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1
Valeriano, Brandon. The Correlates of Cyber Strategy. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190618094.003.0003.
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This chapter explores the effects of cyber strategy and coercion through an empirical lens. It addresses this empirical gap and conducts a series of quantitative tests to answer key questions based on data collected covering the years 2000–2014. The results of the data analyses suggest cyber operations rarely produce concessions. The digital domain demonstrates minimal coercive utility to date. A state’s latent cyber capacity, as a proxy measure of potential cyber power in a state, is not a significant predictor of coercive potential. The analysis demonstrates more traditional arbiters of strategic competition such as military or economic power are likely better predictors for explaining rival behavior. Finally, it examines escalation in cyber incidents, which lead to some form of escalation 53.65% of the time. When the Russia-Georgia and Russia-Ukraine dyads are removed, all military escalation involved only threats and displays of force. Escalation observed after cyber incidents tends to be limited and consistent with rivalry dynamics.
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(Editor), J. Duncan Keppie, J. Brendan Murphy (Editor), F. Ortega-Gutierrez (Editor), and W. G. Ernst (Editor), eds. Middle American Terranes, Potential Correlatives, and Orogenic Processes. CRC, 2008.
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Fugate, Jennifer, and Eelco Wijdicks. Coma. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199658602.003.0002.
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Coma is an ominous sign and has been known since antiquity. Over several decades, a much better understanding of the mechanisms of coma, patterns of brain tissue shift, and its clinical correlates has developed. Methods of the examination and the details of approaching a diagnosis of patients in coma have evolved gradually over this time. In this chapter, the key articles that formed the basis of this evaluation are discussed. These articles offer an understanding of how the current level of sophistication regarding determination of the severity of brain injury, of improvement potential, and of an appropriate level of care was reached.
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Bonneh, Yoram. Motion-Induced Blindness. Oxford University Press, 2017. http://dx.doi.org/10.1093/acprof:oso/9780199794607.003.0103.
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Motion-induced blindness (MIB) is a phenomenon characterized by “visual disappearance” in which relatively small but salient visual objects may disappear from one’s awareness intermittently for several seconds when embedded within a moving pattern. It is a compelling example of multistable perception in which physically invariant stimulation leads to fluctuations in perception. The interest in MIB stems from its potential use in studying visual processing outside the locus of awareness and the neural correlates of consciousness. Current studies of MIB provide evidence against low-level suppression of the visual signal and demonstrate residual processing of the invisible. This chapter explores these and related concepts.
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Bind, Rebecca Hannah, and Carmine M. Pariante. Psychoneuroimmunology of Post-Traumatic Stress Disorder. Edited by Charles B. Nemeroff and Charles R. Marmar. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190259440.003.0021.
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This chapter reviews the evidence linking post-traumatic stress disorder (PTSD) with changes in immune function. The chapter starts with a brief explanation of the components of the immune system, including cytokines, and of the mechanisms linking psychological and psychiatric phenomena with changes in immune function (i.e., psychoneuroimmunology). Specific studies on PTSD are then described, including the potential neurobiological and health consequences of these immune changes and, finally, the effects of PTSD treatment on both symptomology and the immune system. While there is a consistent pattern of findings indicating increased immune activation in this condition, there is a paucity of research on the immunological correlates of PTSD, especially compared with the large number of immunological studies on depression and other psychiatric disorders.
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L, Pinheiro Marilyn, and Musiek Frank E, eds. Assessment of central auditory dysfunction: Foundations and clinical correlates. Baltimore: Williams & Wilkins, 1985.
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7
Siebner, Hartwig R., Martin Peller, and Lucy Lee. TMS and positron emission tomography: methods and current advances. Edited by Charles M. Epstein, Eric M. Wassermann, and Ulf Ziemann. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780198568926.013.0035.
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This article provides an overview of how transcranial magnetic stimulation (TMS) and positron emission tomography (PET) can be combined. It explains the methodology concerning the combination of TMS with PET and discusses the applications of this combination to study human brain function. TMS represents a nonphysiological means of producing or modulating neuronal activity in the human brain. PET imaging can make an important contribution to the understanding of the mechanisms of action of repetitive TMS and has the potential to determine neural correlates of compensatory plasticity in both healthy subjects and disease states. By using different sources of information, the TMS-PET approach provides insight into the neurophysiological effects of TMS on human brain function. The future use of TMS is to improve the understanding of how the nonphysiological mode of brain stimulation interacts with ‘normal’ activity in the human brain.
