{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:43:21Z","timestamp":1792514601822,"version":"4.5.0"},"reference-count":51,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"unspecified","delay-in-days":111,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"JSPS","award":["JP23K15357"],"award-info":[{"award-number":["JP23K15357"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2026,9,18]]},"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1136\/lupus-2026-002234","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:05:10Z","timestamp":1792512310000},"page":"e002234","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Fatigue outcomes with anifrolumab in low-disease-activity SLE: DNA damage in plasmacytoid dendritic cells as a candidate biomarker for responders"],"prefix":"10.1136","volume":"13","author":[{"given":"Eitaro","family":"Yoshida","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4959-7892","authenticated-orcid":false,"given":"Taiga","family":"Kuga","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Yanagimoto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayako","family":"Makiyama","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goh","family":"Murayama","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0370-2297","authenticated-orcid":false,"given":"Kentaro","family":"Minowa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0064-4765","authenticated-orcid":false,"given":"Makio","family":"Kusaoi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Yamaji","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Tamura","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,20]]},"reference":[{"key":"2026102009050628000_13.2.e002234.1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2023-224514"},{"key":"2026102009050628000_13.2.e002234.2","doi-asserted-by":"crossref","first-page":"16039","DOI":"10.1038\/nrdp.2016.39","article-title":"Systemic lupus erythematosus","volume":"2","author":"Kaul","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"2026102009050628000_13.2.e002234.3","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2022-002395","article-title":"Fatigue is independently associated with disease activity assessed using the Physician Global Assessment but not the SLEDAI in patients with systemic lupus erythematosus","volume":"8","author":"Mertz","year":"2022","journal-title":"RMD Open"},{"key":"2026102009050628000_13.2.e002234.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051135"},{"key":"2026102009050628000_13.2.e002234.5","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1093\/rheumatology\/key398","article-title":"Predictors of fatigue and severe fatigue in a large international cohort of patients with systemic lupus erythematosus and a systematic review of the literature","volume":"58","author":"Arnaud","year":"2019","journal-title":"Rheumatology (Oxford)"},{"key":"2026102009050628000_13.2.e002234.6","doi-asserted-by":"crossref","DOI":"10.3390\/jcm10173996","article-title":"Fatigue in Systemic Lupus Erythematosus: An Update on Its Impact, Determinants and Therapeutic Management","volume":"10","author":"Kawka","year":"2021","journal-title":"J Clin Med"},{"key":"2026102009050628000_13.2.e002234.7","doi-asserted-by":"publisher","DOI":"10.1177\/0961203317722412"},{"key":"2026102009050628000_13.2.e002234.8","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.6.1171"},{"key":"2026102009050628000_13.2.e002234.9","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1002795"},{"key":"2026102009050628000_13.2.e002234.10","doi-asserted-by":"publisher","DOI":"10.1038\/s41590-019-0398-x"},{"key":"2026102009050628000_13.2.e002234.11","doi-asserted-by":"crossref","DOI":"10.1126\/scitranslmed.abn2263","article-title":"Nonlesional lupus skin contributes to inflammatory education of myeloid cells and primes for cutaneous inflammation","volume":"14","author":"Billi","year":"2022","journal-title":"Sci Transl Med"},{"key":"2026102009050628000_13.2.e002234.12","doi-asserted-by":"publisher","DOI":"10.1038\/s41590-020-0743-0"},{"key":"2026102009050628000_13.2.e002234.13","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2024.1320444","article-title":"Enhanced GATA4 expression in senescent systemic lupus erythematosus monocytes promotes high levels of IFN\u03b1 production","volume":"15","author":"Kuga","year":"2024","journal-title":"Front Immunol"},{"key":"2026102009050628000_13.2.e002234.14","doi-asserted-by":"crossref","first-page":"2992","DOI":"10.1093\/rheumatology\/keaa060","article-title":"Inhibition of mTOR suppresses IFN\u03b1 