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Systemic Lupus Erythematosus: HELP
Articles from Chaim Sheba Medical Center
Based on 84 articles published since 2008
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These are the 84 published articles about Lupus Erythematosus, Systemic that originated from Chaim Sheba Medical Center during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Guideline EULAR recommendations for women's health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. 2017

Andreoli, L / Bertsias, G K / Agmon-Levin, N / Brown, S / Cervera, R / Costedoat-Chalumeau, N / Doria, A / Fischer-Betz, R / Forger, F / Moraes-Fontes, M F / Khamashta, M / King, J / Lojacono, A / Marchiori, F / Meroni, P L / Mosca, M / Motta, M / Ostensen, M / Pamfil, C / Raio, L / Schneider, M / Svenungsson, E / Tektonidou, M / Yavuz, S / Boumpas, D / Tincani, A. ·Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. · Unit of Rheumatology and Clinical Immunology, Spedali Civili, Brescia, Italy. · Department of Rheumatology, Clinical Immunology and Allergy, University of Crete Medical School, Heraklion, Greece. · The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel. · The Faculty of Medicine, Tel Aviv University, Israel. · Royal National Hospital For Rheumatic Diseases, Bath, UK. · Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Catalonia, Spain. · AP-HP, Hôpital Cochin, Centre de référence maladies auto-immunes et systémiques rares, Paris, France. · Université Paris Descartes-Sorbonne Paris Cité, Paris, France. · Rheumatology Unit, Department of Medicine, University of Padua, Italy. · Policlinic of Rheumatology, Hiller Research Unit, University Clinic Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany. · Department of Rheumatology, Immunology and Allergology, University Hospital of Bern, Bern, Switzerland. · Unidade de Doenças Auto-imunes-Serviço Medicina Interna 7.2, Hospital Curry Cabral/Centro Hospitalar Lisboa Central, NEDAI/SPMI, Lisboa, Portugal. · Lupus Research Unit, The Rayne Institute, St. Thomas Hospital, London, UK. · Department of Rheumatology, Dubai Hospital, Dubai, United Arab Emirates. · EULAR PARE Patient Research Partner, London, UK. · Unit of Obstetrics and Gynaecology, Spedali Civili, Brescia, Italy. · EULAR PARE Patient Research Partner, Rome, Italy. · Department of Clinical Sciences and Community Health, University of Milan, Istituto Auxologico Italiano, Milan, Italy. · Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. · Neonatology and Neonatal Intensive Care Unit, Spedali Civili, Brescia, Italy. · Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. · Department of Rheumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. · Department of Obstetrics and Gynaecology, University Hospital of Bern, Inselspital, Switzerland. · Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. · Rheumatology Unit, Joint Academic Rheumatology Programme, 1st Department of Propaedeutic Internal Medicine Athens, National and Kapodistrian University of Athens, Athens, Greece. · Department of Rheumatology, Istanbul Bilim University, Istanbul Florence Nightingale Hospital, Esentepe-Istanbul, Turkey. · 4th Department of Internal Medicine, 'Attikon' University Hospital, Medical School, University of Athens, Athens, Greece. · Joint Academic Rheumatology Program, National and Kapodestrian University of Athens, Athens, Greece. ·Ann Rheum Dis · Pubmed #27457513.

ABSTRACT: OBJECTIVES: Develop recommendations for women's health issues and family planning in systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS). METHODS: Systematic review of evidence followed by modified Delphi method to compile questions, elicit expert opinions and reach consensus. RESULTS: Family planning should be discussed as early as possible after diagnosis. Most women can have successful pregnancies and measures can be taken to reduce the risks of adverse maternal or fetal outcomes. Risk stratification includes disease activity, autoantibody profile, previous vascular and pregnancy morbidity, hypertension and the use of drugs (emphasis on benefits from hydroxychloroquine and antiplatelets/anticoagulants). Hormonal contraception and menopause replacement therapy can be used in patients with stable/inactive disease and low risk of thrombosis. Fertility preservation with gonadotropin-releasing hormone analogues should be considered prior to the use of alkylating agents. Assisted reproduction techniques can be safely used in patients with stable/inactive disease; patients with positive antiphospholipid antibodies/APS should receive anticoagulation and/or low-dose aspirin. Assessment of disease activity, renal function and serological markers is important for diagnosing disease flares and monitoring for obstetrical adverse outcomes. Fetal monitoring includes Doppler ultrasonography and fetal biometry, particularly in the third trimester, to screen for placental insufficiency and small for gestational age fetuses. Screening for gynaecological malignancies is similar to the general population, with increased vigilance for cervical premalignant lesions if exposed to immunosuppressive drugs. Human papillomavirus immunisation can be used in women with stable/inactive disease. CONCLUSIONS: Recommendations for women's health issues in SLE and/or APS were developed using an evidence-based approach followed by expert consensus.

2 Editorial Autoimmune rheumatic diseases. 2014

Anaya, Juan-Manuel / Shoenfeld, Yehuda / Buttgereit, Frank / Gonzalez-Gay, Miguel A. ·Center for Autoimmune Diseases Research (CREA), Universidad del Rosario, Carrera 24 No. 63C-69, 111221 Bogota, Colombia. · Zabludowitcz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel Aviv University, 52621 Tel-Hashomer, Israel. · Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Charitéplatz 1, 10117 Berlin, Germany. · Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Avenida de Valdecilla, s/n, Cantabria, 39008 Santander, Spain. ·Biomed Res Int · Pubmed #25162038.

ABSTRACT: -- No abstract --

3 Editorial The spectrum between antiphospholipid syndrome and systemic lupus erythematosus. 2014

Agmon-Levin, Nancy / Shoenfeld, Yehuda. ·Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, 52621, Israel. ·Clin Rheumatol · Pubmed #24435353.

ABSTRACT: -- No abstract --

4 Review HPV vaccines and lupus: current approaches towards preventing adverse immune cross-reactivity. 2019

Bragazzi, Nicola L / Bridgewood, Charlie / Sharif, Kassem / Kamal, Mohamad / Amital, Howard / Watad, Abdulla / Shoenfeld, Yehuda. ·a Postgraduate School of Public Health, Department of Health Sciences (DISSAL) , University of Genoa , Genoa , Italy. · b Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine , University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital , Leeds , UK. · c Department of Medicine B and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel. ·Expert Rev Vaccines · Pubmed #30526148.