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Rees, Lesley. Growth and development. Edited by Norbert Lameire and Neil Turner. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0291.
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Enabling achievement of full height potential in a child with chronic kidney disease (CKD) is one of the major and most challenging goals for the paediatric nephrologist. Short stature is associated with psychological maladjustment and with increased morbidity and mortality. The causes of poor growth are multifactorial and include poor nutrition, and metabolic, haematological, and endocrine disturbances. The most vulnerable times are the periods of most rapid growth, that is, infancy and puberty. Growth during infancy is principally dependent on nutrition so many infants need supplemental enteral feeding. Growth delay correlates with severity of CKD, with those on dialysis faring the worst such that by CKD stage 5, approximately 25% of patients are below the normal range for height. Height achieved post transplant is dependent on graft function and is better in younger children and those who have the best height attainment pre transplant. The use of steroid-free immunosuppressive regimens is encouraging. The prognosis for final height is improving.
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Andrade, M. J. Tumours and masses. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0022.
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Transthoracic and transoesophageal echocardiography is the first-line diagnostic tool for imaging space-occupying lesions of the heart. Cardiac masses can be classified as tumours, thrombi, vegetations, iatrogenic material, or normal variants. Occasionally, extracardiac masses may compress the heart and create a mass effect. Cardiac masses may be suspected from the clinical presentation. This is the case in patients with an embolic event presumed of cardiac origin or in patients with infective endocarditis. Otherwise, a cardiac mass can be identified during the routine investigation of common, non-specific cardiac manifestations or as an incidental finding.In general, an integrated approach which correlates the patient’s clinical picture with the echocardiographic findings may reasonably predict the specific nature of encountered cardiac masses and, in the case of tumours, discriminate between primary versus secondary, and benign versus malignant. Furthermore, echocardiography alone or with complementary imaging modalities, can provide information to help decide on the resectability of cardiac tumours, enhance effective diagnosis and management of infective endocarditis, and assist in planning therapy and follow-up. Because several normal structures and variants may mimic pathological lesions, a thorough knowledge of potential sources of misinterpretation is crucial for a correct diagnosis. After surgical resection, histological investigation is mandatory to confirm the diagnosis.
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Nugent, Allison C., and Maura L. Furey. Neuroimaging Promises and Caveats. Edited by Sara Maltzman. Oxford University Press, 2016. http://dx.doi.org/10.1093/oxfordhb/9780199739134.013.41.
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Neuroscience research has clearly demonstrated neurological correlates of psychological disorders. We believe that neuroscience, particularly neuroimaging, has great potential to increase our understanding of these disorders, leading to more effective treatments, prevention, and perhaps even cure. Nevertheless, the popular media is replete with misinformation and exaggerated claims. The present chapter is intended to give the reader the necessary knowledge to critically evaluate neuroimaging studies of psychological disorders. We provide an overview of all the major neuroimaging techniques, example studies relevant to psychological disorders (with a particular emphasis on depression), particular pitfalls and caveats associated with each technique, and the promise of each technique. We first cover the nuclear imaging techniques, single photon emission computed tomography (SPECT) and positron emission tomography (PET). We then explore several magnetic resonance imaging (MRI) techniques, both structural and functional. Finally, we give an overview of the electrophysiological techniques, electroencephalography (EEG) and magnetoencephalography (MEG). Each of these techniques has particular strengths, and particular weaknesses. At this point, none of these tools are diagnostic, but each one provides a unique window into psychological disorders. When applied in a methodologically rigorous and statistically rigorous manner, neuroimaging has great promise for achieving greater understanding of psychological disorders, and relieving the great burdens they cause.
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Andrade, Maria João, Jadranka Separovic Hanzevacki, and Ricardo Ronderos. Cardiac tumours. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0052.
