{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T04:38:01Z","timestamp":1794285481850,"version":"4.9.0"},"reference-count":319,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2024,8,18]],"date-time":"2024-08-18T00:00:00Z","timestamp":1723939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Lupus Nephritis (LN) still represents one of the most severe complications of Systemic Lupus Erythematosus (SLE) and a major risk factor for morbidity and mortality. However, over the last few years, several studies have paved the way for a deeper understanding of its pathogenetic mechanisms and more targeted treatments. This review aims to provide a comprehensive update on progress on several key aspects in this setting: pathogenetic mechanisms of LN, including new insight into the role of autoantibodies, complement, vitamin D deficiency, and interaction between infiltrating immune cells and kidney resident ones; the evolving role of renal biopsy and biomarkers, which may integrate information from renal histology; newly approved drugs such as voclosporin (VOC) and belimumab (BEL), allowing a more articulate strategy for induction therapy, and other promising phase III-immunosuppressive (IS) agents in the pipeline. Several adjunctive treatments aimed at reducing cardiovascular risk and progression of chronic renal damage, such as antiproteinuric agents, represent an important complement to IS therapy. Furthermore, non-pharmacological measures concerning general lifestyle and diet should also be adopted when managing LN. Integrating these therapeutic areas requires an effort towards a holistic and multidisciplinary approach. At the same time, the availability of an increasingly wider armamentarium may translate into improvements in patient\u2019s renal outcomes over the next decades.<\/jats:p>","DOI":"10.3390\/ijms25168981","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T07:37:21Z","timestamp":1724053041000},"page":"8981","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":73,"title":["Lupus Nephritis from Pathogenesis to New Therapies: An Update"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2484-0963","authenticated-orcid":false,"given":"Annalisa","family":"Roveta","sequence":"first","affiliation":[{"name":"Research and Innovation Department (DAIRI), \u201cSS Antonio e Biagio e Cesare Arrigo\u201d University Hospital, 15121 Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7365-7287","authenticated-orcid":false,"given":"Emanuele Luigi","family":"Parodi","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, \u201cSS Antonio e Biagio e Cesare Arrigo\u201d University Hospital, 15121 Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigida","family":"Brezzi","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, \u201cSS Antonio e Biagio e Cesare Arrigo\u201d University Hospital, 15121 Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2235-4933","authenticated-orcid":false,"given":"Francesca","family":"Tunesi","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, IRCCS \u201cSan Raffaele\u201d Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Zanetti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Genova, 16126 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9069-6192","authenticated-orcid":false,"given":"Guido","family":"Merlotti","sequence":"additional","affiliation":[{"name":"Department of Primary Care, Azienda Socio Sanitaria Territoriale (ASST) of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5999-6111","authenticated-orcid":false,"given":"Alessia","family":"Francese","sequence":"additional","affiliation":[{"name":"Research and Innovation Department (DAIRI), \u201cSS Antonio e Biagio e Cesare Arrigo\u201d University Hospital, 15121 Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1904-7277","authenticated-orcid":false,"given":"Antonio G.","family":"Maconi","sequence":"additional","affiliation":[{"name":"Research and Innovation Department (DAIRI), \u201cSS Antonio e Biagio e Cesare Arrigo\u201d University Hospital, 15121 Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9423-9255","authenticated-orcid":false,"given":"Marco","family":"Quaglia","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, \u201cSS Antonio e Biagio e Cesare Arrigo\u201d University Hospital, 15121 Alessandria, Italy"},{"name":"Department of Translational Medicine, University of Piemonte Orientale (UPO), 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2326","DOI":"10.1016\/S0140-6736(24)00398-2","article-title":"Systemic Lupus Erythematosus","volume":"403","author":"Hoi","year":"2024","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Echavarria, R., Cardona-Mu\u00f1oz, E.G., Ortiz-Lazareno, P., Andrade-Sierra, J., G\u00f3mez-Hermosillo, L.F., Casillas-Moreno, J., Campos-Bayardo, T.I., Rom\u00e1n-Rojas, D., Garc\u00eda-S\u00e1nchez, A., and Miranda-D\u00edaz, A.G. 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