CYTOKINE STORM IN SLE: MECHANISMS OF IMMUNOINFLAMMATION AND THERAPEUTIC OPPORTUNITIES
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Abstract:
Systemic lupus erythematosus (SLE) is an autoimmune multisystem disorder in which pro-inflammatory cytokines play a central pathogenic role. In a subset of patients, a cytokine storm (CS) develops, characterized by persistent fever, hyperferritinemia, cytopenias and acute organ failure. Dysregulation of adaptive and innate immunity results in excessive production of IL-6, IL-1β, TNF-α and IFN-γ by T- and B-cells, accompanied by macrophage activation. Cytokine monitoring and the HScore are applied for CS diagnosis. Biological therapy — including belimumab, tocilizumab and anifrolumab — expands therapeutic opportunities for inflammation control. A personalized approach based on cytokine profiling and genetic markers represents a promising direction in the management of SLE.
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