Full textAbstract:
Transthoracic and transoesophageal echocardiography represent the first-line diagnostic tools for imaging space-occupying lesions of the heart. Cardiac masses can be classified as tumours, thrombi, vegetations, iatrogenic material, or normal variants. Occasionally, extracardiac masses may compress the heart and create a mass effect. Cardiac masses may be suspected from the clinical presentation. This is the case in patients with an embolic event presumed to be of cardiac origin or in patients with infective endocarditis. Otherwise, a cardiac mass can be identified during the routine investigation of common, non-specific cardiac manifestations or as an incidental finding. In general, an integrated approach which correlates the patient’s clinical picture with the echocardiographic findings may reasonably predict the specific nature of encountered cardiac masses and, in the case of tumours, discriminate between primary versus secondary, and benign versus malignant. Furthermore, echocardiography alone or with complementary imaging modalities, can provide information to decide on the resectability of cardiac tumours and assist on planning the therapy and follow-up. Because several normal structures and variants may mimic pathological lesions, a thorough knowledge of potential sources of misinterpretation is crucial for a correct diagnosis. After surgical resection, histological investigation is mandatory to confirm the diagnosis.
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Lopes da Silva, Fernando H., and Eric Halgren. Neurocognitive Processes. Edited by Donald L. Schomer and Fernando H. Lopes da Silva. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228484.003.0048.
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Transmembrane neuronal currents that embody cognition in the cortex produce magnetoencephalographic and electroencephalographic signals. Frequency-domain analysis reveals standard rhythms with consistent topography, frequency, and cognitive correlates. Time-domain analysis reveals average event-related potentials and field (ERP/ERF) components with consistent topography, latency, and cognitive correlates. Standard rhythms and ERP/ERF components underlie perceiving stimuli; evaluating whether stimuli match predictions, and taking appropriate action when they do not; encoding stimuli to permit semantic processing and then accessing lexical representations and assigning syntactic roles; maintaining information in primary memory; preparing to take an action; and closing processing of an event–response sequence. Sustained mental processes are associated with theta and gamma. Consolidating memories appears to occur mainly during replay of specific firing patterns during sleep spindles and slow oscillations. Biophysical, neuroanatomical, and neurophysiological factors interact to render cognitive rhythms and components particularly sensitive to the large-scale modulatory processes that sequence and integrate higher cortical processing.
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Hughes, Jeremy. Proteinuria as a direct cause of progression. Edited by David J. Goldsmith. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0137.
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Proximal tubular cells reabsorb any filtered proteins during health via cell surface receptors such as megalin and cubulin so that very low levels of protein are present in the excreted urine. Significant proteinuria is a common finding in patients with many renal diseases. Proteinuria is a marker of glomerular damage and podocyte loss and injury in particular. The degree of proteinuria at presentation or during the course of the disease correlates with long-term outcome in many renal diseases. Proteinuria per se may be nephrotoxic and thus directly relevant to the progression of renal disease rather than simply acting as a marker of the severity of glomerular injury and podocytes loss. Seminal studies used the atypical renal anatomy of the axolotl to instill proteins directly into the tubular lumen without requiring passage through the glomerulus. This indicated that tubular protein could be cytotoxic and induce interstitial inflammation and fibrosis in the peritubular region. Cell culture studies demonstrate that exposure to proteins results in proximal tubular cell activation and the production of pro-inflammatory and pro-fibrotic mediators. Proximal tubular cell death occurred in some studies reinforcing the potential of protein to exert cytotoxic effects via oxidative stress or endoplasmic reticulum stress. Analysis of renal biopsy material from both experimental studies using models of proteinuric disease or patients with various proteinuric diseases provided evidence of activation of transcription factors and production of chemokines and pro-inflammatory mediators by proximal tubular cells. These data strongly suggest that although proteinuria is the result of glomerular disease it also represents an important cause of progression in patients with chronic kidney disease associated with proteinuria.
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Blackmore, Susan. Consciousness: A Very Short Introduction. Oxford University Press, 2017. http://dx.doi.org/10.1093/actrade/9780198794738.001.0001.
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Consciousness is ‘the last great mystery for science’. How can a physical brain create our experience of the world? What creates our identity? Do we really have free will? Could consciousness itself be an illusion? Exciting new developments in brain science are continuing these debates, and the field has now expanded to include biologists, neuroscientists, psychologists, and philosophers. Consciousness: A Very Short Introduction clarifies the potentially confusing arguments, and the major theories, whilst also outlining the amazing pace of neuroscience discoveries. Covering areas such as construction of self in the brain, mechanisms of attention, neural correlates of consciousness, and physiology of altered states of consciousness, it highlights the latest findings.
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Supernant, Kisha. Archaeology of the Métis. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780199935413.013.70.
