Objective:

To synthesize evidence for accelerated immunosenescence in systemic lupus erythematosus (SLE) and its clinical implications, highlighting the importance of these findings for patient management.

Key Findings:

• SLE patients exhibit marked immune dysfunction beyond physiological age, impacting their overall health.
• Accelerated immunosenescence is linked to increased susceptibility to infections and suboptimal vaccine responses, necessitating tailored interventions.
• Molecular features include cytokine patterns, telomere attrition, and epigenetic age acceleration, which could serve as biomarkers for future research.
• Current immune-aging measures are candidate research biomarkers, not validated clinical tools, highlighting the need for further validation.

Interpretation:

Accelerated immunosenescence provides a framework for understanding SLE heterogeneity across systemic, cellular, and molecular levels, with implications for patient management.

Limitations:

• Most investigations remain fragmented with substantial methodological heterogeneity, indicating a need for standardized approaches.
• Prospective SLE-specific studies are needed to establish predictive value and clinical utility, particularly in diverse populations.

Conclusion:

Immunosenescence in SLE represents a biologically plausible framework for understanding disease progression, but further research is urgently required to validate these findings.