ABSTRACT: INTRODUCTION: If not properly treated, human papillomavirus (HPV) infection may evolve from a common sexually transmitted disease to genital warts and cervical cancer. Various prophylactic HPV vaccines (HPVv), approved to reduce the incidence of the infection, have been found to be effective and safe; however, accounts of post-vaccination autoimmune phenomena, including systemic lupus erythematosus (SLE), have been reported in genetically susceptible individuals. AREAS COVERED: Infectious agents play a role in breaking the immunologic tolerance to self-antigens, resulting in autoimmune events. There is molecular evidence supporting the involvement of HPV in SLE, with a high prevalence of L1 HPV peptide homology to proteins being associated with SLE. Therefore, approaches in vaccine preparations aiming to prevent adverse immune cross-reactivity are sought. Performing a broad search of the literature, we review the association between SLE, HPV, and HPVv, with a focus on the mechanisms of molecular mimicry and cross-reactivity, and the approaches currently being elaborated towards preventing such phenomena. EXPERT COMMENTARY: The advantages of using low-similarity peptide antigens may be two-fold, abolishing the risk of cross-reactivity and eliminating the vaccine adjuvantation procedure. Vaccines based on pathogen unique sequences would provide effective vaccine preparation while curbing the risk for the human host.

5 Review Vimentin as antigenic target in autoimmunity: A comprehensive review. 2018

Musaelyan, Aram / Lapin, Sergey / Nazarov, Vladimir / Tkachenko, Olga / Gilburd, Boris / Mazing, Alexandra / Mikhailova, Lilia / Shoenfeld, Yehuda. ·Laboratory for Diagnostics of Autoimmune Diseases, Center for Molecular Medicine, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russian Federation. · Laboratory for Diagnostics of Autoimmune Diseases, Center for Molecular Medicine, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russian Federation. Electronic address: autoimmun@mail.ru. · Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty in Medicine, Sheba Medical Center, Tel-Aviv University, Israel. · Laboratory of the Mosaics of Autoimmunity, Saint-Petersburg University, Saint-Petersburg, Russian Federation. ·Autoimmun Rev · Pubmed #30009963.

ABSTRACT: Vimentin is a protein of intermediate filament family, which is expressed in all mesenchymal cells. Vimentin plays a key role in the physiology of the cell, cellular interactions and the functioning of the immune system. Post-translationally modified and native forms of vimentin are involved in the pathogenesis of inflammation and many autoimmune diseases: rheumatoid arthritis, sarcoidosis, systemic lupus erythematosus, antiphospholipid syndrome, Crohn's disease, ankylosing spondyloarthritis and idiopathic pulmonary fibrosis. Modifications of the protein lead to the formation of antigenic epitopes and, as a result, to the synthesis of antibodies. Citrullinated, carbamylated and acetylated forms of vimentin participate in the pathogenesis of RA, and antibodies against them serve as diagnostic and prognostic markers of the disease. Epitopes of native vimentin are antigenic in the group of HLA-DRB1*0301 positive patients with sarcoidosis. In addition, vimentin takes part in pathogenesis of tubulointerstitial inflammation and glomerulonephritis in lupus. In antiphospholipid syndrome interactions of vimentin and cardiolipin on the surface of apoptotic cells lead to the formation of an immunogenic complex. Antibodies against vimentin/cardiolipin complex are involved in the mechanism of thrombogenesis and serve to identify patients seronegative for antibodies to cardiolipin and ß2glycoprotein-I with the clinical features. Post-translationally modified form of the protein is citrullinated and MMP-degraded vimentin, which was found in serum of patients with Crohn's disease and ankylosing spondyloarthritis.

6 Review Imaging Features of the Juvenile Inflammatory Arthropathies. 2018

Sudoł-Szopińska, Iwona / Jans, Lennart / Jurik, Anne Grethe / Hemke, Robert / Eshed, Iris / Boutry, Nathalie. ·Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation and Department of Medical Imaging, Medical University of Warsaw, Warsaw, Poland. · Department of Radiology, Ghent University Hospital, Gent, Belgium. · Department of Radiology, Aarhus University Hospital and Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark. · Department of Radiology and Nuclear Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. · Department of Radiology, Sheba Medical Centre, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. · Department of Paediatric Imaging, Hospital Jeanne de Flandre, CHU Lille, France. ·Semin Musculoskelet Radiol · Pubmed #29672804.

ABSTRACT: We discuss the imaging of several juvenile inflammatory arthropathies including juvenile idiopathic arthritis, juvenile systemic lupus erythematosus, juvenile scleroderma, juvenile dermatomyositis, and chronic recurrent multifocal osteomyelitis. Juvenile idiopathic arthritis is the most common autoimmune chronic systemic disease of connective tissue in children. The remaining systemic juvenile connective tissue diseases are rare. However, they require early diagnosis and initiation of treatment to prevent injury, not only to the musculoskeletal system but also to the internal organs, and even death. Imaging of juvenile inflammatory arthropathies has relied for years on radiography. Recent advances in disease-modifying drugs have led to a greater emphasis on the detection of early inflammation not evident on plain radiography. Ultrasound examination allows for the early recognition of the disease process in the soft tissues. Magnetic resonance imaging detects early inflammatory changes involving the soft tissues, the subcortical bone of peripheral joints, the spine, and entheses.

7 Review Vitamin D and systemic lupus erythematosus - The hype and the hope. 2018

Shoenfeld, Yehuda / Giacomelli, Roberto / Azrielant, Shir / Berardicurti, Onorina / Reynolds, John A / Bruce, Ian N. ·Sheba Medical Center, The Zabludowicz Center for Autoimmune Diseases, Tel-Hashomer, Ramat-Gan 5265601, Israel; Tel-Aviv University, Sackler Faculty of Medicine, Ramat-Aviv, Tel-Aviv 6997801, Israel; Tel-Aviv University, Incumbent of the Laura Schwarz-Kip Chair for Research of Autoimmune Diseases, Ramat-Aviv, Tel-Aviv 6997801, Israel. Electronic address: shoenfel@post.tau.ac.il. · Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Rheumatology Unit, delta 6 building, L'Aquila, Italy. · Sheba Medical Center, The Zabludowicz Center for Autoimmune Diseases, Tel-Hashomer, Ramat-Gan 5265601, Israel; Tel-Aviv University, Sackler Faculty of Medicine, Ramat-Aviv, Tel-Aviv 6997801, Israel. · Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology Medicine and Health, The University of Manchester, UK. · Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology Medicine and Health, The University of Manchester, UK; NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK. ·Autoimmun Rev · Pubmed #29108830.

