The Program

The CHUC Lupus Clinic is located at the Rheumatology Department, Coimbra University Hospital – ULS Coimbra, in Coimbra, Portugal (coordinator: Prof. Luís Inês, MD, PhD). It is an academic referral lupus centre, founded in 2005. We provide multidisciplinary care and work in collaboration with clinicians with a special interest in SLE from other medical specialties, including nephrology, dermatology and a dedicated pregnancy clinic.

Our main research focus is in clinical outcomes research and measures of SLE disease activity, notably the development of the SLE Disease Activity Score (SLE-DAS). The clinical research program is based in the HUC Lupus Cohort, an open prospective cohort now including 600 SLE patients. We collaborate in national and international multicentre research in SLE.

Prof. Luís Inês is currently the President of SLE – The European Lupus Society and chair of the 2026 European Lupus Meeting (Lisbon, 4-7 March, 2026).

Selection of publications:

1. Mucke J, Bertsias G, Aringer M, et al. EULAR recommendations for a core data set to support clinical care and translational and observational research in systemic lupus erythematosus. Ann Rheum Dis 2025; 84:1621-31.

2. Jesus D, Matos A, Henriques C, Doria A, Ines LS. SLE-DAS enables an accurate definition of severe lupus disease activity: derivation and validation in a post hoc study of anifrolumab phase II and III studies. Lupus Sci Med 2025; 12:e001499.

3. Arnaud L, Ruiz-Irastorza G, Aranow C, et al. ERN ReCONNET–SLICC–SLEuro expert consensus on the therapeutic management of rare systemic lupus erythematosus manifestations. Lancet Rheumatol 2025: S2665-9913(25)00063-3.

4. Nielsen W, Kharouf F, Grajales CM, et al. Scoping literature review to identify candidate domains for the OMERACT Systemic Lupus Erythematosus core outcome set. Semin Arthritis Rheum 2025; 72:152684.

5. Saraiva L, Cunha RN, Jesus DJ, Gatto M, Zen M, Iaccarino L, Silva JAP, Doria A, Inês LS. The SLE-DAS provides an accurate and feasible flare tool in the clinical setting: a validation study. Rheumatology 2024; 63(4): 1123–9.

6. Jesus D, Henriques C, Matos A, Doria A, Inês L. Systemic Lupus Erythematosus Disease Activity Score Remission and Low Disease Activity States Discriminate Drug from Placebo and Better Health‐Related Quality of Life. Arthritis Care Res (Hoboken) 2024;76(6):788-95.

7. Fanouriakis A, Kostopoulou M, Andersen J, et al. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Ann Rheum Dis 2024; 2;83(1):15-29.

8. Inês LS, Fredi M, Jesus D, Shumilova A, Franceschini F, Vital EM. What is the best instrument to measure disease activity in SLE? – SLE-DAS vs Easy BILAG. Autoimmunity Reviews 2023; 23(2):103428.

9. Assunção H, Jesus D, Larosa M, Henriques C, Matos A, Le Guern V, Rubiño F, Silva JAP, Rua-Figueroa I, Costedoat-Calumeau N, Doria A, Inês L. Definition of low disease activity state based on the SLE-DAS: derivation and validation in a multicentre real-life cohort. Rheumatology (Oxford) 2022;61: 3309-16.

10. Jesus D, Larosa M, Henriques C, Matos A, Zen M, Tomé P, Alves V, Costa N, Le Guern V, Iaccarino L, Costedoat-Calumeau N, Doria A, Inês L. Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) enables accurate and user-friendly definitions of clinical remission and categories of disease activity. Ann Rheum Dis 2021;80(12):1568-74.

11. Jesus D, Matos A, Henriques C, Zen M, Larosa M, Iaccarino L, Da Silva JAP, Doria A, Inês LS. Derivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activity. Ann Rheum Dis 2019;78: 365-71.

Description of the mentorship program:

We provide a structured clinical mentorship program to visiting clinical fellows. Our program includes participation in the Lupus Clinic (3 weekly sessions of outpatient clinic and day hospital, and inpatients), a mentoring program in clinical aspects of SLE with a focus on outcome measures, practical implementation of treat-to-target management, and development of skills to optimize a Lupus Clinic and a research cohort. The mentees are supported to develop a clinical research project that can be implemented in their home centre with ongoing mentorship.

Housing and practical information: Housing must be self-arranged after acceptance of the mentorship. Lodgement within walking distance to the University Hospital or up to 30 minutes in public transportation is usually available. Online platforms such as uniplaces.com/accommodation/coimbra provide a wide range of choices.

The Lupus Clinic at the Centre for Rheumatology, University College London has been running since 1979. Over that time we have treated over 600 patients with SLE and we are currently following over 400 patients.

