Robinson, George A; Knight, Andrea; Tucker, Lori B; Belot, Alexandre; Isenberg, David A; Ciurtin, Coziana; (2025) Insights into the pathogenesis of childhood-onset SLE in the past decade. Nature Reviews Rheumatology 10.1038/s41584-025-01321-x. (In press).

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Abstract

Childhood-onset systemic lupus erythematosus (SLE) is associated with more active disease trajectories, increased cardiovascular risk, earlier development of organ damage (which commonly affects the kidney, central nervous and musculoskeletal systems) and increased use of glucocorticoids and immunosuppressive treatments than adult-onset SLE. However, the understanding of immunopathogenic mechanisms in childhood-onset SLE is far less established than in adult-onset disease. Technological advances over the past decade have accelerated progress in understanding the immune, genetic, epigenetic, metabolic and proteomic profiles of childhood-onset SLE, and have also established the mechanistic roles of immune dysregulation, interferon signalling, biological sex, gender and ethnicity in shaping disease heterogeneity. These insights have led to the elucidation of the mechanisms that drive the increased severity of childhood-onset SLE and point towards new pathways for personalized therapeutic approaches aimed at improving long-term outcomes and quality of life for patients.

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