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Editorial
From a caterpillar to a butterfly. There is much to learn in systemic lupus erythematosus
De la oruga a la mariposa. Mucho que aprender en lupus eritematoso sistémico
Gloria Vásquez
Rheumatology Group, Cellular Immunology Group and Immunogenetics, Faculty of Medicine, University of Antioquia, Medellin, Colombia
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">This project started more than one year ago&#44; it was intended to generate an issue of the Journal with current topics on a disease whose study is amazing&#58; systemic lupus erythematosus &#40;SLE&#41;&#44; and the tasks began&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Professors and colleagues interested in this complex disease were convened&#44; and the response was impressive&#44; review and original articles about multiple aspects and concerns generated by SLE were received&#44; coming from different places of the world&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Thus&#44; it was decided to develop two issues in order to be able to disclose new&#44; known and established aspects about the pathogenesis&#44; associated diseases&#44; special situations and management challenges&#46; In this second issue there are five review articles and three original articles&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The use of antimalarial drugs in SLE is always a topic of interest&#44; in this issue there is an original work<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> which shows&#44; in a group of patients with nephritis better outcomes in those patients under treatment with antimalarial drugs and strict control of their blood pressure&#46; Previous evidences have demonstrated the importance of these two aspects as coadjuvants in the management of the nephritis&#44; but this finding in the Latino population&#44; known its severe renal involvement&#44; is of utmost importance&#46; In addition to this original work&#44; it includes a topic review which emphasizes the safety of the antimalarial agents&#44; the low frequency of retinal toxicity and also&#44; the importance of early detection of adverse events in order to take advantage of their reversibility&#59; likewise&#44; recommendations are made on diagnostic aids for the follow-up of these patients&#44; and how these aids should be implemented five years after the drug is started&#44; since after this time the risk of toxicity increases&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Another great challenge in lupus is its association with the antiphospholipid syndrome&#59; this issue includes an excellent review by the experts of the Hospital Clinic de Barcelona which illustrates on the importance of this syndrome&#44; its association with SLE and its incidence in morbidity and mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The predominant lupus affection in women of reproductive age implies to consider special situations during the period of illness&#44; such as pregnancy&#44; birth control and breastfeeding&#46; In this issue there is an in-depth review<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a> of these aspects&#44; including management guidelines&#46; It is worth highlighting that it is a topic of such interest that two articles in this regard were included in these two monographic issues on lupus&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Similarly&#44; a very current topic is the relationship between environmental events and the onset of the disease&#44; this issue includes a review article<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> in which the evidence of hormonal and infectious factors associated with the onset of SLE is presented&#59; in addition&#44; the associations described with the exposure to silica&#44; mercury and other chemical agents are reviewed&#46; The information on the possible participation of retroviral agents draws attention&#44; information on their possible role is presented and the technical difficulties for the study of these components in the pathogenesis of this entity are described&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">In this monographic issue it could not be forgotten to take a look at basic science topics&#44; for this reason an excellent review about the role of cytokines in the pathogenesis of lupus was included&#44; in which the evidence of the participation of multiple cytokines involved in different aspects of the disease is presented&#46; Reviewing the function of these molecules in the pathogenesis opens the possibility of observing how cytokines can be therapeutic targets in lupus&#44; as is currently the case with BAFF and interferon&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">An original work conducted by an Indonesian group which evaluates the association of micro RNA-146a and its target molecule IRAK in the pathogenesis of SLE is also included&#46; As an interesting finding&#44; it is one of these articles with negative findings that are rarely published&#44; since the associations were given as a protective factor against the disease&#44; and not as an inducer thereof&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Aspects such as the quality of life cannot be missed when talking about SLE&#44; for this reason&#44; it was included an original article in which the quality of life was assessed in 200 patients with rheumatoid arthritis and SLE in Egypt&#46; In order to evaluate this aspect&#44; validated instruments such as the SF36 questionnaire&#44; tools for the evaluation of anxiety and depression such as the HAM-A and the Zung self-rating depression questionnaire were used&#46; Aspects of sexuality are also evaluated and an interesting finding in which the degree of sexual dysfunction in patients with lupus was not associated with the disease activity was described&#44; in contrast to the findings in rheumatoid arthritis&#44; in which it was positively associated with the disease activity&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">This introductory editorial can be concluded with the following words&#58; there is much&#44; much to learn on this disease and&#44; although it is considered to be a butterfly with its spectrum of colors&#44; sizes and variations&#44; it is still in the caterpillar stage&#44; and we must learn a lot about this disease and its multiple challenges&#46;</p></span>"
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Article information
ISSN: 01218123
Original language: English
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