We have extensive databases of clinical and serological information including activity measured by BILAG for each patient at each visit. Thus we have been able to write a large number of research papers looking at long-term clinical outcomes in SLE, for example cancer, damage, cardiovascular events, infection and neuropsychiatric lupus. We were one of the first centres to develop use of B cell depletion to treat patients with refractory SLE.

Our centre is affiliated to both the British Isles Lupus Assessment Group and the Systemic Lupus International Collaborative Clinics and we are therefore involved in multi-centre studies of lupus.

We also have a thriving programme of laboratory research in SLE and APS, including both mouse models and human studies. We have published work on T Cells, B cells, monocytes, autoantibodies and lipid profiles and the impact of these biological factors on clinical outcomes.

Many European fellows have spent time in our unit over the last 20 years, ranging from a few months to several years. Many of them published research based on projects that they did here.

The area of expertise of Cochin's Hospital Center includes systemic lupus erythematosus (SLE) especially for its rare or complex presentations, antiphospholipid syndrome (APS), but also systemic sclerosis (SSc), Sjogren's syndrome, mixed connective tissue disease (MCTD) and undifferentiated connective tissue disease (UCTD), myositis (dermatomyositis, polymyositis, antisynthetase syndrome) and relapsing polychondritis. In addition, we have a specific national expertise on pregnancies and connective tissue diseases (CTD).

The Department of Internal Medicine is located in Cochin Hospital, University of Paris and it ensures a global management of these patients. Patients are referred based on the expertise of our center. As a healthcare Provider, we provide:

• 15 weekly clinics dedicated to CTD: 4 SLE, 4 SSc and 7 with different CTD, including 2 clinics dedicated to pregnancy and CTD.
• 2 hospitalization and 1 week hospitalization wards (20 and 14 beds respectively) dedicated to CTD (and vasculitis and other rare systemic autoimmune diseases). We perform in real time a number of instrumental examinations, including videocapillaroscopy, pulmonary function tests, computerized tomodensitometry scanning, echocardiography, articular ultrasound, renal biopsy and ophthalmological monitoring of hydroxychloroquine treatment (visual field testing, Optical Coherence Tomography spectral domain (OCT-SD), Fundus autofluorescence, electroretinogram). All these tests are performed and analysed by CTD specialized physicians, ensuring accurate evaluation. We also perform plasma exchanges and administrate infused therapies including intravenous immunoglobulin, cyclophosphamide and biologics.
• 1 day hospitalization ward in obstetric where high risk pregnant patients with CTD are offered the best available care in a department with more than 6000 deliveries/year
• Urgent care (24/7) and admission of patients with acute problems or requiring specific treatments in the traditional hospitalization wards, where an infectious mobile team is available for immuno-compromised patients.
• An access to an intensive care unit with physicians trained to manage severe CTD.
• A daily facility for the dressing of ulcers or skin lesions (on demand).
• An access to high quality immunological lab
• A transitioning circuit from pediatric to adult care in collaboration with the Necker hospital pediatric departments has been established for years.
• A multidisciplinary team with physicians, nurses, physiotherapists, nutritionists, psychologists and social workers specialized in therapeutic education of patients
• Numerous multidisciplinary regular expert reviews and joint meetings for difficult nephrological cases, muscular cases, ophthalmological cases, pediatric cases, obstetrical and rheumatological cases.

Our center is part of a national network on rare diseases since 2004. As a referral center for rare autoimmune and systemic diseases, we are organised to fulfill 6 major missions:

• coordinating the research effort and participating in the epidemiological surveillance, in connection with the French National Institute of Health Monitoring; to that end, databases have been established for SLE and APS (n>500), SSc (n=2500 patients), and CTD pregnancies (n>1500). Our center has been leading several projects and contributing to many others. It could be highlighted that we contributed to the 2013 reclassification criteria for SSc and to the new ACR/EULAR classification criteria for SLE.
• participating in training and information initiatives for the healthcare providers, as well as for sick people and their families; communication and dissemination are pillars of our activities, our center being an academic centers hosting medical students (n=144 per year), residents (n=30 per year) and PhD (n=5) in training. We also deliver lectures at the nurse school of Cochin hospital and to nurses in our departments. We organize at the local (hospital), regional (Ile de France), national and international levels meeting to share projects and ideas and improve the management of patients.
• facilitating the diagnosis and defining a strategy of treatment including psychological care and social support; as above described, patients' management has been organised to reach this goal and is fully included in our routine care with the participation of specialised nurses and psychologists.
• setting up and making available for other centers therapeutic protocols and recommendations of care, in connection with the French National Health Authorities and the French National Health Insurance Funds, the so-called PNDS have been supervised by our center in 2006 for SSc and is publicly available on the "Haute Autorité de Santé website" Click Here
• leading and coordinating the networks of physicians, paramedics and social correspondents involved in the care of patients; We organize weekly medical meetings with CTD correspondents to review patient's charts.

