Diagnosis and management of juvenile-onset SLE

Rapid diagnosis of systemic lupus erythematosus by Raman spectroscopy combined with spiking neural network

Multiple organs are affected by the autoimmune inflammatory connective tissue disease known as systemic lupus erythematosus (SLE). If not diagnosed and treated in a timely manner, it can lead to nephritis and damage to the blood system in severe cases, resulting in the patient's death. Therefore, correct and timely diagnosis and treatment are essential for patients. In this study, a framework based on neural network algorithm and Raman spectroscopy technique was established to diagnose SLE patients. Firstly, we pre-processed the obtained Raman data by three methods: baseline correction, smoothing processing and normalization methods, before using it as input for the model, and then ANN, ResNet and SNN classification models were established. The respective classification accuracies for SLE patients were 89.61%, 85.71%, and 95.65% for the three models, with corresponding AUC values of 0.8772, 0.8100, and 0.9555. The results of the experimental indicate that SNN possesses a good classification effect, and the number of model parameters is only 525,826, which is 414,221 less than that of ResNet model. Since the network only uses 0 and 1 to transmit information, and only has basic operations such as summation, compared with the second-generation artificial neural network, which simplifies the product operation of floating point numbers into multiple addition operations, the network has low energy consumption and is suitable for embedding portable Raman spectrometer for clinical diagnosis. This research highlights the significant potential for quick and precise SLE patient discrimination offered by Raman spectroscopy in conjunction with spiking neural networks.

Juvenile-onset systemic lupus erythematosus: Update on clinical presentation, pathophysiology and treatment options

Juvenile-onset systemic lupus erythematosus (jSLE) accounts for up to 20% of all SLE patients. Key differences between juvenile- and adult-onset (aSLE) disease include higher disease activity, earlier development of damage, and increased use of immunosuppressive treatment in jSLE suggesting (at least partial) infectivity secondary to variable pathomechanisms. While the exact pathophysiology of jSLE remains unclear, genetic factors, immune complex deposition, complement activation, hormonal factors and immune cell dysregulation are involved to variable extents, promising future patient stratification based on immune phenotypes. Though less effective and potentially toxic, jSLE patients are treated based upon evidence from studies in aSLE cohorts. Here, age-specific clinical features of jSLE, underlying pathomechanisms, treatment options and disease outcomes will be addressed. Future directions to improve the care of jSLE patients, including implementation of the Single Hub and Access point for pediatric Rheumatology in Europe (SHARE) recommendations, biomarkers, treat to target and personalized medicine approaches are discussed.