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This article reviews the history of Métis archaeological research in Canada. The Métis of Canada arose as a distinct Indigenous identity in the postcontact period and provide an interesting archaeological case study to explore how and why new cultures emerge. Previous research attempted to correlate patterns in material culture with Métis identity, particularly in terms of economy, use of space, and certain artifact types. New research has the potential to take a more nuanced approach to the process of identification among the Métis, to contribute to a broad understanding of ethnogenesis, and to do research that is relevant to the contemporary Métis community, as well as the discipline of historical archaeology.
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Zawiszewski, Adam. Processing Ergativity: Behavioral and Electrophysiological Evidence. Edited by Jessica Coon, Diane Massam, and Lisa Demena Travis. Oxford University Press, 2017. http://dx.doi.org/10.1093/oxfordhb/9780198739371.013.28.
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So far ergativity has been mostly studied from a language-theoretic perspective and the evidence on how it is processed and represented is rather scarce. In this paper I provide an insight into ergativity from an experimental approach. First, I present an overview of the experimental methods used to investigate ergativity (self-paced reading, event-related potentials and functional magnetic resonance imaging) and next I review studies that examined behavioral, electrophysiological and neuroanatomical correlates of ergativity in both native and non-native speakers, as well as those focused on the universality of processing strategies in ergative languages. Finally, I also review and discuss the experimental data from works that dealt with syntactic and semantic aspects of ergativity and discuss the implication of the results for future research.
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Morawetz, Klaus. Deep Impurities with Collision Delay. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198797241.003.0017.
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The linearised nonlocal kinetic equation is solved analytically for impurity scattering. The resulting response function provides the conductivity, plasma oscillation and Fermi momentum. It is found that virial corrections nearly compensate the wave-function renormalizations rendering the conductivity and plasma mode unchanged. Due to the appearance of the correlated density, the Luttinger theorem does not hold and the screening length is influenced. Explicit results are given for a typical semiconductor. Elastic scattering of electrons by impurities is the simplest but still very interesting dissipative mechanism in semiconductors. Its simplicity follows from the absence of the impurity dynamics, so that individual collisions are described by the motion of an electron in a fixed potential.
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Seedat, Soraya, and Sharain Suliman. PTSD in Low- and Middle-Income Countries. Edited by Charles B. Nemeroff and Charles R. Marmar. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190259440.003.0009.
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The burden of post-traumatic stress disorder (PTSD) in low- and middle-income countries (LMIC) is high. In addition to trauma type and sociodemographic correlates, cultural and social drivers of the disorder are critical to consider in diagnosis and treatment provision. Sociocultural factors may underpin the cognitive and affective neural mechanisms of PTSD and its phenotypic presentation. Although steps have been taken to evaluate and disseminate empirically supported interventions for PTSD in LMIC that are feasible, affordable, and potentially sustainable despite the limited resources that exist in these countries, well-designed quantitative and qualitative randomized controlled trials are needed in order to gain a more nuanced understanding of the cultural expressions of PTSD.
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Radde-Gallwitz, Andrew. Excursus: The Distinction of Hypostases. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780199668977.003.0004.
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The Excursus examines Gregory’s attempts to articulate the distinction of the three hypostases, addressing current debates over Gregory’s position on the divine nature as a universal. It argues that Gregory articulates three conditions as necessary for an orthodox conception of how the three hypostases are differentiated: the hypostases must be unconfused, ordered in accordance with the baptismal formula, and conceived of as individuals within the common nature. Gregory never offers an account of how the three diverse and potentially contradictory conditions correlate. Still, the varied models he uses to explain the distinction of hypostases are not so much incompatible as mutually correcting. The works addressed are To Peter and the final section of To Ablabius. The Excursus argues that To the Greeks is inauthentic.
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Garrett, Don. Postscript Consciousness Revisited. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780195307771.003.0019.
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Chapter 14 (“Representation and Consciousness in Spinoza’s Naturalistic Theory of the Mind and Imagination”) argues that Spinoza identifies consciousness (conscientia) with power of thinking (cogitandi potentia). In his important article “Spinoza and Consciousness” (2008), Steven Nadler rejects this interpretation, proposing instead that consciousness for Spinoza is “a certain complexity in thinking that is the correlate of the complexity of a body.” In another important article, “Theories about Consciousness in Spinoza’s Ethics” (2010), Michael LeBuffe proposes that the interpretation of consciousness as power of thinking is “promising” but should be restricted to the consciousness of ideas within a mind and not applied to a mind’s overall consciousness. This postscript raises objections to Nadler’s complexity-based interpretation, rebuts Nadler’s objections to Chapter 14’s “Power of Thinking” interpretation, and argues against LeBuffe’s proposal to restrict the scope of that interpretation.