Our center is implicated in the clinical and translational research in CTDs:

• 3 international clinical trials and numerous national clinical trials initiated by the members of the healthcare Provider.
• 23 international and 13 national trials in which members of the healthcare Provider currently participate.
• Six international and two national consensus conferences in which members of the healthcare Provider participate.
• More than ten national or international courses on CTD including the university diploma on systemic autoimmune diseases at University of Paris (director Luc Mouthon and Nathalie Costedoat-Chalumeau), EULAR course in SLE, EUSTAR course and EUSTAR master class in SSc, in which members of the healthcare Provider participate.
• International congresses including the international Lupus congress (co-organiser), the world congress on scleroderma and the international Workshop on scleroderma for which the members of the healthcare Provider participate in the organizing committee.
• A member of our center is head of one basic research unit located at the Cochin institute, Inserm U1016, UMR 1804, Paris Descartes University, Paris: "neutrophils and vasculitis": Head Pr luc Mouthon and Dr Véronique Witko-Sarsat. We are affiliated to other basic research unit including epidemiology (Centre for Clinical Epidemiology, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Centre of Research in Epidemiology and Statistics, Paris, France)

Clinical Immunology Unit (UIC) was formally created in 1996 in the Internal Medicine Department with internists directly involved in the field of Immunology. UIC has developed its activities in diagnosis and follow-up of patients with diseases resulting from altered immune mechanisms, mainly autoimmune diseases and immunodeficiencies.

In collaboration with the Immunology Service of our hospital and with the Immuno-Genetic department of ICBAS – Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, there are regular and proficuous contact with the laboratory techniques, their indications, methods, limitations and pitfalls. In addition to the theoretical approach in basic and laboratory immunology, residents will participate in the practical discussions associated with the use of the tests in real clinical cases.

Main areas of intervention:

1. Clinical practice: Every day outpatient clinic of Autoimmune Diseases, Immunodeficiencies and Raynaud / Capillaroscopy is our main working area.
2. Multidisciplinary group consultation: It is held every Friday from 11 am to 2 pm, with the collaboration of different medical specialists, like nefrology, neurology, lab. immunology, pediatrics, dermatology, and others. It is a unique meeting of its kind in Portugal – where doctors from inside and other hospitals are also regularly involved. Several clinical cases with problems regarding diagnosis or therapy decision, such as those proposed for biological therapy, are discussed on a weekly basis. It is an extraordinary learning forum for the different levels of knowledge involved.
3. In-patient counseling: We support hospitalized patients with pathologies in the area of Clinical Immunology.
4. Formation: UIC has regularly scheduled, seminars to discuss topics such as SLE, Behçet, Sjogren, RA, Scleroderma, Myositis, Uveitis, Spondyloarthropathies, Undifferentiated connectivites, Antiphospholipid syndrome, Imaging in rheumatic diseases, Infiltration techniques in simulators, Clinical trials, Physiotherapy, Basic immunology, Primary and secondary Immunodeficiencies and Autoinflamatory syndromes. We also have Journal Club sessions.
5. Research: There is no good clinical care without associated research. Research lead clinician to raise questions, stimulate new sights that translate, in the short / medium term, into better care to the patient and his illness. UIC participate in several research projects at both national and international level and also participates in several Phase II, III and IV Clinical Trials.
6. Conference organization: UIC provide conditions for meetings between national and international experts, with an active role in the discussion and sharing of ideas, based on clinical evidence and personal experience, sharing experiences among centers of high level of differentiation in the area of autoimmunology and immunodeficiencies. UIC organize every year an International meeting, PAM – Porto's Autoimmunity Meeting and was responsible for the organization of the 11th European Lupus Meeting (Porto, chair Prof. Carlos Vasconcelos)

Selection of publications
ISI factor for Lupus – Carlos Vasconcelos PhD from 2015-2018: 70.7861

1: van Vollenhoven R, Voskuyl A, Bertsias G, Aranow C, Aringer M, Arnaud L, Askanase A, Balážová P, Bonfa E, Bootsma H, Boumpas D, Bruce I, Cervera R, Clarke A, Coney C, Costedoat-Chalumeau N, Czirják L, Derksen R, Doria A, Dörner T, Fischer-Betz R, Fritsch-Stork R, Gordon C, Graninger W, Györi N, Houssiau F, Isenberg D, Jacobsen S, Jayne D, Kuhn A, Le Guern V, Lerstrøm K, Levy R, Machado-Ribeiro F, Mariette X, Missaykeh J, Morand E, Mosca M, Inanc M, Navarra S, Neumann I, Olesinska M, Petri M, Rahman A, Rekvig OP, Rovensky J, Shoenfeld Y, Smolen J, Tincani A, Urowitz M, van Leeuw B, Vasconcelos C, Voss A, Werth VP, Zakharova H, Zoma A, Schneider M, Ward M. A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS). Ann Rheum Dis. 2017 Mar;76(3):554-561.

