Systemic lupus erythematodes (SLE) is chronic autoimmune disease, characteristic by production of autoantibodies against different autoantigens. Etiopathogenesis in not precise determinated, but genetic, immunologic, hormonal factors or influence of environment are assumed. It manifests by various symptoms and it can affect whichever organ or system in the body. Clinical manifestation are due chronic inflammation in the tissues, which is caused first of all by deposit of immunocomplex and by cytotoxic damage. At the last decades the mortality of patients with SLE is markly lower and their live is prolong. In spite of this diagnostic, to follow up and therapy of this disease is complicated and it requires the colaboration of more branches of medicine.

• MeSH
• lidé MeSH
• systémový lupus erythematodes * komplikace   diagnóza   farmakoterapie   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: To determine differences in the blood innate gene expression signatures of systemic lupus erythematosus (SLE) patients across various organ manifestations and disease activity, with a focus on lupus nephritis (LN) and central nervous system (CNS) involvement. METHODS: Toll-like receptor family (TLR 1-10) mRNA expression was investigated in peripheral blood mononuclear cells from patients with SLE (n = 74) and healthy controls (n = 34). We compared patients with histologically confirmed active LN or neuropsychiatric systemic lupus erythematosus (NPSLE) with patients without these symptoms. The expression of TLR mRNA was determined by RT‒qPCR using a high-throughput SmartChip Real-Time-qPCR system (WaferGen). Multivariate analysis and nonparametric statistics were used for data analysis to assess the associations between TLRs and disease activity and severity. RESULTS: TLR4 (0.044 vs. 0.081, p = 0.012) was upregulated and TLR10 (0.009 vs. 0.006, p = 0.0007) was downregulated in the whole cohort of SLE patients compared to healthy controls. A comparison of the active LN group with participants without kidney involvement revealed increased expression of TLR2 (0.078 vs. 0.03, p = 0.009), and TLR5 (0.035 vs. 0.017, p = 0.03). Moreover, a significant difference was observed in TLR9 expression between inactive LN and the control group (0.014 vs. 0.009, p = 0.01), together with borderline correlation in TLR2 expression (0.04 vs. 0.03, p = 0.06). Receiver operating characteristic (ROC) curve analysis revealed that TLR1 and TLR2 expression were the best potential diagnostic markers for active LN. The NPSLE group showed upregulation of TLR1 (0.088 vs. 0.048, p = 0.01), TLR4 (0.173 vs. 0.066, p = 0.0003) and TLR6 (0.087 vs. 0.036, 0.007). Our correlation analysis supported the close relationships among the expression of individual TLRs in the whole lupus cohort and its subgroups. CONCLUSION: Our study revealed differences in TLR expression between a lupus cohort and healthy controls. Additionally, our analysis provides insight into specific TLR expression in cases with severe organ manifestations, such as LN and NPSLE. The multiple mutual relationships of TLRs demonstrate the activation of innate immunity in SLE and suggest promising targets for future therapies or diagnostics.

• Klíčová slova
• Disease activity, Innate immunity, Lupus nephritis, Systemic lupus erythematosus, Toll-like receptors,
• MeSH
• dospělí MeSH
• exprese genu MeSH
• leukocyty mononukleární metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• nefritida při lupus erythematodes * genetika   krev   diagnóza   MeSH
• systémový lupus erythematodes * genetika   krev   MeSH
• toll-like receptory * genetika   krev   biosyntéza   MeSH
• vaskulitida centrálního nervového systému při lupus erythematodes * genetika   krev   diagnóza   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• toll-like receptory * MeSH

Systemic lupus erythematosus treatment is targeted to achieve remission or low disease activity and protection from disease flares. A number of immunosupresive drugs in combination with glucocorticoids are used for this purpose and there is an increased possibility of the use of biologic treatment, especially of belimumab. Calcineurin inhibitor voclosporin is a novelty in lupus nephritis treatment. Another novelty is anifrolumab, a biologic drug which inhibits the activity of type I interferons. An integral part of care is the prevention of late disease complications, especially cardiovascular risk management.

• Klíčová slova
• Lupus nephritis, Systemic lupus erythematosus, anifrolumab, belimumab, systemic lupus erythematosus, voclosporin,
• MeSH
• biologické přípravky * terapeutické užití   MeSH
• glukokortikoidy terapeutické užití   MeSH
• imunosupresiva terapeutické užití   MeSH
• inhibitory kalcineurinu terapeutické užití   MeSH
• interferon typ I * terapeutické užití   MeSH
• lidé MeSH
• systémový lupus erythematodes * komplikace   farmakoterapie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biologické přípravky * MeSH
• glukokortikoidy MeSH
• imunosupresiva MeSH
• inhibitory kalcineurinu MeSH
• interferon typ I * MeSH

We have examined electroencephalography (EEG) and Mini-Mental State Examination (MMSE) in 38 patients with verified diagnosis of systemic lupus erythematosus (SLE). In the clinical neurological finding there were epileptic attacks in 9 patients, 10 patients suffered from stroke, 15 patients from lupus headache, 4 patients from psychosis, in 15 patients cranial neuropathy was present, in one person extrapyramidal syndrome. EEG findings were in 12 patients normal (32%), in 26 patients abnormal (66%). In 3 cases there were focal abnormalities (8%), in 19 cases episodic ones (48%), four times abnormalities were diffuse (10%). Diffuse abnormalities correlated in EEG findings with case history of GM attacks.