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Podsakoff, Philip M., Scott B. Mackenzie, and Nathan P. Podsakoff, eds. The Oxford Handbook of Organizational Citizenship Behavior. Oxford University Press, 2016. http://dx.doi.org/10.1093/oxfordhb/9780190219000.001.0001.
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The purpose of this handbook is to provide a broad and interdisciplinary review of state-of-the-art research on organizational citizenship behaviors (OCBs), and related constructs such as contextual performance, spontaneous organizational behavior, prosocial behavior, proactive behavior, employee voice, and counterproductive work behavior. Chapters by leading scholars in the field address: (a) the conceptualization of OCBs; (b) the distinction between these behaviors and related constructs; (c) the antecedents, correlates, and consequences of these behaviors; (d) the mechanisms through which these behaviors influence organizational success and the boundary conditions limiting these effects; and (e) the methodological and measurement issues that are common when studying OCBs. In addition, this handbook has several chapters that explore the implications for managerial practice and career success. Finally, each of the chapters identifies substantive questions, methods, and issues for future research. The overarching goal of this handbook is to offer a single resource that will inform and inspire scholars, students, and practitioners of the origins of this construct, the current state of research on this topic, and potentially exciting avenues for future exploration.
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Cunningham, Scott, and Todd D. Kendall. Examining the Role of Client Reviews and Reputation within Online Prostitution. Edited by Scott Cunningham and Manisha Shah. Oxford University Press, 2016. http://dx.doi.org/10.1093/oxfordhb/9780199915248.013.17.
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Seller reputation can incentivize the fulfillment of contractual obligations and the provision of noncontractible services if buyers have lower willingness to pay for products offered by sellers with poor reputations. For this reason, reputational mechanisms can substitute for court enforcement of contracts, when court enforcement is costly or unavailable, and more generally can improve sellers’ behavior toward buyers. This Chapter examines the market for professional escorts, a high-quality segment of the market for prostitution. Since prostitution is illegal in most US locations, court enforcement of contracts between buyers and sellers is problematic. We examine how the diffusion of websites that allow escort customers to share information with each other has created an important reputational mechanism where only weak measures of reputation were previously available. We show that the diffusion of one well-known website appears to correlate with a trend toward better escort behavior toward buyers. Welfare implications of this reputational mechanism are, however, ambiguous, since it likely expands the market for prostitution, potentially generating negative externalities.
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Horing, Norman J. Morgenstern. Non-Equilibrium Green’s Functions: Variational Relations and Approximations for Particle Interactions. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198791942.003.0009.
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Chapter 09 Nonequilibrium Green’s functions (NEGF), including coupled-correlated (C) single- and multi-particle Green’s functions, are defined as averages weighted with the time-development operator U(t0+τ,t0). Linear conductivity is exhibited as a two-particle equilibrium Green’s function (Kubo-type formulation). Admitting particle sources (S:η,η+) and non-conservation of number, the non-equilibrium multi-particle Green’s functions are constructed with numbers of creation and annihilation operators that may differ, and they may be derived as variational derivatives with respect to sources η,η+ of a generating functional eW=TrU(t0+τ,t0)CS/TrU(t0+τ,t0)C. (In the non-interacting case this yields the n-particle Green’s function as a permanent/determinant of single-particle Green’s functions.) These variational relations yield a symmetric set of multi-particle Green’s function equations. Cumulants and the Linked Cluster Theorem are discussed and the Random Phase Approximation (RPA) is derived variationally. Schwinger’s variational differential formulation of perturbation theories for the Green’s function, self-energy, vertex operator, and also shielded potential perturbation theory, are reviewed. The Langreth Algebra arises from analytic continuation of integration of products of Green’s functions in imaginary time to the real-time axis with time-ordering along the integration contour in the complex time plane. An account of the Generalized Kadanoff-Baym Ansatz is presented.
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Ramani, Ramachandran, ed. Functional MRI. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190297763.001.0001.