2: Tamirou F, D'Cruz D, Sangle S, Remy P, Vasconcelos C, Fiehn C, Ayala GuttierezMdel M, Gilboe IM, Tektonidou M, Blockmans D, Ravelingien I, le Guern V, Depresseux G, Guillevin L, Cervera R, Houssiau FA; MAINTAIN Nephritis Trial Group. Long-term follow-up of the MAINTAIN Nephritis Trial, comparing azathioprine and mycophenolate mofetil as maintenance therapy of lupus nephritis. Ann Rheum Dis. 2016 Mar;75(3):526-31.

3: Oparina NY, Delgado-Vega AM, Martinez-Bueno M, Magro-Checa C, Fernández C, Castro RO, Pons-Estel BA, D'Alfonso S, Sebastiani GD, Witte T, Lauwerys BR, Endreffy E, Kovács L, Escudero A, López-Pedrera C, Vasconcelos C, da Silva BM, Frostegård J, Truedsson L, Martin J, Raya E, Ortego-Centeno N, de Los Angeles Aguirre M, de Ramón Garrido E, Palma MJ, Alarcon-Riquelme ME, Kozyrev SV. PXK locus in systemic lupus erythematosus: fine mapping and functional analysis reveals novel susceptibility gene ABHD6. Ann Rheum Dis. 2015 Mar;74(3):e14.

4: Cervera R, Serrano R, Pons-Estel GJ, Ceberio-Hualde L, Shoenfeld Y, de Ramón E, Buonaiuto V, Jacobsen S, Zeher MM, Tarr T, Tincani A, Taglietti M, Theodossiades G, Nomikou E, Galeazzi M, Bellisai F, Meroni PL, Derksen RH, de Groot PG, Baleva M, Mosca M, Bombardieri S, Houssiau F, Gris JC, Quéré I, Hachulla E, Vasconcelos C, Fernández-Nebro A, Haro M, Amoura Z, Miyara M, Tektonidou M, Espinosa G, Bertolaccini ML, Khamashta MA; Euro-Phospholipid Project Group (European Forum on Antiphospholipid Antibodies). Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicenter prospective study of 1000 patients. Ann Rheum Dis. 2015 Jun;74(6):1011-8.

5: Marinho A, Carvalho C, Boleixa D, Bettencourt A, Leal B, Guimarães J, Neves E, Oliveira JC, Almeida I, Farinha F, Costa PP, Vasconcelos C, Silva BM. Vitamin D supplementation effects on FoxP3 expression in T cells and FoxP3(+)/IL-17A ratio and clinical course in systemic lupus erythematosus patients: a study in a Portuguese cohort. Immunol Res. 2017 Feb;65(1):197-206.

6: Marinho A, Taveira M, Vasconcelos C. Topics on vitamin D in systemic lupus erythematosus: analysis of evidence and critical literature review. Immunol Res. 2017 Apr;65(2):495-511.

7: Bettencourt A, Carvalho C, Leal B, Brás S, Lopes D, Martins da Silva A, Santos E, Torres T, Almeida I, Farinha F, Barbosa P, Marinho A, Selores M, Correia J, Vasconcelos C, Costa PP, da Silva BM. The Protective Role of HLA-DRB1(∗)13 in Autoimmune Diseases. J Immunol Res. 2015;2015:948723.

8: Tamirou F, Lauwerys BR, Dall'Era M, Mackay M, Rovin B, Cervera R, Houssiau FA; MAINTAIN Nephritis Trial Investigators. A proteinuria cut-off level of 0.7 g/day after 12 months of treatment best predicts long-term renal outcome in lupus nephritis: data from the MAINTAIN Nephritis Trial. Lupus Sci Med. 2015 Nov 12;2(1):e000123.