production and the STING pathway in monocytes from systemic lupus erythematosus patients","volume":"59","author":"Murayama","year":"2020","journal-title":"Rheumatology (Oxford)"},{"key":"2026102009050628000_13.2.e002234.15","doi-asserted-by":"crossref","DOI":"10.1186\/s13075-017-1441-7","article-title":"Enhanced IFN-\u03b1 production is associated with increased TLR7 retention in the lysosomes of palasmacytoid dendritic cells in systemic lupus erythematosus","volume":"19","author":"Murayama","year":"2017","journal-title":"Arthritis Res Ther"},{"key":"2026102009050628000_13.2.e002234.16","doi-asserted-by":"crossref","DOI":"10.1186\/s13075-023-03010-0","article-title":"Relationship of systemic type I interferon activity with clinical phenotypes, disease activity, and damage accrual in systemic lupus erythematosus in treatment-naive patients: a retrospective longitudinal analysis","volume":"25","author":"Miyachi","year":"2023","journal-title":"Arthritis Res Ther"},{"key":"2026102009050628000_13.2.e002234.17","doi-asserted-by":"crossref","DOI":"10.1136\/lupus-2018-000270","article-title":"Interferon pathway in SLE: one key to unlocking the mystery of the disease","volume":"6","author":"R\u00f6nnblom","year":"2019","journal-title":"Lupus Sci Med"},{"key":"2026102009050628000_13.2.e002234.18","doi-asserted-by":"crossref","DOI":"10.1136\/lupus-2021-000625","article-title":"Type 1 interferon status in systemic lupus erythematosus: a longitudinal analysis","volume":"9","author":"Northcott","year":"2022","journal-title":"Lupus Sci Med"},{"key":"2026102009050628000_13.2.e002234.19","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23251"},{"key":"2026102009050628000_13.2.e002234.20","doi-asserted-by":"crossref","first-page":"e208","DOI":"10.1016\/S2665-9913(19)30076-1","article-title":"Type I interferon inhibitor anifrolumab in active systemic lupus erythematosus (TULIP-1): a randomised, controlled, phase 3 trial","volume":"1","author":"Furie","year":"2019","journal-title":"Lancet Rheumatol"},{"key":"2026102009050628000_13.2.e002234.21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1912196"},{"key":"2026102009050628000_13.2.e002234.22","doi-asserted-by":"publisher","DOI":"10.1080\/19420862.2015.1007810"},{"key":"2026102009050628000_13.2.e002234.23","doi-asserted-by":"crossref","DOI":"10.1136\/lupus-2018-000261","article-title":"Characterisation of anifrolumab, a fully human anti-interferon receptor antagonist antibody for the treatment of systemic lupus erythematosus","volume":"5","author":"Riggs","year":"2018","journal-title":"Lupus Sci Med"},{"key":"2026102009050628000_13.2.e002234.24","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1136\/annrheumdis-2021-221425","article-title":"Anifrolumab efficacy and safety by type I interferon gene signature and clinical subgroups in patients with SLE: post hoc analysis of pooled data from two phase III trials","volume":"81","author":"Vital","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"2026102009050628000_13.2.e002234.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2013.08.004"},{"key":"2026102009050628000_13.2.e002234.26","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2020.554725","article-title":"Oxidative DNA Damage Accelerates Skin Inflammation in Pristane-Induced Lupus Model","volume":"11","author":"Tumurkhuu","year":"2020","journal-title":"Front Immunol"},{"key":"2026102009050628000_13.2.e002234.27","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.62852","article-title":"DNA damage-how and why we age?","volume":"10","author":"Yousefzadeh","year":"2021","journal-title":"Elife"},{"key":"2026102009050628000_13.2.e002234.28","doi-asserted-by":"crossref","DOI":"10.1136\/lupus-2016-000148","article-title":"Histone H2AX phosphorylation as a measure of DNA double-strand breaks and a marker of environmental stress and disease activity in lupus","volume":"3","author":"Namas","year":"2016","journal-title":"Lupus Sci Med"},{"key":"2026102009050628000_13.2.e002234.29","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-54986-x","article-title":"Radiation exposure lymphocyte damage assessed by \u03b3-H2AX level using flow cytometry","volume":"14","author":"Chen","year":"2024","journal-title":"Sci Rep"},{"key":"2026102009050628000_13.2.e002234.