Cardiovascular Complications in Lupus: Mechanistic Insights and Emerging Bioengineering Approaches

Abstract Lupus is a complex, multifaceted autoimmune disease characterized by autoantibody production and immune complex deposition, which collectively lead to multi-organ damage within the body, including the heart. Cardiac manifestations within lupus encompass inflammation and fibrosis, which contribute to morbidity and mortality. While animal and human studies have provided valuable insight into autoimmune related cardiovascular complications, these systems provide limited insight into disease onset. Further, conventional cell culture vessels poorly recapitulate the dynamic in vivo micro-environment. There is a need for platforms to support the interrogation of mechanisms that contribute to lupus-associated heart diseases. Advances in bio-engineered platforms have enabled more physiologically relevant approaches for investigating auto-immune and cardiovascular diseases. In this review, we discuss autoimmune mediated cardiovascular diseases and the potential impact of bio-engineered approaches such as organs-on-chips and organoids as alternatives to traditional cell culture platforms and animal testing for studying heart complications associated with lupus.