9: Langefeld CD, Ainsworth HC, Cunninghame Graham DS, Kelly JA, Comeau ME, Marion MC, Howard TD, Ramos PS, Croker JA, Morris DL, Sandling JK, Almlöf JC, Acevedo-Vásquez EM, Alarcón GS, Babini AM, Baca V, Bengtsson AA, Berbotto GA, Bijl M, Brown EE, Brunner HI, Cardiel MH, Catoggio L, Cervera R, Cucho-Venegas JM, Dahlqvist SR, D'Alfonso S, Da Silva BM, de la Rúa Figueroa I, Doria A, Edberg JC, Endreffy E, Esquivel-Valerio JA, Fortin PR, Freedman BI, Frostegård J, García MA, de la Torre IG, Gilkeson GS, Gladman DD, Gunnarsson I, Guthridge JM, Huggins JL, James JA, Kallenberg CGM, Kamen DL, Karp DR, Kaufman KM, Kottyan LC, Kovács L, Laustrup H, Lauwerys BR, Li QZ, Maradiaga-Ceceña MA, Martín J, McCune JM, McWilliams DR, Merrill JT, Miranda P, Moctezuma JF, Nath SK, Niewold TB, Orozco L, Ortego-Centeno N, Petri M, Pineau CA, Pons-Estel BA, Pope J, Raj P, Ramsey-Goldman R, Reveille JD, Russell LP, Sabio JM, Aguilar-Salinas CA, Scherbarth HR, Scorza R, Seldin MF, Sjöwall C, Svenungsson E, Thompson SD, Toloza SMA, Truedsson L, Tusié-Luna T, Vasconcelos C, Vilá LM, Wallace DJ, Weisman MH, Wither JE, Bhangale T, Oksenberg JR, Rioux JD, Gregersen PK, Syvänen AC, Rönnblom L, Criswell LA, Jacob CO, Sivils KL, Tsao BP, Schanberg LE, Behrens TW, Silverman ED, Alarcón-Riquelme ME, Kimberly RP, Harley JB, Wakeland EK, Graham RR, Gaffney PM, Vyse TJ. Transancestral mapping and genetic load in systemic lupus erythematosus. Nat Commun. 2017 Jul 17;8:16021.

The Division of Rheumatology at Karolinska University Hospital in Stockholm, Sweden, operates across three sites: Solna, Danderyd, and Huddinge. Patients with systemic lupus erythematosus (SLE) are seen at all three sites, both in general rheumatology outpatient clinics and in dedicated lupus clinics. An inpatient ward specifically for patients with rheumatic diseases is located at the Solna site, alongside Day Care Units at each location. In total, we follow approximately 600 patients with SLE, the majority of whom contribute to clinical trials and observational studies conducted at the Division of Rheumatology.

Our research activities are anchored at the Department of Medicine Solna, Karolinska Institutet, and are conducted in close proximity to our laboratory facilities at the Center for Molecular Medicine (CMM). This environment offers a strong platform for translational research by integrating clinical and molecular expertise, supported by infrastructure for proteomics, immunoassays, and bioinformatics.

At the Division of Rheumatology, we foster collaboration between clinical and research staff to advance understanding and treatment of rheumatic diseases. Weekly research meetings facilitate the exchange of ideas and feedback, while PhD students collaborate across teams to promote interdisciplinary learning and innovation. The division also hosts central core facilities, including one for the coordination and storage of biological samples.

SLE-focused research is conducted within two research groups, both of which offer one SLEuro training bursary placement:

• Research Group Aleksandra Antovic — Read more — Contact: Aleksandra Antovic (aleksandra.antovic@ki.se)
• Research Group Ioannis Parodis — Read more — Contact: Ioannis Parodis (ioannis.parodis@ki.se)

The Department of Autoimmune Diseases of the Hospital Clínic de Barcelona devotes its clinical activity to the diagnosis, treatment and follow-up of patients with systemic autoimmune diseases. It is a reference center for these diseases at European level (member of ERN-ReCONNET and ERN-RITA) and Spanish level (CSUR Enfermedades Autoinmunes Sistémicas).

Outpatient Clinics: Every day, 30-50 patients (5-10 first consultations and 20-30 successive consultations) are visited in 2 offices. More than 10,000 new patients have been visited over the 25 years.

Hospital Admissions: The Department has 6 beds for conventional hospitalisation.

Day Hospital: The Department has two offices and several sites for the administration of intravenous treatments located at the Day Hospital. This area also allows access to unscheduled and emergency visits without a prior appointment (Monday to Friday, from 9:00 to 21:00).

Diagnostic Tools: The following exams are carried out by members of the Department: Capillaroscopy, temporal artery biopsy, muscle and nerve biopsy, minor gland biopsy and temporal artery ultrasonography.

Current clinical and research programs: It takes care and perform clinical and epidemiological studies of patients with systemic lupus erythematosus, antiphospholipid syndrome, Sjögren's syndrome, systemic sclerosis, systemic vasculitis, inflammatory myopathies, sarcoidosis, Behçet's disease, autoimmune uveitis, autoinflammatory diseases and primary immunodeficiencies. Our Department organises the Master in Autoimmune Diseases of the Universitat de Barcelona. This is a master's degree adapted to the European Higher Education Area, made up of by 60 ECTS credits. This is the first University Master in Europe that presents autoimmune diseases comprehensively, bringing together the basic concepts of autoimmunity with clinical aspects of the autoimmune diseases. For more information.

