Systemic lupus erythematosus: latest insight into etiopathogenesis

Rheumatol Int. 2023 Aug;43(8):1381-1393. doi: 10.1007/s00296-023-05346-x. Epub 2023 May 24.


Systemic lupus erythematosus (SLE) is a complex autoimmune disorder of unknown etiology. Multifactorial interaction among various susceptible factors such as environmental, hormonal, and genetic factors makes it more heterogeneous and complex. Genetic and epigenetic modifications have been realized to regulate the immunobiology of lupus through environmental modifications such as diet and nutrition. Although these interactions may vary from population to population, the understanding of these risk factors can enhance the perception of the mechanistic basis of lupus etiology. To recognize the recent advances in lupus, an electronic search was conducted among search engines such as Google Scholar and PubMed, where we found about 30.4% publications of total studies related to genetics and epigenetics, 33.5% publications related to immunobiology and 34% related to environmental factors. These outcomes suggested that management of diet and lifestyle have a direct relationship with the severity of lupus that influence via modulating the complex interaction among genetics and immunobiology. The present review emphasizes the knowledge about the multifactorial interactions between various susceptible factors based on recent advances that will further update the understanding of mechanisms involved in disease pathoetiology. Knowledge of these mechanisms will further assist in the creation of novel diagnostic and therapeutic options.

Keywords: Environmental factors; Epigenetics; Etiology; Immunobiology; Lupus; Multifactorial interactions.

Publication types

  • Review

MeSH terms

  • Autoimmune Diseases*
  • Epigenesis, Genetic
  • Humans
  • Lupus Erythematosus, Systemic* / drug therapy
  • Risk Factors