ABSTRACT: Over the past 20years, much has been written about the potential role of vitamin D in on adverse health outcomes. In recent years, evidence has accumulated regarding the effect of vitamin D on the immune system, and its different cells. Some studies have noted lower vitamin D concentrations in patients with SLE. These epidemiological data still not answer the question: is vitamin D deficiency the cause or the effect? To answer this, we will discuss the association between vitamin D deficiency and SLE and review the evidence from interventional studies.

8 Review Breastfeeding and autoimmunity: Programing health from the beginning. 2018

Vieira Borba, Vânia / Sharif, Kassem / Shoenfeld, Yehuda. ·Department 'A' of Internal Medicine, Coimbra University Hospital Centre, Coimbra, Portugal. · Faculty of Medicine, University of Coimbra, Coimbra, Portugal. · Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel. · Department 'B' of Internal Medicine, Sheba Medical Center, Tel-Hashomer, Israel. · Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. ·Am J Reprod Immunol · Pubmed #29083070.

ABSTRACT: Breast milk is not only a completely adapted nutrition source for the newborn but also an impressive array of immune-active molecules that afford protection against infections and shape mucosal immune responses. Decisive imprinting events might be modulated during the first months of life with potential health long-term effects, enhancing the importance of breastfeeding as a major influence on the immune system correct development and modifying disease susceptibility. The aim of this review was to clarify the link between breastfeeding and autoimmune diseases, inquiring the related mechanisms, based on data available in the literature. Being breastfed was associated with a lower incidence of diabetes, celiac disease, multiple sclerosis and asthma, explained by the protection against early infections, anti-inflammatory properties, antigen-specific tolerance induction, and regulation of infant's microbiome. The protective role of human milk in idiopathic juvenile arthritis, rheumatoid arthritis, and inflammatory bowel diseases remains controversial. On the other hand, the breastfeeding mother faces a health-challenging period in life. High levels of prolactin may lead either to the development of autoimmune diseases in susceptible mothers or exacerbations of current immune-mediated disorders. These features raise the question if mothers with autoimmune diseases, mainly systemic lupus erythematosus, should avoid breastfeeding.

9 Review Diverse patterns of anti-TNF-α-induced lupus: case series and review of the literature. 2018

Shovman, Ora / Tamar, Shalev / Amital, Howard / Watad, Abdulla / Shoenfeld, Yehuda. ·Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, 52621, Tel-Hashomer, Israel. · Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel. · Department of Gastroenterology, The E. Wolfson Medical Center, Holon, Israel. · Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. · Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, 52621, Tel-Hashomer, Israel. shoenfel@post.tau.ac.il. · Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. shoenfel@post.tau.ac.il. · Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. shoenfel@post.tau.ac.il. ·Clin Rheumatol · Pubmed #29063464.

ABSTRACT: The induction of autoantibodies is common following therapy with anti-TNF-α agents. However, anti-TNF-α-induced lupus (ATIL) is rare. We assessed the clinical characteristics of three patients with inflammatory bowel disease (IBD) who were treated with infliximab and developed distinct subsets of ATIL. Also, we searched for similar cases in the published literature. We describe three patients with ATIL. The first patient had a classical drug-induced lupus (DIL) presented by thrombocytopenia that resolved after infliximab discontinuation. The second case experienced symmetric polyarthritis of 14 joints in rheumatoid arthritis (RA)-like distribution accompanied by lymphopenia. The third one had a severe serositis including ascites and pleural and pericardial effusions along with pancytopenia. In this patient, ATIL coexisted with anti-TNF-α-induced hepatitis. The second and third patients met the American College of Rheumatology classification criteria for SLE. Nevertheless, all three cases exhibited ANA and anti-dsDNA positivity, and only the second patient had anticardiolipin (aCL IgG) and anti-histone antibodies. The coexistence of both lupus-like syndrome and hepatitis following anti-TNF-α therapy in the same patient is very rare, and to the best of our knowledge, only four such case reports are mentioned in literature. Patients with mild ATIL may tolerate another anti-TNF-α agent without recurrence of the disease. Rheumatologists should be aware of the distinct clinical presentations of ATIL and its coexistence with other rare anti-TNF-alpha complications such as hepatitis.

10 Review [NEUROPSYCHIATRIC MANIFESTATIONS OF SYSTEMIC LUPUS ERYTHEMATOSUS]. 2017

Stryjer, Rafael / Shriki Tal, Liron / Gizunterman, Alex / Amital, Daniela / Amital, Howard / Kotler, Moshe. ·Beer-Yaacov - Ness Ziona Mental Health Center. · Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel. ·Harefuah · Pubmed #29292617.

ABSTRACT: INTRODUCTION: This review deals with the neuropsychiatric disorders resulting from systemic lupus erythematosus (SLE). SLE is a chronic autoimmune disease that impacts all systems in the human body, including the central nervous system. Neuropsychiatric symptoms in SLE are a common complication of the disease. This complication has significant implications for the severity of the illness. In most cases no thorough psychiatric assessment is performed during initial evaluation of the disease and no protocol or clear guidelines for treating the psychiatric symptoms in SLE are available. Early diagnosis of the psychiatric symptoms in SLE is critical since absence of treatment may result in severe psychiatric complications. Clinical pharmacological studies are needed in order to develop guidelines for treating psychiatric symptoms in SLE.

