Bone Involvement in Systemic Lupus Erythematosus
Abstract
:1. Introduction
2. SLE and Osteoporosis
2.1. Epidemiology of Osteoporosis
2.2. Fracture Risk
2.3. Physiopathology of Bone Loss in SLE
3. SLE and Osteonecrosis
3.1. Osteonecrosis in SLE Patients: Epidemiology, Risk Factors and Pathophysiology
3.2. Osteonecrosis Imaging
3.3. Osteonecrosis Management in SLE
4. SLE and Osteomyelitis
4.1. Osteomyelitis in SLE Patients: Epidemiology, Risk factors and Pathophysiology
4.2. Clinical Manifestations of Osteomyelitis in SLE Patients
4.3. Osteomyelitis Imaging
4.4. Osteomyelitis Management in SLE
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
1,25(OH)2D | 1,25-dihydroxy vitamin D |
aCL | Anti-cardiolipin |
ACPA | Antibody against citrullinated protein |
ACR | American College of Rheumatology |
AntiCarP | Anti-carbamylated protein antibody |
aPL | Anti-phospholipid antibodies |
APOL1 | Apolipoprotein L1 |
APS | Anti-Phospholipid Syndrome |
AVN | Avascular necrosis |
BAX | Bcl-2 associated X |
BM | Bone marrow |
BMD | Bone mineral density |
BMP | Bone morphogenetic protein |
CT | Computerized tomography |
CTLA4 | Cytotoxic T-Lymphocyte antigen 4 |
CTSG | Cathepsin G |
DHEA | Dehydroepiandrosterone |
DKK1 | Dickkopf-1 |
DNA | Deoxyribo-nucleic acid |
DXA | Dual-energy X-ray absorptiometry |
GCs | Glucocorticoids |
HCQ | Hydroxychloroquine |
HR | Hazard ratio |
IGF-1 | Insulin-like growth factor-1 |
IL1-RN | IL-1 receptor antagonist |
IL-1 | Interleukin-1 |
IL-1α | Interleukin-1α |
IL-1β | Interleukin-1β |
IL-4 | Interleukin-4 |
IL-6 | Interleukin-6 |
IL-8 | Interleukin-8 |
IL-10 | Interleukin-10 |
IL-12 | Interleukin-12 |
IL-12β | Interleukin-12β |
IL-17 | Interleukin-17 |
IL-21 | Interleukin-21 |
IFNα | Interferon α |
INFβ | Interferon β |
IFNγ | Interferon γ |
LDL | Low density lipoproteins |
M-CSF | Macrophage-colony stimulating factor |
MMP1 | Matrix metalloproteinase 1 |
MRI | Magnetic resonance imaging |
MSCs | Mesenchymal stem cells |
OM | Osteomyelitis |
OP | Osteoporosis |
OPG | Osteoprotegerin |
pDC | Plasmacytoid dendritic cell |
PLAT | Plasminogen activator, tissue type |
PTGS2 | Prostaglandin-endoperoxide synthase 2 |
RANK | Receptor activator of nuclear factor-kB |
RANKL | Receptor activator of nuclear factor-kB ligand |
Rx | Radiography |
Runx2 | Runt-related transcription factor 2 |
SLE | Systemic lupus erythematosus |
Smad | Small mother against decapentaplegic |
SNPs | Single-nucleotide polymorphisms |
TBS | Trabecular bone score |
Th1 | T helper 1 cell |
Th2 | T helper 2 cell |
Th17 | T helper 17 cell |
TLR2 | Toll-like receptor 2 |
TNFα | Tumor necrosis factor α |
Treg | Regulatory T cell |
VDR | Vitamin D receptor |
VF | Vertebral fracture |
Wnt | Wingless/integrated |
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Traditional Independent Risk Factors | Disease-Related Risk Factors |
---|---|
Low body mass index [12,13,14,16] | Systemic inflammation [14,16,17,18,19] |
Old age [11,12,13,14,16] | Lupus nephritis [14,16,17,21] |
