Diagnostic and Therapeutic Challenges in Rare and Complex Autoimmune Diseases

Rare and Complex Autoimmune diseases represent a heterogeneous group of conditions, overall affecting up to 5% of the population. Autoimmune diseases are typically classified as systemic or organ-specific, although intermediate features are frequently observed, notably due to the complex locations of antigens and mechanisms of immune responses. Key features of autoimmune diseases include the wide variety of organs/systems targeted, the complexity of immune system components involved (innate, humoral and cellular) and the interplay of complex genetic and environmental elements. Due to their kaleidoscopic heterogeneity, they can mimic any conditions, often representing a diagnostic challenge in the field of internal medicine. In fact, despite extensive and long-established knowledge of the features and pathogenesis of these diseases, a prompt identification and consequent treatment of patients with autoimmune conditions can still be challenging. However, in recent years, the long-term prognosis of patients with autoimmune diseases has dramatically improved due to the development of drugs targeting the molecular components directly implicated in the inflammatory response. The development of these biological drugs has radically changed the therapeutic approach of autoimmune diseases, especially in patients resistant to standard treatment.

This Research Topic aims to provide an updated overview on diagnostic and therapeutic aspects of autoimmune diseases and their management, providing emerging research data and expert opinions to guide the care of patients with systemic vasculitis, lupus, and other rare or complex autoimmune diseases.

Accordingly, we call for both original research and review articles to address the following themes:

• New diagnostic approaches to systemic vasculitis, systematic lupus and systematic sclerosis including but not limited to patient phenotyping;
• Novel therapeutic perspectives on systemic vasculitis, systematic lupus and systematic sclerosis including but not limited to biological therapies;
• An updated review on emerging therapeutic approaches to rare autoimmune diseases.