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Systemic Lupus Erythematosus
Transcript of Systemic Lupus Erythematosus
Lupus is an autoimmune disease
Many scientists believe that lupus develops in response to a combination of factors both inside and outside the body
Zouali, M., & Uy, E. (2013). Belimumab Therapy in Systemic Lupus Erythematosus. Biodrugs, 27(3), 225-235. doi:10.1007/s40259-013-0031-8
Systemic Lupus Erythematosus
Lupus: Latin for wolf
4 people who played a big role in the discovery of lupus
Sir William Osler
The discovery of lupus happened in three different time periods
9 of 10 people with lupus are women
Researchers looked at relationship between lupus and estrogen
No causal effect has been proven between estrogen, or any other hormone, and lupus
Many women have more lupus symptoms before menstrual periods and/or during pregnancy when estrogen production is high
When the term "Lupus" was coined
Rogerius thought the facial lesions looked like wolf bites
1872, Moriz Kaposi was the first person to keep a journal about lupus.
He discovered 2 forms: systemic lupus erythematosus and discoid lupus
Sir William Olser and J. Jadassohn also followed up on this theory and published papers saying the same.
Discovery of the LE cell
Cells found in bone marrow of patients
No gene or group of genes has been proven to cause lupus
However, lupus appears in certain families, and certain genes have been identified as contributing to the development of lupus
Most researchers today think that an environmental agent, such as a virus or possibly a chemical, randomly encountered by a genetically susceptible individual, acts to trigger the disease.
Ultraviolet rays from the sun
Ultraviolet rays from fluorescent light bulbs
Sun-sensitizing tetracycline drugs
Penicillin or other antibiotic drugs
Cold or a viral illness
Anything else that causes stress to the body such as surgery, physical harm, pregnancy, or giving birth
Lupus symptoms vary from person to person
Nonsteroidal anti-inflammatory drugs
Once you have been diagnosed with lupus, your doctor will develop a treatment plan based on your age, symptoms, general health, and lifestyle.
The goals of any treatment plan are to:
Reduce inflammation caused by lupus
Suppress your overactive immune system
Prevent flares, and treat them when they occur
Control symptoms like joint pain and fatigue
Minimize damage to organs
Skin & Blood
Lungs & Heart
Lupus Nephritis: Inflammation of the Glomeruli
Belimumab- First ever immunomodulating biologic drug successfully studied in clinical trials for SLE.
Fully Human monoclonal IgG1 (made by identical immune cells) antibody directed at BAFF inhibiting its biological activity
Modest treatment effects but seems to improve disease activity, reduce flares, decrease steroid requirement and improve overall quality of life.
4 clinical trials (2 phase III). Corticosteroid use down 50% for patients already on corticosteroids. Auto-antibodies were reduced b 35-37% (anti-dsDNA) increased or normalized compliment levels (36%-46%)
BAFF – B-cell activating factor or BLyS B-Lymphocyte Stimulator
Weak stimulant and potent costimulant of B-cell growth in vitro
Affects mature B-cells
Stimulates proliferation of human B cells along with other B activators
Increases Ig (immunoglobulin) production
Affects molecules involved in B-cell effector function
BAFF inhibits B-cell apoptosis and stimulates the differentiation of B cells into immunoglobulin-producing plasma cells