Female gender [11,12,13,14,16] | High levels of oxidized LDL [14,16,17] |
Postmenopausal status [11,12,13,14,16] | Hormonal abnormalities [14,16,17,21] |
Smoking [13,14,16] | Presence of anti-Ro, ACPA and/or antiCarP antibodies [14,15,16,21] |
Alcohol abuse [13,14,16] | Medication [12,13,14,16,17,19,22,23,24] |
Low level of vitamin D [12,13,14,16] | Immobility [14,15,16,17] |
Low intake of calcium [12,13,14,16] | |
Low physical activity [12,13,14,16] | |
Hypogonadism [12,13] Family history of osteoporosis [11,12,13,14,16] |
Independent Risk Factors | Disease-Related Risk Factors | Medication-Induced Adverse Effects | Bone Impairment |
---|---|---|---|
Old age [11,12,13,14,16] | Disease duration [14,16,17,18] | Glucocorticoids [14,16,17,22,23,33] | Low BMD [11,12,13,14,16,17,19] |
Female gender [11,12,14,16] | Seizures [16,17,18] | Antiepileptic drugs [16] | Low TBS [19,28,31] |
Smoking [13,14,16] | History of stroke [16,18] | Anticoagulants [16] | Previous fragility fractures [13,16,18] |
Alcohol abuse [13,16] | Renal failure [14,16,21] | Cyclophosphamide [16] | |
Postmenopausal status [11,12,14,16] | Presence of lupus anticoagulant [14,16] | ||
Frailty [16,32] | |||
Obesity [14,16] | |||
Low level of vitamin D [12,13,14,16] |
Independent Risk Factors | Disease-Related Factors | |
---|---|---|
Traumatic-Associated Risk Factors | Atraumatic-Associated Risk Factors | |
Fractures [49,52] | Hyperlipidemia [44,45,49] | High disease activity [24,44,45,46,47,53] |
Dislocation or fracture- dislocation [48,49] | Chronic renal failure/ hemodialysis [44,47,48,49] | Medication-induced adverse effects [44,45,46,47,48,51,53,54] |
Radiation [49] | Smoking [44,47,48,49] | Antiphospholipid syndrome [24,44,45,46,47,52,55] |
Other comorbidities (i.e., hematologic diseases) [45,48,49] | Alcohol use [44,45,48,49] | Vasculopathy and abnormal endothelial function [44,45,46,47] |
Organ transplantation [49] | Clinical features [24,44,45,46,53] | |
Hyperuricemia/gout [49] | Genetic factors (APOL1 variant alleles) [44,47,56] | |
HIV [49] | Younger age of disease onset [24,44,45,46] | |
Intravascular coagulation [44,49] | ||
Thrombophlebitis [49] | ||
Cushing disease [44,49] | ||
Drugs (GCs) [45,47,48,49,51] | ||
Pancreatitis [49] | ||
Pregnancy [49] |
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Rella, V.; Rotondo, C.; Altomare, A.; Cantatore, F.P.; Corrado, A. Bone Involvement in Systemic Lupus Erythematosus. Int. J. Mol. Sci. 2022, 23, 5804. https://doi.org/10.3390/ijms23105804
Rella V, Rotondo C, Altomare A, Cantatore FP, Corrado A. Bone Involvement in Systemic Lupus Erythematosus. International Journal of Molecular Sciences. 2022; 23(10):5804. https://doi.org/10.3390/ijms23105804
Chicago/Turabian StyleRella, Valeria, Cinzia Rotondo, Alberto Altomare, Francesco Paolo Cantatore, and Addolorata Corrado. 2022. "Bone Involvement in Systemic Lupus Erythematosus" International Journal of Molecular Sciences 23, no. 10: 5804. https://doi.org/10.3390/ijms23105804