Transcript Lupus Erythematosis - University of California, Irvine

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Autoimmune disease
› “The great imitator”
› Inflammation
› Episodic flares
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Forms
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Systemic
Cutaneous/Discoid
Drug-induced
Neonatal
 Mother-fetus Ab transfer
“The wolf” ca. 14th century
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SOAP BRAIN MD
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Serositis: inflammation of pleura, pericardium and peritoneum
Oral ulcers
Arthritis
Photosensitivity
Blood: Blood disorders like anemia, leukopenia, lymphopenia
and thrombocytopenia, cardiovascular disease
Renal disorder: Leading cause of death in SLE
Antinuclear antibodies: Anti-DNA, etc.
Immunologic disorder: Syphilis false positive, antiphospholipid
syndrome, susceptibility to infection
Neurologic Disorder: Can attack nervous system
Malar Rash: Butterfly rash on cheeks
Discoid Rash: Red, disc-shaped rashes.
Discoid Rash
Malar or “Butterfly” Rash
From RadioGraphics Journal
Malar rash
Pericarditis
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Estimated 5 million afflicted globally
› 1.5 million in the U.S.
› 16,000 new cases each year in the U.S.
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Risk factors
› Genetics
 ITGAM, BANK1, TLR-7, STAT4, etc.
 FcγR Iib: Suspected Plasmodium resistance
› Ethnicity
 More prevalent in non-caucasians
› Sex
 More than 90% are female
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No Cure
› Except drug-induced LE
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Reduce inflammation
› Corticosteroids
› NSAIDS
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Antimalarial drugs
› Hydroxychloroquine
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Immunosuppressants
› Methotrexate
› Azathioprine
› Opportunistic Infections?
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Monoclonal Antibodies
› Benlysta®: Inhibit B-lymphocyte Stimulator
› Rituxan®: Tag and destroy B-cells
› These and others reduce B-cell activity and thus auto-
antibodies.
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Mesenchymal Stem Cell Transplant
› Trials to for most severe cases
› Reset the immune system
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The Lupus Foundation of America
› www.lupus.org
Mayo Clinic: Lupus
› http://www.mayoclinic.com/health/lupus/DS00115
Clatworthy et al. Systemic lupus erythematosus-associated
defects in the inhibitory receptor FcγRIIb reduce
susceptibility to malaria. PNAS. (2007) 104:7169-7174.
Yuan YJ, Luo XB, Shen N. Current advances in lupus genetic
and genomic studies in Asia. (2010) 19:1374-1383.
Liang et al. Allogenic mesenchymal stem cells
transplantation in refractory systemic lupus
erythematosus: a pilot clinical study. Ann Rheum Dis
(2010) 69:1423-1429