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Systemic lupus erythematosus: one year in review 2025.

Clin Exp Rheumatol

March 2025

Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.

This review highlights key advancements in systemic lupus erythematosus (SLE) research during 2024, covering pathogenesis, novel therapies, biomarkers, and clinical outcomes. Notable findings include new insights into immune dysregulation, promising therapeutic targets, and real-world data confirming the efficacy of anifrolumab and belimumab. Advances in biomarkers enhance disease monitoring, while multidisciplinary approaches improve reproductive outcomes and quality of life.

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The DNase TREX1 is a substrate of the intramembrane protease SPP with implications for disease pathogenesis.

Cell Mol Life Sci

March 2025

Institute for Physiological Chemistry, Faculty of Medicine Carl Gustav Carus, Medizinisch-Theoretisches Zentrum MTZ, Technische Universität Dresden, Fiedlerstraße 42, 01307, Dresden, Germany.

Signal peptide peptidase (SPP) is an ER-resident aspartyl intramembrane protease cleaving proteins within type II-oriented transmembrane segments. Here, we identified the tail-anchored protein Three prime repair exonuclease 1 (TREX1) as a novel substrate of SPP. Based on its DNase activity, TREX1 removes cytosolic DNA acting as a negative regulator of the DNA-sensing cGAS/STING pathway.

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Approximately 17% of our genome consists of copies of the retrotransposon "long interspersed element-1" (LINE-1 or L1). Patients with systemic lupus erythematosus (SLE) frequently have autoantibodies against the L1-encoded ORF1 protein (ORF1p), which correlate with disease activity and interferon gene signature. ORF1p is present in neutrophils from patients with active disease in perinuclear ribonucleoprotein particles that also contain Ro60 and nucleic acid sensors.

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Introduction: Hydroxychloroquine (HCQ), originally an antimalarial drug, is currently used to treat multiple disorders, especially rheumatic diseases. Given its good efficacy and safety, HCQ is widely administered in pregnant patients. However, the safety profile of HCQ during pregnancy remains controversial due to limited research.

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