Requirements:

Currently the way to perform this fellowship at our center is by performing the Master in Autoimmune Diseases of the Universitat de Barcelona that we coordinate. It includes 60 ECTS credits (one academic year), but it is not necessary to stay in Barcelona the whole year:

– Module 1 is performed completely on-line and, therefore, it can be performed anywhere.
– Module 2 includes lectures performed every Friday from October to February (plus complementary activities, readings, portfolios…). This is the suggested period to stay in Barcelona.
– Module 3 is the clinical rotation that can be performed during the stay in Barcelona (i.e., from October to February).
– Module 4 is the research project.

they must perform the Master's in Autoimmune Diseases of the University of Barcelona that we coordinate.

Our Lupus Center offers the unique opportunity to work closely with rheumatologists, dermatologists, nephrologists and internists, experts in systemic lupus. We are labelled French National Reference Center for Rare Auto-immune diseases. We are also part of the ERN ReCONNET and of the Euskampus consortium in collaboration with Bilbao (Spain, Prof Ruiz-Irastorza)

The center follows very large cohorts of patients with systemic lupus and is interfaced with an Immunology Lab, ImmunoConcept CNRS UMR 5164.

Our current research mainly focuses on:
– The role of different immunological actors (ferroptosis, Tfh, soluble FasL and Tregs) in lupus pathogenesis
– Immune mediators and metabolites involved in cardiovascular risk of SLE patients
– Pregnancy and systemic Lupus

Participants to our training program will gain extensive clinical experience and practical knowledge of SLE and will be offered the possibility to perform research at the highest international level.

Members of our SLE Center are currently:

• Christophe Richez, MD PhD, rheumatologist (director of reference center);
• Estibaliz Lazaro, MD PhD, internist (co-director of center of reference);
• Patrick Blanco, MD PhD, immunologist (head of autoimmunity department of the Immunology lab);
• Claire Leibler, MD PhD, immunologist;
• Lionel Couzi, MD PhD, nephrologist;
• Julien Seneschal, MD PhD, dermatologist.

Selected recent publications

1. Divergent TIR signaling domains in TLR7 and TLR9 control opposing effects on systemic autoimmunity. J Clin Invest. 2025 Aug 12:e189566
2. The role of platelets in immune-mediated inflammatory diseases. Nat Rev Immunol. 2023 Jan 27:1–16
3. Genetic dissection of TLR9 reveals complex regulatory and cryptic proinflammatory roles in mouse lupus. Nat Immunol. 2022 Oct;23(10):1457-1469.
4. Trial of Anifrolumab in Active Systemic Lupus Erythematosus. N Engl J Med. 2020 Jan 16;382(3):211-221.
5. Selectins impair regulatory T cell function and contribute to systemic lupus erythematosus pathogenesis. Sci Transl Med. 2021 Jun 30;13(600).

The Leeds Institute of Rheumatic and Musculoskeletal Medicine is a EULAR centre of excellence. The lupus group is led by Ed Vital and covers clinical and translational research. Key areas of interest at present include:

1. "At Risk" populations followed to progression to SLE, discovering disease mechanisms and diagnostic processes
2. Stratification of biologic therapies
3. Lupus arthritis, including imaging, outcome measures and novel clinical trial designs
4. Cutaneous lupus, studying mechanisms of disease and novel therapeutic targets

The lupus clinic includes more than 1000 patients in observational studies for SLE and related autoimmune diseases. We have specialist lupus clinics for nephrology, dermatology, neurology, obstetrics and pulmonology. A visiting student will also benefit from several collaborations including the BILAG group. Clinics and research are conducted in English.

The Rheumatology Unit is part of the University Department of Clinical and Experimental Science of UniBs; patients care, clinical research and education are the three main objectives of the Unit. The Unit is one of the partecipating centers of the ERN-RECONNET, the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases approved by the European Commission in 15th December 2016.

The clinical activity of the Unit is focused on systemic autoimmune diseases, including Systemic lupus erythematosus (SLE), Systemic Sclerosis (SSc), undifferentiated connective tissue disease, antiphospholipid syndrome, inflammatory myopathies and Systemic Vasculitides.

The clinical activity of the Unit is structured in outpatients visits and day-hospital for daily drug infusions. The outpatients clinic provides more than 50 daily visits for first rheumatologic assessment and follow-up evaluations; disease-specific second/third-level visits for SLE, Systemic sclerosis, Sjogren's Syndrome, rheumatoid arthritis, Inflammatory myopathies, systemic vasculitis. In particular, the Unit hosts a formal Lupus Clinic since January 2015, including, in addition to the above described activities, a dedicated mail and phone number active for sudden needs or lupus related emergency problems.

