From Early Diagnosis to Improved Outcomes in Children and Adolescents with Childhood-Onset Systemic Lupus Erythematosus

Childhood-onset systemic lupus erythematosus (cSLE) is a complex, chronic autoimmune disease with multisystem involvement that affects children and adolescents during critical stages of growth and development. For the purposes of this Research Topic, cSLE is used broadly to encompass both childhood-onset and juvenile-onset SLE, covering disease onset from infancy through adolescence. Compared with adult-onset lupus, cSLE often presents with more severe disease activity, earlier organ involvement, and a greater risk of renal, neuropsychiatric, hematological, and treatment-related complications. Important advances have been made in recent years through improved classification criteria, expanding knowledge of genetic and immunological mechanisms, and the introduction of targeted therapies. However, major challenges remain in achieving timely diagnosis, distinguishing heterogeneous disease phenotypes, predicting disease course, and ensuring that advances in treatment translate into better long-term outcomes across diverse pediatric populations. There is also a continued need to better understand how biological, environmental, psychosocial, and healthcare-related factors shape disease burden and quality of life in children and adolescents with cSLE.This Research Topic aims to provide a comprehensive platform for new insights into the full clinical journey of cSLE, from early recognition and diagnosis to disease monitoring, treatment optimization, and long-term outcome improvement. The collection seeks to bring together clinical, laboratory, translational, and population-based research that advances understanding of disease mechanisms, improves risk stratification, and supports more personalized and equitable care. Particular interest lies in studies evaluating diagnostic and classification approaches, identifying biomarkers and predictors of organ involvement and prognosis, assessing therapeutic strategies, and addressing the broader impact of cSLE on neurocognitive health, psychosocial well-being, transition of care, and health-related quality of life. By integrating expertise from pediatric rheumatology, immunology, nephrology, neurology, genetics, psychology, and public health, this Research Topic aims to support earlier diagnosis and better outcomes for children and adolescents living with cSLE.The scope of this Research Topic is centered on childhood-onset systemic lupus erythematosus from infancy through adolescence, including both younger childhood-onset and adolescent (juvenile-onset) presentations, with a focus on improving diagnosis, management, and outcomes in pediatric patients. We welcome submissions addressing, but not limited to, the following themes:• Early recognition and diagnostic pathways for cSLE in children and adolescents• Evaluation and implementation of SLE classification criteria in pediatric and resource-variable settings• Development and validation of biomarkers and predictive models for disease activity, organ involvement, flare risk, remission, and damage accrual• Clinical features, mechanisms, and management of major cSLE manifestations, including lupus nephritis, neuropsychiatric lupus, hematological complications, and cardiovascular risk• Molecular genetics, monogenic lupus, immune dysregulation, and population-specific risk factors influencing cSLE phenotypes• Therapeutic advances, including biologics, precision medicine approaches, treat-to-target strategies, and individualized care models• Monitoring tools and outcome measures for short-term disease control and long-term health outcomes• Neurocognitive outcomes, psychosocial burden, mental health support, and quality of life in children and adolescents with cSLE• Medication adherence and treatment engagement in adolescents with cSLE, including drivers of non-adherence, disease flares linked to treatment discontinuation, treatment access, and outcomes in cSLE• Transition from pediatric to adult care and long-term follow-up strategies for adolescents and young adults with childhood-onset disease We encourage submissions of many different article types, including original research, systematic review, methods, review, clinical trial, mini review, brief research report and case report articles aligned with this scope.Professor Leandro is a consultant and advisory board member for Roche, UCB, and GSK, and serves as principal investigator for clinical trials sponsored by Autolus Therapeutics, BMS, Roche, and Fate Therapeutics. Topic editors: Ana Luisa Rodríguez-Lozano, Debajit Sen, Maria Leandro, Selma Cecilia Scheffler-Mendoza Source: https://www.frontiersin.org/research-topics/82830/from-early-diagnosis-to-improved-outcomes-in-children-and-adolescents-with-childhood-onset-systemic-lupus-erythematosus