11 Review Rheumatic diseases and autoimmune vascular dementia. 2017

Atzeni, Fabiola / Pipitone, Nicolò / Iaccarino, Luca / Masala, Ignazio Francesco / Weiss, Ronen / Alciati, Alessandra / Doria, Andrea / Chapmanand, Joab / Sarzi-Puttini, Piercarlo. ·IRCCS Orthopedic Institute of Galeazzi, Milan, Italy. Electronic address: atzenifabiola@hotmail.com. · Rheumatology Department, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. · Division of Rheumatology, University of Padoa, Italy. · Orthopedic and Trauma Unit, Santissima Trinità Hospital, Cagliari, Italy. · Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Neurology, Chaim Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel. · Department of Clinical Neurosciences, Villa San Benedetto Menni, Hermanas Hospitalarias, FoRiPsi, Albese con Cassano, Como, Italy. · Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Neurology, Robert and Martha Harden Chair in Mental and Neurological Diseases, Sackler Faculty of Medicine, Tel Aviv University, Israel. · Rheumatology Unit, L. Sacco University Hospital, Milan, Italy. ·Autoimmun Rev · Pubmed #29037904.

ABSTRACT: Vascular dementia (VD) comes second after Alzheimer's disease (AD) as a cause of impaired cognition. VD is not a specific nosological entity, but rather a syndrome encompassing a number of diseases caused by impaired supply of blood to the brain. Systemic autoimmune disorders such as systemic lupus erythematosus, rheumatoid arthritis, vasculitis and antiphospholipid syndrome (APS) can be associated with dementia. VD is often related to the presence of traditional cardiovascular risk factors, but it may also be associated with a host of disorders affecting the brain blood vessels, neuronal cells, or both. It is important to entertain in the differential diagnosis of VD, to recognize and to cure them accurately in order to preserve life's quality of our patients.

12 Review Human papilloma virus and lupus: the virus, the vaccine and the disease. 2017

Segal, Yahel / Calabrò, Michele / Kanduc, Darja / Shoenfeld, Yehuda. ·aZabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel bDepartment of Emergency and Organ Transplantation cDepartment of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy dSackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel. ·Curr Opin Rheumatol · Pubmed #28394823.

ABSTRACT: PURPOSE OF REVIEW: Systemic lupus erythematosus (SLE) is a well known, widespread autoimmune disease, involving multiple organ systems, with a multifaceted, widely unmapped etiopathogenesis. Recently, a new aspect of morbidity has been described among SLE patients: infection with human papilloma virus (HPV). We set out to review data regarding the intricate relationship between the two and attempt to determine whether HPV may pose as a contributing factor to the development of SLE. RECENT FINDINGS: We relate to epidemiological, molecular and clinical data. We have found evidence in all these fields suggesting HPV to be involved in the pathogenesis of SLE: increased prevalence of HPV infection among SLE patients; vast molecular homology between viral peptides and human proteins associated with SLE; several reports of SLE development post-HPV vaccination. Our findings suggest a possible involvement of HPV infection in the induction of SLE, via a mechanism of immune cross-reaction due to molecular homology. SUMMARY: We review clinical, epidemiological and molecular data suggesting involvement of HPV infection in the pathogenesis of SLE. We suggest that these findings may justify the development of new HPV vaccines containing viral peptides that bear no homology to the human proteome, in order to avoid possible adverse immune cross-reactivity.

13 Review Neuropsychiatric SLE: from animal model to human. 2017

Pikman, R / Kivity, S / Levy, Y / Arango, M-T / Chapman, J / Yonath, H / Shoenfeld, Y / Gofrit, S G. ·1 Israel Defense Forces Medical Corps, Ramat Gan, Israel. · 2 Department of Medicine A, Sheba Medical Center, Tel-Hashomer, Israel. · 3 The Zabludovicz Center for Autoimmune Diseases. · 4 The Dr Pinchas Borenstein Talpiot Medical Leadership Program 2013; and Sheba Medical Center, Tel-Hashomer, Israel. · 5 Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel. · 6 Department of Medicine E, Meir Medical Center, Kfar Saba, Israel; affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. · 7 Doctoral Program in Biomedical Sciences, Universidad del Rosario, Bogotá-Colombia. · 8 Department of Neurology, Sagol Neuroscience Center, Sheba Medical Center, Tel-Hashomer, Israel. · 9 The Danek Gartner Institute of Human Genetics, Sheba Medical Center, Tel-Hashomer, Israel. · 10 Incumbent of the Laura Schwarz-Kip Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel Aviv University, Israel. ·Lupus · Pubmed #28394237.

ABSTRACT: Animal models are a key element in disease research and treatment. In the field of neuropsychiatric lupus research, inbred, transgenic and disease-induced mice provide an opportunity to study the pathogenic routes of this multifactorial illness. In addition to achieving a better understanding of the immune mechanisms underlying the disease onset, supplementary metabolic and endocrine influences have been discovered and investigated. The ever-expanding knowledge about the pathologic events that occur at disease inception enables us to explore new drugs and therapeutic approaches further and to test them using the same animal models. Discovery of the molecular targets that constitute the pathogenic basis of the disease along with scientific advancements allow us to target these molecules with monoclonal antibodies and other specific approaches directly. This novel therapy, termed "targeted biological medication" is a promising endeavor towards producing drugs that are more effective and less toxic. Further work to discover additional molecular targets in lupus' pathogenic mechanism and to produce drugs that neutralize their activity is needed to provide patients with safe and efficient methods of controlling and treating the disease.

