozygotes, 7.75 [3.01-20.0], heterozygotes, 3.15 [1.85-5.37]). In multivariate analysis, possession of HLA-DR3, TNF-308A, and C1_2_5*192 remained independently associated with susceptibility to SLE (2.58 [1.29-5.18], 2.76 [1.43-5.31], and 0.26 [0.10-0.66], respectively). The association of possession of TNF-308A with susceptibility to SLE cannot be attributed to linkage to HLA-DR3 alone, nor to other polymorphic markers in the vicinity of the TNF gene. Further loci that are independently associated with SLE might be in the vicinity of marker C1_2_5.
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PMID:Six microsatellite markers on the short arm of chromosome 6 in relation to HLA-DR3 and TNF-308A in systemic lupus erythematosus. 1170 3

It has been more than three decades since the withdrawal of thalidomide from the marketplace. Thalidomide is attracting growing interest because of its reported immunomodulatory and anti-inflammatory properties. Current evidence indicates that thalidomide reduces the activity of the inflammatory cytokine tumor necrosis factor-alpha by accelerating the degradation of its messenger RNA. Thalidomide inhibits angiogenesis. Recently, thalidomide was approved for sale in the United States for the treatment of erythema nodosum leprosum, an inflammatory complication of Hansen's disease. Thalidomide has been used successfully in several other dermatologic disorders, including aphthous stomatitis, Behcet's syndrome, chronic cutaneous systemic lupus erythematosus, and graft-versus-host disease, the apparent shared characteristic of which is immune dysregulation. Many recent studies have evaluated thalidomide in patients with HIV infection, in which this drug is an efficacious agent against oral aphthous ulcers, HIV-associated wasting syndrome, HIV-related diarrhea, and Kaposi's sarcoma. Only in the last several years has thalidomide been aggressively investigated for its antiangiogenic potential and immunomodulatory properties in various tumor types. Current research on thalidomide in oncology covers investigation in a wide range of both solid tumors and hematologic malignancies.
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PMID:Thalidomide: an antineoplastic agent. 1173 14

The B lymphocyte stimulator (BLyS), also known as BAFF, THANK, TALL-1 and zTNF4, is the most recent addition to the tumor necrosis factor family (TNF) ligands and has a unique role in B cell immunity. Its requirement for the humoral immune response is evident in mice lacking BlyS, which exhibit profound deficiencies in peripheral B cell development and maturation. It regulates the antibody response, as shown in mice overexpressing BLyS, which develop autoimmune manifestations resulting from peripheral B cell expansion and differentiation. Attenuation of apoptosis appears to underlie BLyS action in B cells. However, elucidation of the mechanism of BLyS has proven to be more challenging, because BLyS binds three different TNF receptors (TACI/BCMA/BAFF-R) and shares overlapping functions with a related TNF ligand, APRIL. The unique role of BLyS in B cell development and differentiation and the pathogenesis of autoimmune diseases, systemic lupus erythematosus (SLE) in particular, makes the study of BLyS and its downstream targets attractive in the development of novel therapies.
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PMID:Mechanism of BLyS action in B cell immunity. 1175 Aug 77

The present study has been undertaken to evaluate bone turn-over in patients with systemic lupus erythematosus (SLE) treated with glucocorticosteroids. Thirty-eight patients with definite SLE has been investigated. The following parameters have been determinated. Some proinflammatory cytokine: interleukin-IL-1 alpha (IL-1 alpha), interleukin-IL-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), granulocyte-macrophage colony stimulating factor (GM-CSF) and some biochemical markers of osteoporosis: osteocalcin (BGP), alkaline phosphatase-bone formation (AP-B), procollagen type I carboxyterminal propeptide (PICP), carboxyterminal telopeptides of type I collagen (CTx) deoxypyridinoline (Dpd) and calcium/creatinin ratio have been determined. The forearm densitometry measurement was performed in all patients. We did not notice statistically significant decrease in bone mineral content and bone mineral density in spite of long term glucocorticosteroids treatment. Based on statistically significant correlation between carboxyterminal telopeptides of type I collagen (CTx) and calcium/creatinin ratio we observed increased bone resorption in analysed group of patients.
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PMID:[Bone tissue metabolism in systematic lupus erythematosus patients treated with glucocorticosteroids]. 1199 9

The size of the known members of the tumor necrosis factor ligand and receptor superfamilies has burgeoned in the past few years. Among the novel tumor necrosis factor ligand and receptor superfamily members recently described is B lymphocyte stimulator (BLyS; Human Genome Sciences, Rockville, MD) protein. By virtue of its ability to promote B-cell survival, expansion, and differentiation, it likely plays an important contributory role in systemic lupus erythematosus pathogenesis and propagation. In addition, it may play a similar role in other systemic immune-based rheumatic diseases, and becomes a legitimate candidate target for antagonist biologic agents.
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PMID:B lymphocyte stimulator protein levels in systemic lupus erythematosus and other diseases. 1212 87