All the dedicated clinics share common characteristics including the multidisciplinary approach to the patients as several health professionals other than rheumatologists are involved in the clinics: nurses, obstetrics and gynaecologists, cardiologists, nephrologists, ophthalmologists, psychiatrist, and orthopaedics. Moreover, all these clinics are characterized by a strong effort toward quality of care and a patient-centered approach. Overall, 400 SLE, 400 UCTD, 350 SSc, 400 SS, 200 antiphospholipid syndromes, 5000 RA, 100 myositides patients are regularly followed at the dedicated clinics of the Rheumatology Unit.

The day hospital/MAC section of the Rheumatology Unit includes 12 seats and 2 beds for daily intravenous drug-infusion; three rheumatologists and four nurses are assigned to this section of the Unit.

The Unit is also the venue of the Specialization School in Rheumatology of Brescia University. The research activity of the Unit is focused on pathogenesis and complications of the different autoimmune diseases:
– associations between autoantibodies' and particular organ involvement of systemic autoimmune diseases
– setting up and validation of new laboratory methods for the determination of autoantibodies;
– analysis of prognostic factors for recurrent miscarriages and thromboses in antiphspholipid syndrome;
– subpopulation lymphocytes modifications during different autoimmune diseases.
The research activity is documented by published scientific articles over 30 years of activity, several participations to national and international congresses and a worldwide esteem of the research activity. The Rheumatology Unit takes part and leads of several collaborative research studies with Italian and European centers. The educational mission of the Rheumatology Unit is achieved by several initiatives addresses to medical students, internal and external rheumatologists in training (since 2015, also 6 trainees from abroad), rheumatologists, nurses, general practitioners.

The Birmingham Lupus Clinics at Sandwell and West Brimingham NHS Trust follows around 600 patients with SLE. We are members of both the BILAG group and the Systemic Lupus International Collaborating Clinics (SLICC). In collaboration with the University of Birmingham we have a programme of lupus research including tissue-based exploratory studies, clinical outcome studies, clinical trials and mixed methods research. We have a large database of patients starting in 1989 with detailed clinical assessment data at each visit.

Current research areas of interest include:

1. Understanding the long-term outcomes of patients with SLE (including the development of organ damage)
2. Defining the pathogenesis at the cellular/molecular level of cutaneous lupus and of poor pregnancy outcomes
3. Improving clinical outcomes for patients with SLE including lupus nephritis
4. The role of exercise and lifestyle modification in patients with SLE

The LuVaCs center of expertise is acknowledged by the Dutch Federation of University Medical Centers (NFU) and by the European Reference Networks (ERN). LuVaCs is an acronym for three complex systemic autoimmune diseases: Lupus, Vasculitis and Complement-associated Systemic Diseases. This acronym brings together 3 conditions for which built upon the long-standing expertise at LUMC on systemic autoimmune diseases.

The LUMC harbors a clinical, multidisciplinary team providing expert Care for patients with (severe) systemic autoimmune diseases involving collaborations with the departments of Rheumatology, Vascular medicine, Obstetrics & Gynaecology, Hematology, Ear-Nose-Throat (ENT), Pulmonology and Immunology. In addition to a multidisciplinary strategy within our hospital, we also initiated the regional 'LuVaCs Shared Care', embracing that we work together as hospitals to deliver the optimal treatment for LuVaCs patients.

Our LuVaCs center of expertise distinguishes two different categories of Science: clinical trials and general research themes. We conduct clinical trials focusing on the development of novel treatment strategies in patients with systemic autoimmune diseases. We combine this with fundamental and translational research focused on neutrophil extracellular traps (NETs), B-cells and complement immunology. In addition, there is also attention for digital health and the use of real-world data. Read more on our science page.

Furthermore, we are involved in the Education programs for medicine and biomedical sciences, as well as the training of specialists in internal medicine and nephrology at LUMC/Leiden University.

Uppsala University Hospital is one of the largest hospitals in Sweden, with more than 900 beds for patients and more than 300.000 out-patient visits. The Department of Medical Sciences, with staff and research laboratories, is located at the University Hospital, and both patient care and research at the Hospital has an excellent reputation. The Section of Rheumatology has a specialized SLE clinic with more than 300 SLE patients supervised and treated. The clinic, as well as the patients, has long experience of both basic research projects and clinical studies.

Main focus of our research is the interferon system and its role in the etiopathogenesis of SLE, and the genetic background to SLE as well as functional consequences of identified risk genes. Associate professor Dag Leonard is head of the Lupus clinic and also member of the steering committee of the Swedish SLE network, which encompass clinicians and basic research scientist from all university clinics in Sweden. More than 40 colleagues are involved in the Swedish SLE network and we have an annual meeting where we share and discuss our most recent research data.