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2011.05.065"},{"key":"2026102009050628000_13.2.e002234.31","doi-asserted-by":"publisher","DOI":"10.1177\/0961203314565413"},{"key":"2026102009050628000_13.2.e002234.32","doi-asserted-by":"crossref","DOI":"10.1126\/sciadv.abo5840","article-title":"ATR-mediated DNA damage responses underlie aberrant B cell activity in systemic lupus erythematosus","volume":"8","author":"Manolakou","year":"2022","journal-title":"Sci Adv"},{"key":"2026102009050628000_13.2.e002234.33","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(02)00392-6"},{"key":"2026102009050628000_13.2.e002234.34","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00002512"},{"key":"2026102009050628000_13.2.e002234.35","unstructured":"Foundation IC . Fatigue Assessment Scale (FAS). n.d. Available: https:\/\/www.ildcare.nl\/index.php\/questionnaires-3\/"},{"key":"2026102009050628000_13.2.e002234.36","doi-asserted-by":"crossref","first-page":"658","DOI":"10.2169\/internalmedicine.4101-24","article-title":"Reliability and Validity of the Japanese Version of the Fatigue Assessment Scale","volume":"64","author":"Tokumasu","year":"2025","journal-title":"Intern Med"},{"key":"2026102009050628000_13.2.e002234.37","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2011.05.004"},{"key":"2026102009050628000_13.2.e002234.38","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2011.582138"},{"key":"2026102009050628000_13.2.e002234.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.01.032"},{"key":"2026102009050628000_13.2.e002234.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2005.08.022"},{"key":"2026102009050628000_13.2.e002234.41","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1002\/cyto.b.21374","article-title":"Validation of a flow cytometry-based detection of \u03b3-H2AX, to measure DNA damage for clinical applications","volume":"92","author":"Johansson","year":"2017","journal-title":"Cytometry B Clin Cytom"},{"key":"2026102009050628000_13.2.e002234.42","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-212988"},{"key":"2026102009050628000_13.2.e002234.43","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2023-225445"},{"key":"2026102009050628000_13.2.e002234.44","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1080\/25785826.2024.2372918","article-title":"Double-filtration plasmapheresis reduces type I interferon bioavailability and inducing activity in systemic lupus erythematosus","volume":"47","author":"Saito","year":"2024","journal-title":"Immunological Medicine"},{"key":"2026102009050628000_13.2.e002234.45","doi-asserted-by":"publisher","DOI":"10.1093\/intimm\/12.4.547"},{"key":"2026102009050628000_13.2.e002234.46","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2297"},{"key":"2026102009050628000_13.2.e002234.47","doi-asserted-by":"crossref","DOI":"10.3389\/fncel.2015.00005","article-title":"Minocycline treatment ameliorates interferon-alpha- induced neurogenic defects and depression-like behaviors in mice","volume":"9","author":"Zheng","year":"2015","journal-title":"Front Cell Neurosci"},{"key":"2026102009050628000_13.2.e002234.48","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1301362"},{"key":"2026102009050628000_13.2.e002234.49","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.bbi.2024.02.003","article-title":"Type I interferons, inflammation, and fatigue in a longitudinal RNA study of women with breast cancer","volume":"118","author":"Bower","year":"2024","journal-title":"Brain Behav Immun"},{"key":"2026102009050628000_13.2.e002234.50","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/j.jid.2021.04.037","article-title":"Photosensitivity and cGAS-Dependent IFN-1 Activation in Patients with Lupus and TREX1 Deficiency","volume":"142","author":"Berndt","year":"2022","journal-title":"J Invest Dermatol"},{"key":"2026102009050628000_13.2.e002234.51","doi-asserted-by":"crossref","first-page":"1515469","DOI":"10.3389\/fimmu.2024.1515469","article-title":"Immune complexes-mediated activation of neutrophils in systemic lupus erythematosus is dependent on RNA recognition by toll-like receptor 8","volume":"15","author":"Wang","year":"2024","journal-title":"Front Immunol"}],"container-title":["Lupus Science & Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/lupus-2026-002234","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:05:15Z","timestamp":1792512315000},"score":1,"resource":{"primary":{"URL":"https:\/\/lupus.bmj.com\/lookup\/doi\/10.1136\/lupus-2026-002234"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":51,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,10,20]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/lupus-2026-002234"],"URL":"https:\/\/doi.org\/10.1136\/lupus-2026-002234","relation":{},"ISSN":["2053-8790"],"issn-type":[{"value":"2053-8790","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}