March 3, 2026Open Access

Elevated ferritin as a companion biomarker of myeloid-driven inflammation in RNP/Sm co-positive, treatment-resistant SLE endotype

Key Points

Elevated ferritin levels correlate with disease activity in RNP/Sm-positive lupus patients, indicating a potential marker for severity.
Patients with RNP/Sm positivity show significant resistance to common treatments, often leading to flare-ups.
Analysis highlights the role of intermediate monocytes and their TLR4 upregulation in myeloid-driven inflammation.
Understanding ferritin as a companion biomarker may help target therapies more effectively in treatment-resistant lupus cases.

Abstract

Anti-RNP/Sm co-positivity defines a high-risk, flare-prone, myeloid-dominant SLE endotypeRNP⁺Sm⁺ patients, especially Black patients, show profound refractoriness to first-line and B-cell depletion therapiesExpanded intermediate monocytes with TLR4 upregulation and IFNA10-biased interferon signallingHyperferritinaemia correlates with disease activity exclusively in RNP⁺Sm⁺ patients.

Elevated ferritin as a companion biomarker of myeloid-driven inflammation in RNP/Sm co-positive, treatment-resistant SLE endotype

Key Points

Abstract

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