Future Directions in Systemic Lupus Erythematosus: Autoantibodies, Organ Protection, and Unmet Needs

Recent progress in understanding SLE immunopathology, including autoantibodies, immune dysregulation, tissue-resident immunity, and complement activation, has significantly expanded the therapeutic possibilities. However, clinical translation remains incomplete; flare rates remain substantial, glucocorticoid dependence persists, and organ damage continues to limit the long-term outcomes.Simultaneously, the growth of global registries and real-world cohort studies, including multi-institutional biobanks, has provided deeper insights into disease heterogeneity, treatment responses and predictors of remission or progression. Innovations in biomarkers, such as urine markers, multi-omics, and spatial transcriptomics, are paving the way for precision medicine. A comprehensive synthesis connecting these advances is needed to identify current limitations and future opportunities, and this Research Topic aims to contribute to this effort.The goal of this Research Topic is to synthesize state-of-the-art knowledge across immunology, biomarkers, treatment strategies, and long-term outcomes in SLE, while highlighting future directions for clinical care. Specifically, we aim to: 1. Advances in autoantibody biology and immune mechanisms have been summarized. 2. The progress and remaining challenges in organ protection, particularly in the renal and cardiovascular systems, are addressed.3. Identify unmet needs, including GC minimization, flare prevention, and optimal treatment selection. 4. Showcased real-world and registry-based evidence relevant to the future of SLE management.We welcome contributions across a wide range of SLE research, including: • Autoantibody biology and molecular pathogenesis • Lupus nephritis, CKD progression, and organ protection • Biomarkers（serum, urine, omics, imaging） • Treatment optimization, hydroxychloroquine, biologics, immunosuppressive agents, JAK inhibitors, GC minimization • Flare prediction models and outcome studies • Unmet needs, guideline development, care coordination • Real-world cohort and registry research • Translational studies bridging mechanistic insights and clinical practice We particularly encourage work highlighting precision medicine, innovative technologies, and multidisciplinary perspectives. Topic editors: Ryusuke Yoshimi, Yuji Nozaki, Kunihiro Ichinose, Hiroshi Oiwa Source: https://www.frontiersin.org/research-topics/76730/future-directions-in-systemic-lupus-erythematosus-autoantibodies-organ-protection-and-unmet-needs