• MeSH
• dospělí MeSH
• elektroencefalografie * MeSH
• lidé středního věku MeSH
• lidé MeSH
• systémový lupus erythematodes patofyziologie   MeSH
• vaskulitida centrálního nervového systému při lupus erythematodes diagnóza   MeSH
• záznam o duševním stavu MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• dítě MeSH
• dospělí MeSH
• kardiovaskulární nemoci * epidemiologie   etiologie   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• rizikové faktory kardiovaskulárních chorob * MeSH
• rizikové faktory MeSH
• systémový lupus erythematodes * komplikace   epidemiologie   MeSH
• věk při počátku nemoci MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

An analysis of three women with retinal vaso-occlusive disease in systemic lupus erythematosus produced evidence for this most severe ophthalmic complication during the acute phase of the syndrome. Vaso-occlusive retinopathy appeared 5 years after the onset of systemic symptomatology in all of them. Association of central nervous system lupus and circulating anti-coagulants with increased occurrence of severe retinal vaso-occlusive disease are the subject of the present report. Unilateral extensive photocoagulation of two cases appeared to result in successful therapy of neovascular glaucoma after the central retinal artery occlusion in one patient. Lupus erythematosus is very serious systemic and ocular disease also in present time.

• MeSH
• dospělí MeSH
• lidé MeSH
• okluze retinální arterie diagnóza   etiologie   terapie   MeSH
• systémový lupus erythematodes komplikace   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH

• Klíčová slova
• LUPUS ERYTHEMATOSUS/case reports *,
• MeSH
• chorobopisy * MeSH
• lidé MeSH
• systémový lupus erythematodes * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

The case presented describes a high-risk pregnancy of a woman with systemic lupus erythematosus (SLE) with multiple lesions of central nervous system (CNS), vasculitis, secondary epilepsy and antiphospholipid syndrome (APS). At gestational age 28 weeks and 3 days the pregnancy was urgently terminated via caesarean section and an extremely hypotrophic immature newborn with a birth weight of 580 g was born. The high disease activity in the mother at the time of conception and the histologically proven chronic placental insufficiency due to APS are presumably the causes for the extensive hypotrophy of the neonate. The significant comorbidity of the newborn, including respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, osteopathy of prematurity, transient hypothyroidism and hypocortisolism, vesicoureteral reflux, and hypertonic-hyperexcitation syndrome complicated his three-month stay in NICU. A positive titre of transplacentally transferred anticardiolipin and anti-β2 glycoprotein antibody was detected in the child and persisted through the following 30 months. During the three-year follow-up, significantly delayed neuropsychological development with microcephaly (-4 SD) and short stature of the child was observed. Finally, the authors discuss possible causes of neuropsychological consequences in children of mothers with SLE and APS and emphasize the need for long-term monitoring and specialized care to improve development of these children.

• Klíčová slova
• Systemic lupus erythematosus, cognitive disorder, hypotrophy, newborn, pregnancy, psychomotor development,
• MeSH
• antifosfolipidový syndrom komplikace   diagnóza   imunologie   MeSH
• časové faktory MeSH
• císařský řez MeSH
• dospělí MeSH
• epilepsie etiologie   MeSH
• gestační stáří MeSH
• komplikace těhotenství diagnóza   etiologie   imunologie   terapie   MeSH
• lidé MeSH
• novorozenec nedonošený * imunologie   MeSH
• novorozenec s extrémně nízkou porodní hmotností * imunologie   MeSH
• novorozenec MeSH
• porodní hmotnost MeSH
• prognóza MeSH
• systémový lupus erythematodes komplikace   diagnóza   imunologie   MeSH
• těhotenství MeSH
• vaskulitida centrálního nervového systému komplikace   MeSH
• vývoj dítěte MeSH
• vývojové poruchy u dětí etiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

The authors review recent findings pertaining to the pathogenesis of systemic lupus erythematosus. It was revealed that knowledge of impaired humoral and cellular immunity is of great practical importance and substantially improves the prognosis of the disease.

• MeSH
• imunologické testy * MeSH
• lidé MeSH
• systémový lupus erythematodes diagnóza   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

The authors assessed the damage of the cardiovascular apparatus in a group of 57 patients with systemic lupus erythematosus. Arterial hypertension was recorded in 19 patients (33%). The other most frequent defects were damage of the pericardium in 12 patients (21%) incl. 8 (14%) who had a pericardial exudate. Ischaemic heart disease was recorded in six patients. Serious forms of vasculitis were recorded in three patients and haemodynamically significant aortal insufficiency in two patients. Other forms of cardiovascular damage were rare.

• MeSH
• dospělí MeSH
• kardiovaskulární nemoci diagnóza   etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• systémový lupus erythematodes komplikace   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH