Table 3.

Antioxidant Therapeutic Strategies for SLE

Antioxidant Molecule or Treatment	Therapeutic Effects	References
NAC	Prevents autoantibody generation and reduces lupus activity by regulating the mTOR pathway in T cells Reverses the expansion of CD4−CD8− T cells and uplifts FoxP3 expression in CD4+CD25+ T cells Decreases lipid peroxidation, improves CNS complications and endothelial function	[75–77]
CLA	Enhances the expression of glutamate-cysteine ligase Increases glutathione synthesis and reverses oxidative stress-induced lupus activity	[78,79]
Rapamycin	Diminishes lupus activity by blocking the mTOR pathway Modulates mitochondrial transmembrane potential and Ca2+ flux Promotes Treg cell expansion	[76,80,81]
MitoQ	Mitigates kidney involvement of SLE by suppressing NETs formation and serum levels of IFN-I	[16,82]
CoQ10	Ameliorates mitochondrial dysfunction and oxidative stress Lowers LDL oxidation levels and proinflammatory cytokine production Suppresses atherosclerotic progression, which is relevant to the pathophysiology of both APS and SLE	[83,84]
Antroquinonol/ Epigallocatechin-3-gallate	Prevents the development of LN by free radical scavenging activities Reduces ROS/NO generation and increases Treg cell activity via activating the Nrf2 antioxidant signaling pathway	[88,89]
Synthetic triterpenoids	Blocks pathways like STAT-3 in immune cells together with Nrf2 pathway activation, thereby preventing oxidative stress and the formation of LN	[75,92]

Abbreviations: NAC, N-acetyl cysteine; ROS, reactive oxygen species; mTOR, mammalian target of rapamycin; NETs, neutrophil extracellular traps; CoQ10, coenzyme Q10; CLA, conjugated linoleic acid; APS, antiphospholipid syndrome; CNS, central nervous system; Treg, regulatory T cell; IFN, interferon; LDL, low density lipoprotein; SLE, systemic lupus erythematosus.