Autoimmune Disease: Lupus By: Remi Coker and Ashley Robinson

The Immune System Innate vs. Adaptive Immunity Cells Phagocytes – engulf pathogen, produce cytokines Phagocytes – engulf pathogen, produce cytokines B Cell – Ab B Cell – Ab T cell – activate B cells T cell – activate B cells Attack pathogen Complement Clear immune complexes and apoptic cells Clear immune complexes and apoptic cells Classical – Ag-Ab Classical – Ag-Ab Alternative – bacterial polysaccharides Alternative – bacterial polysaccharidesAntibodies Neautralize Neautralize Opsonize Opsonize Activate complement Activate complementCytokines Chemokines ChemokinesInflammationApoptosis Programmed Cell death Programmed Cell death

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

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.”

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.

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)

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.

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 years old and this causes when women are able to have children and this causes scientist to believe that women’s hormones may have something to do with the disease although men can contract the disease as well.

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 doctor’s 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, Tolectin Acetaminophen: Tylenol Corticosteroids: Prednisone Antimalarials: Aralen, Plaquenil Immunomodulating Drugs: Imuran, Cytoxan Anticoagulants: Aspirin, Heparin, Coumadin

Bibliography Web sites: Books: Chapter 5.1: The Immune System Chapter 5.1: The Immune System Systemic Lupus Erythematosus by Rosalind Ramsey-Goldman and Susan Manzi Systemic Lupus Erythematosus by Rosalind Ramsey-Goldman and Susan Manzi The Immune System, Peter Parham, Garland Publishers, The Immune System, Peter Parham, Garland Publishers, Immunobiology, Charles Janeway and Paul Travers, Garland Publishing, Immunobiology, Charles Janeway and Paul Travers, Garland Publishing, 1999.

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 Tracking different variations of the disease The role of complement and apoptosis in autoimmunity 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.

Contact Information Joseph Ahearn, MD Lynne Welshons Lynne Welshons Biomedical Science Tower S705A Biomedical Science Tower S705A School of Medicine School of Medicine University of Pittsburgh University of Pittsburgh Susan Manzi, MD Judy Webb Biomedical Science Tower S721A School of Medicine University of Pittsburgh V. Emily Stark, MS V. Emily Stark, MS Biomedical Science Tower S736A Biomedical Science Tower S736A School of Medicine School of Medicine University of Pittsburgh University of Pittsburgh