14 Review A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS). 2017

van Vollenhoven, Ronald / Voskuyl, Alexandre / Bertsias, George / Aranow, Cynthia / Aringer, Martin / Arnaud, Laurent / Askanase, Anca / Balážová, Petra / Bonfa, Eloisa / Bootsma, Hendrika / Boumpas, Dimitrios / Bruce, Ian / Cervera, Ricard / Clarke, Ann / Coney, Cindy / Costedoat-Chalumeau, Nathalie / Czirják, László / Derksen, Ronald / Doria, Andrea / Dörner, Thomas / Fischer-Betz, Rebecca / Fritsch-Stork, Ruth / Gordon, Caroline / Graninger, Winfried / Györi, Noémi / Houssiau, Frédéric / Isenberg, David / Jacobsen, Soren / Jayne, David / Kuhn, Annegret / Le Guern, Veronique / Lerstrøm, Kirsten / Levy, Roger / Machado-Ribeiro, Francinne / Mariette, Xavier / Missaykeh, Jamil / Morand, Eric / Mosca, Marta / Inanc, Murat / Navarra, Sandra / Neumann, Irmgard / Olesinska, Marzena / Petri, Michelle / Rahman, Anisur / Rekvig, Ole Petter / Rovensky, Jozef / Shoenfeld, Yehuda / Smolen, Josef / Tincani, Angela / Urowitz, Murray / van Leeuw, Bernadette / Vasconcelos, Carlos / Voss, Anne / Werth, Victoria P / Zakharova, Helena / Zoma, Asad / Schneider, Matthias / Ward, Michael. ·Department of Medicine, Unit for Clinical Therapy Research, Inflammatory Diseases (ClinTRID), Karolinska Institutet, D1:00 Karolinska University Hospital, Solna, Stockholm, Sweden. · Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands. · Department of Rheumatology, Clinical Immunology and Allergy, University of Crete School of Medicine, Iraklion, Greece. · Feinstein Institute for Medical Research, Manhasset, New York, USA. · Department of Medicine III, University Medical Center TU Dresden, Dresden, Germany. · New York University, New York, USA. · LPRe SR-Klub Motýlik, Bratislava, Slovakia. · Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. · Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. · Department of Medicine and Joint Academic Rheumatology Program Medical School, National and Kapodestrian University of Athens, Athens, Greece. · NIHR Manchester Biomedical Research Unit, The University of Manchester and Central Manchester Foundation Trust, Manchester, UK. · Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Catalonia, Spain. · Division of Rheumatology, The Arthritis Society Chair in Rheumatic Diseases Cumming School of Medicine University of Calgary, Calgary, Alberta, Canada. · Lupus Foundation of America, Washington DC, USA. · Université Paris-Decartes, Paris, France. · AP-HP, Hôpital Cochin, service de médecine interne, centre de reference maladies auto-immunes et systémiques rares, Paris, France. · Department of Rheumatology and Immunology, Institute of Bioanalysis, Institute of Family Medicine, University of Pécs, Pécs, Hungary. · Third Department of Internal Medicine, Semmelweis University, Budapest, Hungary. · Department Rheumatology and Clinical Immunology, University Medical Center, Utrecht, The Netherlands. · Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy. · Department Medicine/Rheumatology and Clinical Immunology, Charite Universitätsmedizin Berlin, Berlin, Germany. · Polyclinic of Rheumatology, Hiller Research Unit, University Clinic Duesseldorf, Heinrich-Heine-University, Duesseldorf, Germany. · Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. · Division of Rheumatology, Medical University of Graz, Graz, Austria. · Service de Rhumatologie, Cliniques universitaires Saint-Luc, Pôle de pathologies rhumatismales inflammatoires et systémiques, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Bruxelles, Belgium. · Department of Medicine, The Centre for Rheumatology, University College London, UK. · Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Copenhagen, Denmark. · Department of Medicine, University of Cambridge, Cambridge, UK. · Interdisciplinary Center for Clinical Trials (IZKS), University Medical Center Mainz, Mainz, Germany. · LUPUS EUROPE, co-opted trustee for research, Essex UK. · Rheumatology Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. · Université Paris-Sud; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-sud; INSERM U1184, Le Kremlin Bicêtre, France. · Bone Densitometry Unit, Monla Hospital, Tripoli, Lebanon. · Monash University, Faculty of Medicine, Nursing & Health Sciences, Monash Medical Centre, Clayton, Australia. · Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. · Department of Internal Medicine, Division of Rheumatology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey. · University of Santo Tomas, Manila, Philippines. · Vasculitis.at, Vienna, Austria. · Department of Connective Tissues Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland. · Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. · RNA and Molecular Pathology Research Group, Institute of Medical Biology, Health Science Faculty, University of Tromsø, Tromsø, Norway. · National Institute for Rheumatic Diseases, Piešťany, Slovak Republic. · Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center (Affiliated to Tel-Aviv University), Tel-Aviv, Israel. · Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria. · 2nd Department of Medicine, Hietzing Hospital, Vienna, Austria. · Dipartimento di Scienze Cliniche e Sperimentali, Università degli Studi di Brescia, U.O. Reumatologia e Immunolgia Clinica, Spedali Civili di Brescia, Brescia, Italy. · Centre for Prognosis Studies in the Rheumatic Diseases, Senior Scientist Krembil Research Institute, Professor Medicine, University of Toronto, Toronto Western Hospital EW 1-409, Toronto, Canada. · Unidade de Imunologia Clínica, Hospital Santo António, Centro Hospitalar do Porto, UMIB, Instituto de Ciencias Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal. · Department of Rheumatology, Odense University Hospital, University of Southern Denmark, Denmark. · Corporal Michael J. Crescenz VA Medical Center (Philadelphia), Philadelphia, Philadelphia, USA. · Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA. · Nephrology Unit, City Clinical Hospital n.a. S.P. Botkin, Moscow, Russia. · Lanarkshire Centre for Rheumatology, Hairmyres Hospital, Scotland, UK. · National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA. ·Ann Rheum Dis · Pubmed #27884822.

ABSTRACT: OBJECTIVES: Treat-to-target recommendations have identified 'remission' as a target in systemic lupus erythematosus (SLE), but recognise that there is no universally accepted definition for this. Therefore, we initiated a process to achieve consensus on potential definitions for remission in SLE. METHODS: An international task force of 60 specialists and patient representatives participated in preparatory exercises, a face-to-face meeting and follow-up electronic voting. The level for agreement was set at 90%. RESULTS: The task force agreed on eight key statements regarding remission in SLE and three principles to guide the further development of remission definitions:1. Definitions of remission will be worded as follows: CONCLUSIONS: The work of this international task force provides a framework for testing different definitions of remission against long-term outcomes.

15 Review CD20-Mimotope Peptide Active Immunotherapy in Systemic Lupus Erythematosus and a Reappraisal of Vaccination Strategies in Rheumatic Diseases. 2017

Favoino, Elvira / Prete, Marcella / Marzullo, Andrea / Millo, Enrico / Shoenfeld, Yehuda / Perosa, Federico. ·Department of Biomedical Sciences and Oncology (DIMO), Systemic Rheumatic and Autoimmune Diseases, University of Bari Medical School, Piazza G. Cesare 11, 70124, Bari, Italy. · Department of Emergency and Organ Transplantation (DETO), Section of Anatomic Pathology, University of Bari Medical School, Piazza G. Cesare 11, 70124, Bari, Italy. · Department of Experimental Medicine-Biochemistry section and Center of Excellence for Biomedical Research University of Genoa, Viale Benedetto XV 9, 16132, Genoa, Italy. · Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Tel Aviv University, Tel Hashomer, 52621, Israel. · Department of Biomedical Sciences and Oncology (DIMO), Systemic Rheumatic and Autoimmune Diseases, University of Bari Medical School, Piazza G. Cesare 11, 70124, Bari, Italy. federico.perosa@uniba.it. ·Clin Rev Allergy Immunol · Pubmed #27216429.