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Functional MRI with BOLD (Blood Oxygen Level Dependent) imaging is one of the commonly used modalities for studying brain function in neuroscience. The underlying source of the BOLD fMRI signal is the variation in oxyhemoglobin to deoxyhemoglobin ratio at the site of neuronal activity in the brain. fMRI is mostly used to map out the location and intensity of brain activity that correlate with mental activities. In recent years, a new approach to fMRI was developed that is called resting-state fMRI. The fMRI signal from this method does not require the brain to perform any goal-directed task; it is acquired with the subject at rest. It was discovered that there are low-frequency fluctuations in the fMRI signal in the brain at rest. The signals originate from spatially distinct functionally related brain regions but exhibit coherent time-synchronous fluctuations. Several of the networks have been identified and are called resting-state networks. These networks represent the strength of the functional connectivity between distinct functionally related brain regions and have been used as imaging markers of various neurological and psychiatric diseases. Resting-state fMRI is also ideally suited for functional brain imaging in disorders of consciousness and in subjects under anesthesia. This book provides a review of the basic principles of fMRI (signal sources, acquisition methods, and data analysis) and its potential clinical applications.
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Naicker, Saraladevi, and Graham Paget. HIV and renal disease. Edited by Vivekanand Jha. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0187_update_001.
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The human immunodeficiency virus (HIV) infection epidemic has particularly affected the poorest regions of the world. HIV can directly or indirectly affect different aspects of renal function, and results in a variable expression of kidney disease.Acute kidney injury (AKI) occurs in approximately 20% of hospitalized patients. The prevalence of chronic kidney disease (CKD) amongst HIV-infected patients is reported at 3.5–38% in different regions of the world. The complex interplay between the pheno- and/or genotypic variants of the virus, the genetic make-up of the host, and environmental factors determine the clinical manifestations of renal disease. The association of APOL1 gene variants G1 and G2 with the risk of focal segmental glomerulosclerosis explains the high frequency of HIV-associated nephropathy (HIVAN) in populations of black ethnicity.Anti-retroviral therapy (ART) is effective in preventing progression of HIVAN. Some of the drugs used in ART regimens are potentially nephrotoxic and require dose adjustment or even avoidance in CKD. Progression to end-stage renal disease (ESRD) in HIVAN has been reported to correlate with the extent of chronic damage quantified by renal biopsy.HIV-infected patients requiring dialysis, who are stable on ART, are achieving survival rates comparable to those of non-HIV dialysis populations. Similarly, HIV infection does not seem to adversely affect patient and graft survival rates after kidney transplantation, and there has been no increase in the prevalence of opportunistic infections in transplant recipients on effective ART.
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van der Vlag, Johan, and Jo H. M. Berden. The patient with systemic lupus erythematosus. Edited by Giuseppe Remuzzi. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0161.
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Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with various clinical manifestations. The hallmark of SLE is the presence of antibodies against nuclear constituents, such as double-stranded (ds)DNA, histones, and nucleosomes. Local deposition of antinuclear antibodies in complex with nuclear autoantigens induces serious inflammatory conditions that can affect several tissues and organs, including the kidney.The levels of antinucleosome and anti-dsDNA antibodies seem to correlate with glomerulonephritis and these autoantibodies can often be detected years before the patient is diagnosed with SLE. Apoptotic debris is present in the extracellular matrix and circulation of patients with SLE due to an aberrant process of apoptosis and/or insufficient clearance of apoptotic cells and apoptotic debris. The non-cleared apoptotic debris in patients with SLE may lead to activation of both the innate (myeloid and plasmacytoid dendritic cells) and adaptive (T and B cells) immune system. In addition to the activation by apoptotic debris and immune complexes, the immune system in SLE may be deregulated at the level of (a) presentation of self-peptides by antigen-presenting cells, (b) selection processes for both B and T cells, and (c) regulatory processes of B- and T-cell responses. Lupus nephritis may be classified in different classes based on histological findings in renal biopsies. The chromatin-containing immune complexes deposit in the capillary filter, most likely due to the interaction of chromatin with the polysaccharide heparan sulphate. A decreased renal expression of the endonuclease DNaseI further contributes to the glomerular persistence of chromatin and the development of glomerulonephritis.Current treatment of lupus nephritis is not specific and aims to reduce the inflammatory response with general immunosuppressive therapies. However, research has revealed novel potential therapeutic candidates at the level of dendritic cells, B cells, and T cells.