Limits...
Non-invasive imaging to monitor lupus nephritis and neuropsychiatric systemic lupus erythematosus.

Thurman JM, Serkova NJ - F1000Res (2015)

Bottom Line: For neurological symptoms, vessel size imaging (VSI, an MRI approach utilizing T2-relaxing iron oxide nanoparticles) has shown promise as a diagnostic tool.Molecular imaging probes (mostly for MRI and nuclear medicine imaging) have also been developed for diagnosing SLE with high sensitivity, and for monitoring disease activity.We describe novel MRI and positron-emission tomography (PET) molecular imaging protocols using targeted iron oxide nanoparticles and radioactive ligands, respectively, for detection of SLE-associated inflammation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Colorado School of Medicine, Aurora, CO, 80045, USA.

ABSTRACT
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple different organs, including the kidneys and central nervous system (CNS). Conventional radiological examinations in SLE patients include volumetric/ anatomical computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound (US). The utility of these modalities is limited, however, due to the complexity of the disease. Furthermore, standard CT and MRI contrast agents are contraindicated in patients with renal impairment. Various radiologic methods are currently being developed to improve disease characterization in patients with SLE beyond simple anatomical endpoints. Physiological non-contrast MRI protocols have been developed to assess tissue oxygenation, glomerular filtration, renal perfusion, interstitial diffusion, and inflammation-driven fibrosis in lupus nephritis (LN) patients. For neurological symptoms, vessel size imaging (VSI, an MRI approach utilizing T2-relaxing iron oxide nanoparticles) has shown promise as a diagnostic tool. Molecular imaging probes (mostly for MRI and nuclear medicine imaging) have also been developed for diagnosing SLE with high sensitivity, and for monitoring disease activity. This paper reviews the challenges in evaluating disease activity in patients with LN and neuropsychiatric systemic lupus erythematosus (NPSLE). We describe novel MRI and positron-emission tomography (PET) molecular imaging protocols using targeted iron oxide nanoparticles and radioactive ligands, respectively, for detection of SLE-associated inflammation.

No MeSH data available.


Related in: MedlinePlus

Treatment paradigm for lupus nephritis.Ideally, aggressive immunosuppression is reserved for those with severe renal disease. Lupus nephritis is associated with the presence of serologic changes, proteinuria, hematuria, and elevated serum creatinine levels. Unfortunately, these changes are not accurate for identifying patients with severe disease that is amenable to treatment. The abundance of glomerular C3 deposits increases with disease severity but falls off in end stage disease80, raising the possibility that non-invasive detection of glomerular C3 will be useful for guiding treatment of patients with lupus nephritis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4536614&req=5

f2: Treatment paradigm for lupus nephritis.Ideally, aggressive immunosuppression is reserved for those with severe renal disease. Lupus nephritis is associated with the presence of serologic changes, proteinuria, hematuria, and elevated serum creatinine levels. Unfortunately, these changes are not accurate for identifying patients with severe disease that is amenable to treatment. The abundance of glomerular C3 deposits increases with disease severity but falls off in end stage disease80, raising the possibility that non-invasive detection of glomerular C3 will be useful for guiding treatment of patients with lupus nephritis.

Mentions: The treatment of patients with SLE requires a continual reevaluation of the risks of the disease versus the risks of immunomodulatory treatment. Ideally, clinicians employ aggressive immunosuppression (e.g. cytotoxic drugs) for treating patients with severe disease, but do not use these agents in patients with mild disease or with renal damage that cannot be salvaged (Figure 2). Currently, the assessment of lupus disease activity and prognosis is based upon a number of clinical, serologic, radiographic, and histologic findings.


Non-invasive imaging to monitor lupus nephritis and neuropsychiatric systemic lupus erythematosus.

Thurman JM, Serkova NJ - F1000Res (2015)

Treatment paradigm for lupus nephritis.Ideally, aggressive immunosuppression is reserved for those with severe renal disease. Lupus nephritis is associated with the presence of serologic changes, proteinuria, hematuria, and elevated serum creatinine levels. Unfortunately, these changes are not accurate for identifying patients with severe disease that is amenable to treatment. The abundance of glomerular C3 deposits increases with disease severity but falls off in end stage disease80, raising the possibility that non-invasive detection of glomerular C3 will be useful for guiding treatment of patients with lupus nephritis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4536614&req=5

f2: Treatment paradigm for lupus nephritis.Ideally, aggressive immunosuppression is reserved for those with severe renal disease. Lupus nephritis is associated with the presence of serologic changes, proteinuria, hematuria, and elevated serum creatinine levels. Unfortunately, these changes are not accurate for identifying patients with severe disease that is amenable to treatment. The abundance of glomerular C3 deposits increases with disease severity but falls off in end stage disease80, raising the possibility that non-invasive detection of glomerular C3 will be useful for guiding treatment of patients with lupus nephritis.
Mentions: The treatment of patients with SLE requires a continual reevaluation of the risks of the disease versus the risks of immunomodulatory treatment. Ideally, clinicians employ aggressive immunosuppression (e.g. cytotoxic drugs) for treating patients with severe disease, but do not use these agents in patients with mild disease or with renal damage that cannot be salvaged (Figure 2). Currently, the assessment of lupus disease activity and prognosis is based upon a number of clinical, serologic, radiographic, and histologic findings.

Bottom Line: For neurological symptoms, vessel size imaging (VSI, an MRI approach utilizing T2-relaxing iron oxide nanoparticles) has shown promise as a diagnostic tool.Molecular imaging probes (mostly for MRI and nuclear medicine imaging) have also been developed for diagnosing SLE with high sensitivity, and for monitoring disease activity.We describe novel MRI and positron-emission tomography (PET) molecular imaging protocols using targeted iron oxide nanoparticles and radioactive ligands, respectively, for detection of SLE-associated inflammation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Colorado School of Medicine, Aurora, CO, 80045, USA.

ABSTRACT
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple different organs, including the kidneys and central nervous system (CNS). Conventional radiological examinations in SLE patients include volumetric/ anatomical computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound (US). The utility of these modalities is limited, however, due to the complexity of the disease. Furthermore, standard CT and MRI contrast agents are contraindicated in patients with renal impairment. Various radiologic methods are currently being developed to improve disease characterization in patients with SLE beyond simple anatomical endpoints. Physiological non-contrast MRI protocols have been developed to assess tissue oxygenation, glomerular filtration, renal perfusion, interstitial diffusion, and inflammation-driven fibrosis in lupus nephritis (LN) patients. For neurological symptoms, vessel size imaging (VSI, an MRI approach utilizing T2-relaxing iron oxide nanoparticles) has shown promise as a diagnostic tool. Molecular imaging probes (mostly for MRI and nuclear medicine imaging) have also been developed for diagnosing SLE with high sensitivity, and for monitoring disease activity. This paper reviews the challenges in evaluating disease activity in patients with LN and neuropsychiatric systemic lupus erythematosus (NPSLE). We describe novel MRI and positron-emission tomography (PET) molecular imaging protocols using targeted iron oxide nanoparticles and radioactive ligands, respectively, for detection of SLE-associated inflammation.

No MeSH data available.


Related in: MedlinePlus