ABSTRACT: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease in which any organs can be potential targets of autoimmune aggression. Although the pathogenic auto-antibodies have been well characterized, the role of B cells goes far beyond that of antibodies production, and B cell-targeted therapy may be an interesting therapeutic approach. The anti-CD20 monoclonal antibody rituximab has been successfully used to control the most severe form of SLE, and even if two controlled clinical trials failed to demonstrate its superiority compared to conventional immunosuppressants, off-label use of rituximab is still commonly adopted in clinical practice in SLE nephritis resistant to immunosuppressants. Different protocols have stipulated heterogeneous dosages but all of them included repeated injections of the drug, exposing the patient to the risk of adverse reactions and to tachyphylaxis (loss of the therapeutic effect). Stimulation of the host's immune system to develop a CD20 antigen-specific immune response by means of CD20-mimotope molecules may offer an approach that can overcome these drawbacks. This study provides a critical overview of vaccination therapy in rheumatic diseases and reports the design of a vaccination strategy in (New Zealand Black/New Zealand White) F1 SLE-prone mice using CD20-mimotope peptides. By week 47, this vaccine induces a B- cell depletion by 74 % (cell number, mean ± SD, 0.57 ± 0.38) as compared to week 29 (2.19 ± 0.55) (p = 0.005) and prolongs survival in peptide-treated mice (median, 46.71 weeks; 95 % CI, 39.78-53.64) as compared to the control group (median 39.85; 95 % CI, 37.41-42.30) (Kaplan-Meier p = 0.002), although no differences between the peptide group and control group were detected in terms of proteinuria and auto-antibodies titers. These data indicate the feasibility of this approach, and the mouse model described here may be useful to optimize vaccination protocol and to define the mechanism(s) underlying B- cell depletion.

16 Review Recent advances and current state of immunotherapy in systemic lupus erythematosus. 2016

Mok, Mo Yin / Shoenfeld, Yehuda. ·a Division of Rheumatology & Clinical Immunology, Department of Medicine , University of Hong Kong , Hong Kong. · b Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center , Tel-Aviv University , Tel-Aviv , Israel. ·Expert Opin Biol Ther · Pubmed #27032059.

ABSTRACT: INTRODUCTION: Systemic lupus erythematosus (SLE) is an autoimmune syndrome that poses significant challenges in diagnosis and treatment. Dysregulated innate and adaptive immune systems are involved in its pathogenesis. A plethora of novel immunotherapies have been developed for the treatment of SLE but many have failed early clinical trials. AREAS COVERED: This review summarizes immunotherapies under recent development with relevance to the targeted cellular or soluble factors involved in the pathogenesis of SLE. EXPERT OPINION: SLE is a complicated disease with much heterogeneity. Novel immunotherapies with different mechanisms of action that are currently under development include biologic agents targeting co-stimulatory molecules, cytokines or their receptors and signaling molecules and B cells, cell-based therapy and peptide therapy. Together with good scientific rationale and advanced biological engineering techniques, optimization of clinical trial design, patient selection and disease outcome measures are essential to demonstrate the clinical efficacy and safety of these agents.

17 Review Hypothyroidism among SLE patients: Case-control study. 2016

Watad, Abdulla / Mahroum, Naim / Whitby, Aaron / Gertel, Smadar / Comaneshter, Doron / Cohen, Arnon D / Amital, Howard. ·Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel, Sackler; Faculty of Medicine, Tel-Aviv University, Israel. · Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel, Sackler. · Chief Physician's Office, Clalit Health Services Tel Aviv, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel. · Chief Physician's Office, Clalit Health Services Tel Aviv, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel. · Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel, Sackler; Faculty of Medicine, Tel-Aviv University, Israel. Electronic address: howard.amital@sheba.health.gov.il. ·Autoimmun Rev · Pubmed #26826435.

ABSTRACT: BACKGROUND: The prevalence of hypothyroidism in SLE patients varies considerably and early reports were mainly based on small cohorts. OBJECTIVES: To investigate the association between SLE and hypothyroidism. METHODS: Patients with SLE were compared with age and sex-matched controls regarding the proportion of hypothyroidism in a case-control study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services. RESULTS: The study included 5018 patients with SLE and 25,090 age and sex-matched controls. The proportion of hypothyroidism in patients with SLE was increased compared with the prevalence in controls (15.58% and 5.75%, respectively, P<0.001). In a multivariate analysis, SLE was associated with hypothyroidism (odds ratio 2.644, 95% confidence interval 2.405-2.908). CONCLUSIONS: Patients with SLE have a greater proportion of hypothyroidism than matched controls. Therefore, physicians treating patients with SLE should be aware of the possibility of thyroid dysfunction.

18 Review Eppur Si Muove: vitamin D is essential in preventing and modulating SLE. 2016

Azrielant, S / Shoenfeld, Y. ·The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. · The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel Incumbent of the Laura Schwarz-Kip Chair for Research of Autoimmune Diseases, Tel-Aviv University, Israel shoenfel@post.tau.ac.il. ·Lupus · Pubmed #26811372.

ABSTRACT: Systemic lupus erythematosus (abbreviated SLE or lupus) is a systemic autoimmune disease, with genetic, immunologic, hormonal, and environmental factors.(1)One of the environmental factors that has been studied over the years is vitamin D, which is created in the human body in response to exposure to sunlight and ultraviolet (UV) radiation.This review aims at examining findings from recent years, specifically 2013-2014, regarding the relationship between vitamin D deficiency and SLE flares, severity, and clinical manifestation, as well as to examine the treatment options derived from this relationship.

