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Systemic lupus erythematosus (<jats:styled-content style=\"fixed-case\">SLE<\/jats:styled-content>) is characterized by both continuous and cyclic stimulation of the innate and adaptive immune system by endogenous nucleic acids released from apoptotic or necrotic cells. <jats:styled-content style=\"fixed-case\">TLR<\/jats:styled-content>7 and <jats:styled-content style=\"fixed-case\">TLR<\/jats:styled-content>9 function as innate sensors of viral infection as their ligands are ss<jats:styled-content style=\"fixed-case\">RNA<\/jats:styled-content> and ds<jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content>, respectively. Recognition of self nucleic acids by endosomal <jats:styled-content style=\"fixed-case\">TLR<\/jats:styled-content>s in B cells and <jats:styled-content style=\"fixed-case\">pDC<\/jats:styled-content>s is thought to be an important step in the pathogenesis of <jats:styled-content style=\"fixed-case\">SLE<\/jats:styled-content>, generating anti\u2010nuclear antibodies and producing type I <jats:styled-content style=\"fixed-case\">IFN<\/jats:styled-content>. In this review, we take a specific look at how <jats:styled-content style=\"fixed-case\">TLR<\/jats:styled-content>7, non\u2010coding <jats:styled-content style=\"fixed-case\">RNA<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">SSA<\/jats:styled-content>\/Ro60 can contribute to clinical autoimmunity and organ damage in the context of neonatal lupus (<jats:styled-content style=\"fixed-case\">NL<\/jats:styled-content>). Although 15 times less common than <jats:styled-content style=\"fixed-case\">SLE<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> NL<\/jats:styled-content> provides a unique opportunity to study two different aspects of autoimmunity: passively acquired tissue injury in a developing fetus and clinical progression of disease in an asymptomatic mother found to have anti\u2010Ro60 autoantibodies only after identification of heart block\/rash in a child. Finally, we discuss hydroxychloroquine (<jats:styled-content style=\"fixed-case\">HCQ<\/jats:styled-content>) use by asymptomatic subjects which may forestall the clinical expression of autoimmunity.<\/jats:p>","DOI":"10.1111\/imr.12383","type":"journal-article","created":{"date-parts":[[2015,12,19]],"date-time":"2015-12-19T07:39:36Z","timestamp":1450510776000},"page":"76-84","source":"Crossref","is-referenced-by-count":42,"title":["Endosomal Toll\u2010like receptors in\u00a0clinically overt and silent autoimmunity"],"prefix":"10.1111","volume":"269","author":[{"given":"Robert M.","family":"Clancy","sequence":"first","affiliation":[{"name":"Division of Rheumatology Department of Medicine New York University School of Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Androo J.","family":"Markham","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Medicine New York University School of Medicine New York NY 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