Ali Al-Asmari, MD د. علي الأسمري

Lupus Fellow @SickKids | @UofT | Young Adult SLE @UHN TWH & @sinaihealth | Monogenic lupus🧬| MD | Ped Rheumatologist | Fellowship Grad @KFSHRC | Writer🇸🇦🇨🇦

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

Honoured to attend the 2025–2026 Graduation Celebration at the University of Toronto and The Hospital for Sick Children (SickKids).

I am grateful to have had the opportunity to pursue advanced clinical fellowship in Lupus within the Division of Rheumatology at SickKids.

This year has been a remarkable opportunity for learning, mentorship, and professional growth.

The journey continue..

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

Recently had the chance to speak with the Arthritis Broadcast Network about our work in early-onset lupus at @SickKids.

We discussed how rare genetic findings and functional immune studies may help us better understand severe pediatric autoimmune disease and move toward more precise approaches to care.

Grateful for the conversation and the opportunity to share this work.

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

Presented our work on a rare SAT1 variant in early-onset childhood SLE, combining clinical findings with functional validation studies.

A reminder of how genetics and translational research continue to reshape our understanding of lupus and immune dysregulation.

Grateful to the teams at #SickKids and University of Toronto. #Lupus #Rheumatology #UofT

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

Had the opportunity to present at the CRA (Canadian Rheumatology Association) Annual Scientific Meeting 2026..

Grateful for the experience..

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

This is largest international cohort of #monogenic #lupus so far (100 children, multi-country).

Early onset (median aprox. 2 years), high consanguinity, and significant disease burden.

C1Q and DNASE1L3 accounted for 50% of cases, with clear genotype–phenotype separation:
- C1Q: more neuro + recurrent infections
- DNASE1L3: milder course

Clinical picture is broad, but mucocutaneous, MSK, and neuro involvement dominate.

Infections were common (aprox. 36%) and not trivial.
Mortality reached 16%..!!

#SLE

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

رب اجعل هذا البلد آمناً🤲🏼 🇸🇦

[يوم التأسيس @SAFoundingDay]

وحدة وتلاحم من 299 عام.

#يوم_التأسيس

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

When lupus starts early and joints erode (Rhupus like), pause…!!
That is not typical SLE, think monogenic lupus…!!

#Monogenic #Lupus #SLE

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

In #Lupus #Nephritis، delay costs nephrons..
Time is nephron, & nephron is time..!!

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

Glad to share this work on #monogenic #lupus , and grateful to work with KFSHRC staff Prof. Sulaiman Al-Mayouf and Dr. AlSaleem

Most of these patients had long journeys with frequent immunosuppressive therapies..
variable but meaningful responses were observed after starting #baricitinib

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

Who knows lupus, knows medicine..

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

Low-grade proteinuria in lupus nephritis is (not benign)
In a 239-patient biopsy proven cohort (156 week follow up), baseline UPro <1 g/day did (not) predict better response or better long-term eGFR outcomes.
Chronic damage, especially glomerulosclerosis, was the key prognostic signal (esp in relapsing LN)..

https://t.co/ByXBvQLevK
Nov 28, 2025, Arthritis Rheumatology

[د. سليمان المعيوف. Sulaiman M Al-Mayouf, MD @sulaimanm2020]

PRKCD deficiency connects autoimmunity and infection: a fatal form of lupus and susceptibility to BCGitis in affected children.

[Lupus Forum @TheLupusForum]

Using a target trial emulation, Grace Haeun Lee showed that belimumab was associated with reduced risk of all cause mortality compared with AZA, MTX, and MMF #ACR2025

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

It’s fascinating to see lupus being approached by organ involvement, rather than one uniform pathway.
This concept has appeared in scattered papers over the years.. but it’s finally being shaped more clearly and clinically..

I think, we should start doing the same for monogenic lupus, but with pathway or gene targeted initial treatments, instead of starting with the traditional SLE medications by default..

[ACR_Journals @ACR_Journals]

Early IL-1 inhibitor introduction in patients with Still disease may lead to higher rates of clinical inactive disease and GC discontinuation compared with late treatment, supporting a window of opportunity in Still disease management

ACROR
https://t.co/KlEqXNGs3Q

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

T-cell engagers are emerging as a next generation therapy in refractory SLE..

By coupling CD3 on T cells to B-cell or plasma-cell targets (CD19, CD20, BCMA), agents like Teclistamab, A-319, and CLN-978 induce precise immune reset…

Early data show deep B-cell depletion with manageable safety.. potentially bridging biologics and CAR-T.

(( Image borrowed from Lupus Therapeutics Webinar ))

#SLE #Immunotherapy #TCellEngagers #Autoimmunity #Rheumatology
#TCE

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

Classically, kidney injury in Lupus Nephritis was attributed to the canonical NLRP3–Caspase-1 inflammasome.

What’s new: recent human & animal data link non-canonical pyroptosis (Caspase-4/5/11–GSDMD in macrophages) directly to LN activity & chronicity.

Pathway itself is known in infection biology and other types if inflammation..
but its role in LN pathogenesis & as a therapeutic target is emerging.

interesting..!!

#Lupus #Nephritis #Immunology

[ACR_Journals @ACR_Journals]

Investigation in lupus nephritis patients and MRL/lpr mice demonstrated caspase-4/5/11-mediated pyroptosis pathway is activated in macrophages of lupus nephritis kidneys and contributes to pathogenesis of LN

Arthritis &amp; Rheumatology
https://t.co/84hER2aH15

[Ali Al-Asmari, MD د. علي الأسمري @Ali__Alasmari]

دوام العز لوطني.. السعودية..
وطنٌ إذا نظرت في أفقه أيقنت أن الفخر لا يشيخ..