19 Review Pharmacologic management of neuropsychiatric lupus. 2016

Kivity, Shaye / Baker, Britain / Arango, Maria-Teresa / Chapman, Joab / Shoenfeld, Yehuda. ·a The Zabludowicz Center for Autoimmune Diseases , The Chaim Sheba Medical Center, Tel-Hashomer , Ramat-Gan , Israel. · b Rheumatology Unit, The Chaim Sheba Medical Center , Tel Hashomer , Ramat-Gan , Israel. · c Department of Medicine 'A', The Chaim Sheba Medical Center , Tel Hashomer , Ramat-Gan , Israel. · d The Dr. Pinchas Borenstein Talpiot Medical Leadership Program 2013, The Chaim Sheba Medical Center , Tel Hashomer , Ramat-Gan , Israel. · e St Georges University of London/Nicosia Medical School , University of Nicosia , Egkomi , Cyprus. · f Doctorate Program of Universidad del Rosario , Bogotá , Colombia. · g Department of Neurology , Sagol Neuroscience Center, Sheba Medical Center, Tel-Hashomer , Ramat Gan , Israel. · h Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel. · i Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases , Tel-Aviv University , Tel-Aviv , Israel. ·Expert Rev Clin Pharmacol · Pubmed #26559084.

ABSTRACT: Neuropsychiatric lupus affects above 50% of patients with systemic lupus erythematosus and may span from mild symptoms to acute devastating life-threatening ones. Owing to the clinical variability, most pharmacological data rely on small, uncontrolled trials and case reports. The mainstay of therapy relies on immune-suppression by glucocorticoids, in adjunction with cyclophosphamide or anti-B-cell therapy, in moderate to severe cases. In selected scenarios (e.g., chorea) intravenous immunoglobulin or plasmapheresis may be effective. Anticoagulation is warranted if anti-phospholipid antibodies are present. In parallel there may be a need for symptomatic treatment such as anti-epileptic or anti-depressive treatments, etc. In the future, more studies addressed to assess pathogenesis and preferred treatments of specific manifestations are needed in order to personalize treatments.

20 Review Infectomics and autoinfectomics: a tool to study infectious-induced autoimmunity. 2015

Bogdanos, D P / Smyk, D S / Rigopoulou, E I / Sakkas, L I / Shoenfeld, Y. ·Institute of Liver Studies, King's College London School of Medicine at King's College Hospital, London, UK Department of Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece bogdanos@med.uth.gr. · Institute of Liver Studies, King's College London School of Medicine at King's College Hospital, London, UK. · Department of Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece. · The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Aviv University, Tel-Hashomer, Israel. ·Lupus · Pubmed #25801879.

ABSTRACT: The exposome represents all exogenous and endogenous environmental exposures that begin at preconception and carry on throughout life, while the microbiome reflects the microbial component of the exposome. We recently introduced the concept of infectome and autoinfectome as a means of studying the totality of infections throughout life that participate in the induction as well as the progression of autoimmune diseases in an affected individual. The investigation of the autoinfectome could help us understand why some patients develop more than one autoimmune disease, a phenomenon also known as mosaic of autoimmunity. It could also explain the infectious and autoantibody burden of various autoimmune rheumatic diseases. The close interplay between infections and the immune system should be studied over time, long before the onset of autoaggression and autoimmunity. Tracking down each individual's exposure to infectious agents (as defined by the autoinfectome) would be important for the establishment of a causative link between infection and autoimmunity.

21 Review State of the art: Reproduction and pregnancy in rheumatic diseases. 2015

Østensen, Monika / Andreoli, Laura / Brucato, Antonio / Cetin, Irene / Chambers, Christina / Clowse, Megan E B / Costedoat-Chalumeau, Nathalie / Cutolo, Maurizio / Dolhain, Radboud / Fenstad, M H / Förger, Frauke / Wahren-Herlenius, Marie / Ruiz-Irastorza, Guillermo / Koksvik, Hege / Nelson-Piercy, Catherine / Shoenfeld, Yehuda / Tincani, Angela / Villiger, Peter M / Wallenius, Marianne / von Wolff, Michael. ·National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, St. Olavs Hospital, University Hospital of Trondheim, Norway. Electronic address: monika.ostensen@gmail.com. · Rheumatology and Clinical Immunology, Spedali Civili of Brescia, Department of Clinical and Experimental Sciences, University of Brescia, Italy. · Department of Internal Medicine, Ospedale papa Giovanni XXIII Bergamo, Italy. · Department of Mother and Child, Hospital Luigi Sacco, University of Milano, Italy. · Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA. · Division of Rheumatology, Department of Medicine, Duke University Medical Center, Durham, NC, USA. · Université Paris-Descartes, Paris, France; AP-HP, Hôpital Cochin, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Paris, France. · Research Laboratories and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Genova, Italy. · Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. · Department of Immunology and Transfusion Medicine, St. Olavs Hospital, Trondheim, Norway. · Department of Rheumatology and Clinical Immunology/Allergology, University Hospital of Bern, CH-3010 Bern, Switzerland. · Department of Medicine, Centre for Molecular Medicine, Karolinska Universitetssjukhuset, Stockholm, Sweden. · Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Bizkaia, Spain. · National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, St. Olavs Hospital, University Hospital of Trondheim, Norway. · Women's Health Academic Centre, St Thomas' Hospital, London, UK. · Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel. · Department of Rheumatology and Clinical Immunology, Ospedale Civile and University of Brescia, Brescia, Italy. · Department of Rheumatology and Clinical Immunology/Allergology, University Hospital of Bern, Bern, Switzerland. · National Service for Pregnancy and Rheumatic Diseases, Department of Rheumatology, Trondheim University Hospital, Trondheim, Norway; Dept of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. · University Women's Hospital, Division of Gynaecological Endocrinology and Reproductive Medicine, University of Berne, Berne, Switzerland. ·Autoimmun Rev · Pubmed #25555818.

