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Drug Therapy of Systemic Lupus Erythematosus
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Drug Therapy of Systemic Lupus Erythematosus

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pharmacology".

Deadline for manuscript submissions: 20 February 2026 | Viewed by 2478

Special Issue Editor

Dr. Dionysis Nikolopoulos

E-Mail Website
Guest Editor
Department of Medicine, Karolinska Universitetssjukhuset, 17177 Stockholm, Sweden
Interests: systemic lupus erythematosus; autoimmunity

Special Issue Information

Dear Colleagues,

The landscape of SLE therapy has experienced significant progress following decades of setbacks and challenges, with the approvals of belimumab, anifrolumab, and voclosporin. More importantly, phase II trials have yielded promising results for TYK2 inhibitor deucravacitinib for general SLE and B-cell depletion therapy with obinutuzumab for lupus nephritis, potentially heralding successful phase III trials. Innovative cell therapies, particularly CD19 targeted CAR T-cell therapy, have demonstrated remarkable preliminary efficacy in SLE patients, paving the way for phase II/III trials. This evidence indicates a rapidly evolving field, with the potential to significantly alter SLE management and improve patient outcomes.

This Special Issue will comprehensively summarize the progress in SLE drug therapy over the past decade and explore emerging treatments. We seek submissions of original research, reviews, and clinical trial reports that delve into these advancements. To this end, contributions will highlight new pharmacological agents, cellular therapies, and personalized medicine approaches that are shaping the future of SLE treatment.

Dr. Dionysis Nikolopoulos
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Molecular Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. There is an Article Processing Charge (APC) for publication in this open access journal. For details about the APC please see here. Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • systemic lupus erythematosus
  • treatment
  • drugs
  • tailored strategies
  • precision medicine
  • biologics
  • cell therapy
  • randomized clinical trials

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Published Papers (2 papers)

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Research

13 pages, 1001 KB  
Article
Impact of Smoking, Steroid Use and Immunosuppression on Anti-dsDNA Antibodies in Systemic Lupus Erythematosus
by Richard Borrelli, Stefania Nicola, Federica Corradi, Luca Lo Sardo, Iuliana Badiu, Anna Quinternetto, Ilaria Vitali, Simone Negrini and Luisa Brussino
Int. J. Mol. Sci. 2025, 26(17), 8705; https://doi.org/10.3390/ijms26178705 - 6 Sep 2025
Viewed by 960
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving multiple organs and the production of anti-double-stranded DNA (anti-dsDNA) antibodies. This study evaluated the associations between anti-dsDNA levels and smoking, oral corticosteroid (OCS) use, and immunosuppressive therapy in SLE patients. A retrospective monocentric [...] Read more.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving multiple organs and the production of anti-double-stranded DNA (anti-dsDNA) antibodies. This study evaluated the associations between anti-dsDNA levels and smoking, oral corticosteroid (OCS) use, and immunosuppressive therapy in SLE patients. A retrospective monocentric analysis was performed on 119 SLE patients. Data on smoking history, OCS dosage, and immunosuppressive treatments were collected. Anti-dsDNA levels were assessed using fluorescent enzyme immunoassays and confirmed via indirect immunofluorescence. Smoking was significantly associated with higher anti-dsDNA levels (Spearman’s ρ = 0.292, p = 0.0014). Logistic regression identified pack-years (PPY) as a predictor of high anti-dsDNA levels (≥75 U/mL), with a 50% probability at 12.51 PPY and a 75% probability at 17.65 PPY (p < 0.001). OCSs were used by 58.82% of patients, with a median prednisone-equivalent dose of 5.0 mg; higher OCS doses correlated weakly but significantly with anti-dsDNA levels (R2 = 0.066, p < 0.001). Anti-dsDNA levels differed across treatments (p = 0.027): MTX vs. AZA/MMF, and belimumab vs. AZA/MTX. Smoking, OCS use, and immunosuppressants influence anti-dsDNA levels. Belimumab showed greater reduction compared to conventional therapies. Personalized treatment strategies are needed, considering the effects of smoking and cortico-steroids. Full article
(This article belongs to the Special Issue Drug Therapy of Systemic Lupus Erythematosus)
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10 pages, 1604 KB  
Article
Anifrolumab Attenuates Follicular Helper T Cell Activation in Patients with Systemic Lupus Erythematosus
by Ádám Diós, Ágnes Gyetvai, Gábor Papp and Tünde Tarr
Int. J. Mol. Sci. 2025, 26(15), 7397; https://doi.org/10.3390/ijms26157397 - 31 Jul 2025
Viewed by 857
Abstract
Systemic lupus erythematosus (SLE) is a severe autoimmune disease characterized by autoantibody production and multi-organ involvement. Anifrolumab, a monoclonal antibody targeting the type I interferon (IFN) receptor, has been approved for the treatment of SLE. Our aim was to investigate the long-term effects [...] Read more.
Systemic lupus erythematosus (SLE) is a severe autoimmune disease characterized by autoantibody production and multi-organ involvement. Anifrolumab, a monoclonal antibody targeting the type I interferon (IFN) receptor, has been approved for the treatment of SLE. Our aim was to investigate the long-term effects of inhibited type I IFN signaling on circulating follicular helper T subsets (TFH), follicular regulatory T cells (TFR), and B lymphocyte subpopulations, reflecting the ongoing germinal center reactions in SLE patients. Peripheral blood samples were obtained from ten SLE patients before the initiation of anifrolumab treatment, and at months 6 and 12 of the intervention period. Flow cytometry analysis was performed to assess the frequencies of circulating TFH cell subsets, TFR cells, and certain B cell subpopulations. Serological parameters, including autoantibody levels and complement components, were determined as part of the routine diagnostic evaluation. We observed a significant and sustained reduction in the percentage of activated circulating TFH cells. Notably, the frequency of CXCR3−CCR6+ TFH17 cells decreased, whereas the proportion of CXCR3+CCR6− TFH1 cells increased significantly. Furthermore, the proportion of the IgD−CD27− double-negative B lymphocytes was also significantly reduced. These findings suggest that anifrolumab therapy attenuates TFH cell activation, which may contribute to its clinical efficacy by modulating germinal center responses in SLE. Full article
(This article belongs to the Special Issue Drug Therapy of Systemic Lupus Erythematosus)
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