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Activation of the IRE1-XBP1 pathway is essential for ER expansion and antibody secretion in plasma cells, further implicating ER stress in SLE pathogenesis

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However, certain circumstances may warrant testing including pre-existing liver or kidney conditions where monitoring organ function during therapy provides appropriate oversight, specific health concerns that might benefit from objective biomarker assessment, desire to objectively measure oxidative stress markers or glutathione status before and during therapy, and medical conditions requiring monitoring for safety reasons