Fig. 5
Risk factors and preventive strategies against SLE development, exacerbation, progression. Risk factors predisposing SLE can be classified into intrinsic and extrinsic factors (in red). Intrinsic factors can occur at genetic, epigenetic and hormonal levels. Extrinsic factors can be environmental, habitual, physiological and phycological. Among these extrinsic factors, SLE comorbidities from the category of physiological factors include cancers, cardiovascular diseases, bone diseases and neuropsychiatric diseases. As intrinsic SLE predisposing factors are difficult to control, preventive strategies against each extrinsic risk factors are listed (in blue). By summarizing preventive strategies against SLE and its comorbidities, 11 recommendations on the lifestyles (i.e., cease smoking, physical exercise, sufficient sleep, mental health, fitness, High-fiber low carbohydrate diet, Ca2+ intake, vitamin D supply, avoid alcohol overdose, avoid environmental immune stimulants, avoid abuse of estrogen-enriched products) and 7 advises on medication aids (avoid abuse of glucocorticoids, immunosuppressive therapeutics, antibiotics, aspirin, statin, virus vaccination, interventions of medicines against cognitive dysfunction) are given. SLE preventive strategies can be classified into three stages, i.e., primary prevention against SLE development, secondary prevention against SLE exacerbation, tertiary prevention against SLE progression. The prevention of SLE comorbidities should start at the time of diagnosis. Applying preventive strategies as early as possible during the disease course can help to avoid organ damage, which is a major trigger of systematic functional decline. Primary prevention recommendations are emphasized using cartoons