TALL-1 is a member of the tumor necrosis factor family that binds to BCMA, TACI, and BAFF-R, three receptors mostly expressed by mature B lymphocytes. Previous studies have shown that the TALL-1 signaling is critically involved in B cell proliferation, maturation, and progression of lupus-like, autoimmune diseases. In this report, we performed cDNA subtractive hybridization experiments to identify downstream genes up-regulated by TALL-1. These experiments indicated that 10 genes, including interleukin (IL)-10, lymphocyte activation gene-1 (LAG-1), GCP-2, PBEF, ferritin, PIM-2, TFG, CD27 ligand, DUSP5, and archain, were up-regulated at the mRNA level by TALL-1 stimulation in B lymphoma RPMI-8226 cells and/or primary B lymphocytes. We also demonstrated that TALL-1 activated transcription of IL-10 and LAG-1 in a nuclear factor-kappaB-dependent manner in reporter gene assays. Moreover, our findings indicated BAFF-R, but not TACI, could dramatically up-regulate IL-10 secretion by RPMI-8226 cells. The identification of TALL-1-up-regulated genes will help explain the mechanisms of TALL-1-triggered biological and pathological effects and to identify molecular targets for intervention of lupus-like autoimmune diseases.
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PMID:Identification of downstream genes up-regulated by the tumor necrosis factor family member TALL-1. 1214 33

B lymphocyte stimulator (BLyS) protein is among the novel tumor necrosis factor (TNF) ligands and receptor superfamily members recently described. BLyS protein can promote B cell survival, expansion, and differentiation both and. Constitutive overexpression of BLyS protein can result in systemic lupus erythematosus (SLE)-like disease in mice, and circulating levels of BLyS protein are elevated in a subset of human SLE patients. Treatment of SLE mice with a BLyS protein antagonist ameliorates disease progression and enhances survival. By inference, BLyS protein may also play an important contributory role in pathogenesis and/or propagation of human SLE and becomes a legitimate candidate target for antagonist biologic agents.
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PMID:Systemic lupus erythematosus: a blissless disease of too much BLyS (B lymphocyte stimulator) protein. 1219 48

Humans and mice deficient in Fas, a tumor necrosis factor (TNF)-receptor family member, cannot induce apoptosis of autoreactive cells, and consequently develop progressive lymphoproliferative disorders and lupus-like autoimmune diseases. Previous studies have shown that short-term administrations of agonistic monoclonal antibodies against CD137, another TNF-receptor family member, activate T cells and induce rejection of allografts and established tumors. Here we report that treatment with an agonistic monoclonal antibody to CD137 (2A) blocks lymphadenopathy and spontaneous autoimmune diseases in Fas-deficient MRL/lpr mice, ultimately leading to their prolonged survival. Notably, 2A treatment rapidly augments IFN-gamma production, and induces the depletion of autoreactive B cells and abnormal double-negative T cells, possibly by increasing their apoptosis through Fas- and TNF receptor-independent mechanisms. This study demonstrates that agonistic monoclonal antibodies specific for costimulatory molecules can be used as novel therapeutic agents to delete autoreactive lymphocytes and block autoimmune disease progression.
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PMID:Costimulatory molecule-targeted antibody therapy of a spontaneous autoimmune disease. 1245 76

Dendritic cells (DCs) control immunity and tolerance. Hence, we surmised that systemic lupus erythematosus (SLE), a systemic autoimmune disease with autoreactive T and B cells, might be due to alterations in DC homeostasis. Taken together, our results demonstrate profound alterations of DCs and DC-poietins homeostasis in SLE. Elevated levels of interferon-alpha (IFN) in serum of SLE patients coexist with decreased numbers of cells producing IFN-alpha, i.e., plasmacytoid dendritic cells (PDCs). Decreased numbers of circulating DCs correlate with increased levels of soluble tumor necrosis factor (TNF) receptors, thus suggesting the potential role of TNF pathway in the observed DC alterations. Finally, increased FMS-like tyrosine kinase 3-ligand (FLT3-L) and its correlation with soluble TNF receptors suggest a physiologic response to compensate low DC numbers. Although IFN-alpha remains at the center of immunologic aberrations in SLE, it remains to be determined whether increased shedding of soluble TNF receptors could also be ascribed to IFN-alpha.
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PMID:Blood dendritic cells and DC-poietins in systemic lupus erythematosus. 1248 Feb 61


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