Our present research focus is on the genetic background to SLE and the molecular and clinical consequences of identified risk genes. In the Swedish SLE network we have clinical and genetic data on more that 2000 patients with SLE and control individuals. Beside identifying risk gene variants and their cellular functions, we also try to identify the connection between the risk gene variants, clinical picture and involved molecular pathways in each patient in order to develop tools for more targeted therapies. We have developed a polygenetic risk score for patients with SLE and this work continues. In our laboratory at the Rudbeck laboratory we perform a number of cellular experiments and at the moment we are looking for drug compounds that can down-regulate, or modulate, the cytokine response in immune cells involved in the SLE disease process. In the research lab we speak both English and Swedish, but at the out-patient clinic at the hospital Swedish in the natural language with patients and the staff.

More information:
https://www.uu.se/en/department/medical-sciences/research/research-groups/rheumatology/systemic-lupus-erythematosus-sle

Rheumatology Clinic at Sahlgrenska University Hospital and the Dept. of Rheumatology and Inflammation Research, Inst of Medicine, Sahlgrenska Academy, University of Gothenburg, (Sweden).

Sahlgrenska University Hospital is one of the largest hospitals in Sweden and the Sahlgrenska Rheumatology clinic is the only one in Sweden with a Rheumatologist on call around the clock. In the out-patient rheumatology clinic, between 2020-23, 666 unique SLE patients were registered. At the patient ward, during 2023, 29 unique SLE patients were registered. We also have a dedicated clinic for SLE pregnancy.

The Dept. of Rheumatology and Inflammation Research is a EULAR-appointed European Centre of Excellence of Rheumatology with research that ranges from basic research and animal models to translation and clinical research. The Dept. holds state-of-the-art equipment for immune system characterization, for example confocal microscopy, cell sorter, a new spectral flow cytometer (BD FACS discoverTM A8 with cellview, the only of its kind in Scandinavia), light sheet microscopy, image stream and histology unit.

At the Dept., both clinicians and basal scientists are involved in SLE research, including PhD student Agnes Torell, ass prof Anna-Carin Lundell, rheumatologist Estelle Trysberg, rheumatologist and prof Anna Rudin and rheumatologist and ass prof Marit Stockfelt. Main focus of the research is the underlying pathological mechanisms in SLE pregnancy complications. We have collected the unique SLE-Placenta cohort, comprising more than 90 pregnant SLE patients and more than 70 healthy controls with peripheral blood samples collected prospectively during pregnancy and postpartum, as well as placentas collected at delivery. In addition, we have the SLE-GOT cohort of SLE patients in Gothenburg, and follow our patients treated with anifrolumab with regular blood samples and clinical data collection. At the lab, both English and Swedish are used, while in the out-patient clinic, Swedish is the language of choice.

We are associated with the Swedish SLE network, where both Anna Rudin and Marit Stockfelt are part of the steering committee. The network has an annual meeting where we discuss recent data and potential collaborations.

Rheumatology Department / Hospital Guillermo Almenara Irigoyen, EsSalud
Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas/ Universidad Científica del Sur, Lima, Perú.

This center, located in Lima, the capital city of Peru and home to about one-third of its population, is a referral for patients with systemic autoimmune diseases. This center includes a 12-bed inpatient unit, an outpatient unit for the administration of biological therapies, and a specialized outpatient setting for the management of patients with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and vasculitis. Our SLE cohort, named the Almenara Lupus cohort, is a prevalent one and was started in 2012; it currently includes over 350 patients; these patients are being followed at regular intervals to ascertain their disease activity, organ damage, comorbidities, patient-reported outcomes (PROs) and mortality. This cohort is focusing on the characteristics and factors associated with poorer outcomes in SLE patients from a mainly Mestizo (European and Native American heritage) population. Among the topics evaluated in our cohort, are the impact of frailty on several outcomes [damage, hospitalizations, mortality and health-related quality of life (HRQoL)], the impact of self-efficacy on damage, HRQoL, fatigue and flares as well as the predictors of damage; we have also focused on disease activity, including the evaluation of new disease activity indices [such as the Lupus Foundation of America-Rapid Evaluation of Activity in Lupus (LFA-REAL) clinician reported-outcome and the LFA-REAL PRO), the definition of treatment targets such as remission or lupus low disease activity state and their impact on these outcomes in predicting flares, among other topics.

The mentorship program will include the participation of the selected trainees in all our clinical activities, being in the outpatient and the inpatient settings. Research projects utilizing our vast database will be strongly encouraged. Results of that work are expected to be presented at national and international venues and subsequently published in peer review journals.