Reconsidering Antimalarials in Systemic Lupus Erythematosus: Developments of Translational Clinical Interest
Bibliographic record
Abstract
Successful trials of biologic therapies in systemic lupus erythematosus (SLE) have raised interest in targeting a variety of additional putative mechanisms of action. These include preparations that antagonize Toll-like receptors (TLR) 7 and 9, one of the actions of antimalarials. Although they have been studied for over a hundred years, the last decade has witnessed a flurry of reports demonstrating novel physiologic effects of these agents. Prospective and retrospective studies that document disease-modifying outcomes of antimalarials have appeared. This report summarizes those breakthroughs and insights, which are important in our approach toward SLE management. ### Historical context According to legend, bark from a “fever tree” in 1620s Peru miraculously cured the mysterious illness of the Countess of Cinchona. That event led the Jesuits in Europe to form the first modern cartel — one that controlled the international production and distribution of quinine by the 1660s1. The first modern clinical investigations of quinine for rheumatic disorders were not published until Payne’s report of its efficacy for cutaneous lupus in 18942 and were expanded upon in the 1920s and 1930s. The quinacrine story is among the most colorful in the annals of pharmacologic interventions. It was the last discovery by German bacteriologist Paul Ehrlich before he died in 1915. In the United States, President Franklin D. Roosevelt’s administration and congressional leadership had to go to court to get pro-German sympathizers at the Winthrop Chemical Company to disclose the quinacrine manufacturing process. … Address correspondence to Dr. Venuturupalli; E-mail: swamy.venuturupalli{at}gmail.com
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.004 |
| Scholarly communication | 0.005 | 0.010 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.010 |
| Insufficient payload (model declined to judge) | 0.006 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".