ABSTRACT: Throughout the last decade, increasing awareness has been raised on issues related to reproduction in rheumatic diseases including basic research to clarify the important role of estrogens in the etiology and pathophysiology of immune/inflammatory diseases. Sub- or infertility is a heterogeneous condition that can be related to immunological mechanisms, to pregnancy loss, to disease burden, to therapy, and to choices in regard to family size. Progress in reproductive medicine has made it possible for more patients with rheumatic disease to have children. Active disease in women with rheumatoid arthritis (RA) affects their children's birth weight and may have long-term effects on their future health status. Pregnancy complications as preeclampsia and intrauterine growth restriction are still increased in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS), however, biomarkers can monitor adverse events, and several new therapies may improve outcomes. Pregnancies in women with APS remain a challenge, and better therapies for the obstetric APS are needed. New prospective studies indicate improved outcomes for pregnancies in women with rare diseases like systemic sclerosis and vasculitis. TNF inhibitors hold promise for maintaining remission in rheumatological patients and may be continued at least in the first half of pregnancy. Pre-conceptional counseling and interdisciplinary management of pregnancies are essential for ensuring optimal pregnancy outcomes.

22 Review Good prognosis for hospitalized SLE patients with non-related disease. 2014

Zimlichman, Eyal / Rothschild, Jacob / Shoenfeld, Yehuda / Zandman-Goddard, Gisele. ·Department of Medicine B, Wolfson Medical Center, Israel. · Sackler Faculty of Medicine, Tel-Aviv University, Israel. · Sackler Faculty of Medicine, Tel-Aviv University, Israel; The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Israel. · Sackler Faculty of Medicine, Tel-Aviv University, Israel; Department of Medicine C, Wolfson Medical Center, Israel. Electronic address: goddard@wolfson.health.gov.il. ·Autoimmun Rev · Pubmed #25182206.

ABSTRACT: Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by widespread organ involvement. Given the scope of modern treatment, there has been a rise in life expectancy and quality with a mean estimated 5-year survival of 82%-90%. Hence, hospitalizations of SLE patients for non-SLE related causes have not been investigated. Our aim was to characterize the SLE patients admitted to the internal medicine wards, the main diagnosis at admission, and the course of hospitalization and to compare the outcome with the general population. We expected to find a significant difference between the SLE population and the general population regarding hospitalization parameters. However we found a good prognosis for hospitalized SLE patients with non-related disease compared to the non-SLE group. SLE was not a significant prognostic factor for outcome in patients hospitalized in the internal medicine ward for non-related causes. Men with SLE had a worse prognosis during hospitalization when compared to females. The SLEDAI score was not an appropriate prognostic method for the outcome of hospitalization.

23 Review Central nervous system involvement in systemic lupus erythematosus: an imaging challenge. 2013

Gal, Yaniv / Twig, Gilad / Mozes, Oshry / Greenberg, Gahl / Hoffmann, Chen / Shoenfeld, Yehuda. ·Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel. Gal.Yaniv@sheba.health.gov.il ·Isr Med Assoc J · Pubmed #23943987.

ABSTRACT: Systemic lupus erythematosus (SLE) is a complex autoimmune disorder involving multiple organs. One of the main sites of SLE morbidity is the central nervous system (CNS), specifically the brain. In this article we review several imaging modalities used for CNS examination in SLE patients. These modalities are categorized as morphological and functional. Special attention is given to magnetic resonance imaging (MRI) and its specific sequences such as diffusion-weighted imaging (DWI), diffuse tensor imaging (DTI) and magnetic resonance spectroscopy (MRS). These modalities allow us to better understand CNS involvement in SLE patients, its pathophysiology and consequences.

24 Review Systemic lupus erythematosus one disease or many? 2012

Agmon-Levin, N / Mosca, M / Petri, M / Shoenfeld, Y. ·The Zabludowicz Center for Autoimmune Diseases Sheba Medical Center, Tel Hashomer, Israel. ·Autoimmun Rev · Pubmed #22041578.

ABSTRACT: Systemic lupus erythematosus (SLE) characterizes by a variety of clinical manifestations and the presence of a wide profile of autoantibodies. This clinical and serological heterogeneity raised the question: is SLE a single disease with varied phenotypes, or a similar phenotype shared by different diseases with diverse pathogenic mechanisms? Herein we debate the clinical, genetic, hormonal and serological differences typically observed in SLE on the one hand, and the numerous similarities between subtypes of this disease on the other. Leading to the conclusion that SLE may be considered not as a single disease but rather as a single syndrome, which defines by a set of signs, symptoms, or phenomena that occur together and suggest a particular abnormality. Additionally, the accumulated knowledge on gene expression pathways, autoantibodies clusters, hormonal and environmental factors associated with SLE may allow a better classification of this syndrome and updating of SLE criteria. This may further allow targeted biologics and other therapies as well as "personalized medicine" to begin.

25 Review [The clinical importance of anti-ribosomal-P antibodies]. 2010

Ben-Ami, Shor Dana / Blank, Miri / Altman, Arie. ·Center for Auto mmune Diseases & Department of Medicine B, Sheba Medical Center, Tel-Hashomer, Israel. benamidana@gmail.com ·Harefuah · Pubmed #21916104.

ABSTRACT: Anti-ribosomal phosphoprotein autoantibodies (anti-RP Abs) are highly specific for SLE, especially for neuropsychiatric manifestations including psychosis, mood disorders, anxiety, cognitive dysfunction and delirium. In addition to the neuropsychiatric involvement, anti-RP antibodies are believed to be correlated with nephritis, hepatitis and dermal diseases in SLE. Several studies indicate the association between increased titers of anti-RP Abs in the patient's sera and active SLE disease. The reported prevalence of anti-RP Abs among SLE patients is 10%-40%. Recently, a connection between the presence of anti-RP Abs in the serum and class V lupus nephritis has been demonstrated. Anti-RP Abs binds 3 ribosomal proteins identified as P0, P1 and P2 (38, 19 and 17-kDa, respectively) by recognizing a certain epitope found in those 3 proteins. This specific epitope contains 22 amino acids at the C terminal end (C-22) of the protein. There are studies in the literature relating to the involvement of anti-RP Abs in the pathogenesis of organ damage. The main pathways described are cross-reaction with anti-dsDNA antibodies, a cytotoxic effect on mesangium cell proliferation, invasion into living cells and onset of apoptosis, a defect in the synthesis of apolipoprotein B resulting in accumulation of lipids inside the cell, and downregulation of the total protein synthesis. The authors provide an updated review concerning the multisystem involvement of anti-RP Abs in SLE, particularly in the brain, kidney and liver. Moreover, this article includes a summary of the most relevant studies regarding the cellular involvement of anti-RP Abs.

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