Autoimmune Disease: Lupus

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Autoimmune Disease Lupus

• By Remi Coker and Ashley Robinson

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The Immune System

• Innate vs. Adaptive Immunity
• Cells
• Phagocytes engulf pathogen, produce cytokines
• B Cell Ab
• T cell activate B cells
• Attack pathogen
• Complement
• Clear immune complexes and apoptic cells
• Classical Ag-Ab
• Alternative bacterial polysaccharides
• Antibodies
• Neautralize
• Opsonize
• Activate complement
• Cytokines
• Chemokines
• Inflammation
• Apoptosis
• Programmed Cell death

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Immunity Autoimmunity

• What is autoimmunity?
• Recognition of self as a pathogen invader
• Examples insulin dependant diabetes, lupus,
  rheumatoid arthritis, multiple sclerosis,
  scleroderma
• Genetics and the environment (i.e.. Chemicals,
  sun exposure) combine to cause diseases

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The Complement Cascade System

• Complement is a part of the innate immune system
  and underlies one of the main effector mechanisms
  of antibody-mediated immunity.

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What is Lupus?
Lupus is an autoimmune disease that can affect
many parts of body and affects each person
differently. There are three main types of
lupus Systemic lupus erythematosus is the most
common form. It's sometimes called SLE, or just
lupus. The word "systemic" means that the disease
can involve many parts of the body such as the
heart, lungs, kidneys, and brain. SLE symptoms
can be mild or serious. Discoid lupus
erythematosus mainly affects the skin. A red rash
may appear, or the skin on the face, scalp, or
elsewhere may change color. Drug-induced lupus
is triggered by a few medicines. It's like SLE,
but symptoms are usually milder. Most of the
time, the disease goes away when the medicine is
stopped. More men develop drug-induced lupus
because the drugs that cause it, hydralazine and
procainamide, are used to treat heart conditions
that are more common in men.
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Symptoms of Lupus

• Lupus is hard to diagnose and is often mistaken
  for other diseases giving it the name the great
  imitator. The signs of lupus differ from person
  to person. Some people have just a few signs,
  while others have more. Some symptoms include

Painful or swollen joints Unexplained
fever Chest pain with deep breathing Swollen
glands Extreme fatigue Discoid rash (red
raised patches) Seizures
Unusual hair loss (mainly on the
scalp) Arthritis Photosensitivity Low blood
count Depression, trouble thinking, and/or
memory problems Mouth ulcers Malar Rash (red
butterfly shaped rash over nose and cheeks)
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Causes of Lupus

• The cause of lupus is unknown, however
  researches believe that the disease is somehow
  genetically linked and the disease can be
  triggered. These triggers include the your diet,
  the environment, other infectious diseases, and
  stress. When these triggers activate the disease
  it causes flares and people can experience any
  of the symptoms of lupus. Flares can occur for
  short or extended periods of time and then go
  into a remission and not see any symptoms for a
  period of time.

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Who Gets Lupus?

• Anyone can contract lupus, however 9 out of 10
  people with lupus are women. African American,
  Hispanic, and Asian women have a higher
  likelihood of getting lupus. Also these women
  have more complicated symptoms then Caucasian
  women. Lupus is most common in women ages 15-44
  years old and this causes when women are able to
  have children and this causes scientist to
  believe that womens hormones may have something
  to do with the disease although men can contract
  the disease as well.

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Treatments for Lupus

• The current treatment for lupus is drug
  therapies specific to the symptoms the patient is
  experiencing. However, some drugs have side
  effects and doctors are researching new
  treatments for lupus. Preventive measures can
  reduce the risk of flares. For photosensitive
  patients, avoidance of excessive sun exposure
  and/or the regular application of sun screens
  will usually prevent rashes. Regular exercise
  helps prevent muscle weakness and fatigue.
  Immunization protects against specific
  infections. Support groups, counseling, talking
  to family members, friends, and physicians can
  help alleviate the effects of stress.
  Pharmaceuticals used for lupus symptoms include
• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
  Aspirin, Motrin, Naprosyn, Arthrotec, Indocin,
  Relafen, TolectinAcetaminophen Tylenol
  Corticosteroids Prednisone Antimalarials
  Aralen, PlaquenilImmunomodulating Drugs
  Imuran, CytoxanAnticoagulants Aspirin,
  Heparin, Coumadin

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Bibliography

• Web sites
• www.lupus.org
• www.hamline.edu/lupus/
• www.aarda.org http//www.niams.nih.gov/hi/topics/
  lupus/shades/index.htm1
• http//www.healthsystem.virginia.edu/intern
  et/rheumatology/lupus.cfm
• http//www.muschealth.com/infectious/immune
  .htm
• http//www.uklupus.co.uk/dxlupus.html
• Books
• Chapter 5.1 The Immune System
• Systemic Lupus Erythematosus by Rosalind
  Ramsey-Goldman and Susan Manzi
• The Immune System, Peter Parham, Garland
  Publishers, 2000.
• Immunobiology, Charles Janeway and Paul
  Travers, Garland Publishing, 1999.

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Resources

• The Ahearn Laboratory, at the Lupus Center of
  Excellence is at the cutting edge, trying to
  develop a clinical assay to test for lupus.
• Tracking different variations of the disease
• The role of complement and apoptosis in
  autoimmunity
• The Pittsburgh Tissue Engineering Institute and
  the University of Pittsburgh are also heavily
  involved in determining a solution or at least a
  proper detection of lupus.

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Contact Information

• Joseph Ahearn, MD
• Lynne Welshons
• Biomedical Science Tower S705A
• School of Medicine
• University of Pittsburgh
• 412.648.9782

• Susan Manzi, MD
• Judy Webb
• Biomedical Science Tower S721A
• School of Medicine
• University of Pittsburgh
• 412.383.8734

• V. Emily Stark, MS
• Biomedical Science Tower S736A
• School of Medicine
• University of Pittsburgh
• 412.648.9685