Current thinking dictates that the diseases are turned on
through a combination of genetic and environmental factors.
Jacob and others have identified six, possibly seven, genes
that confer susceptibility to lupus. Once all the genes are
noted, there could be a diagnostic test for lupus, he says. At
the present time, Jacob is working with families where one
member has lupus to determine the prevalence and number of the
One type of lupus, drug-induced lupus, occurs after the
use of hydralazine (used to treat high blood pressure or hypertension)
and procainamide (used to treat irregular heart rhythms).
Researchers are focusing on environmental triggers, such as
infections, antibiotics, ultraviolet light, extreme stress, and
certain drugs and chemicals.
Last December, researchers from the University of Oklahoma
announced a study linking the Epstein-Barr virus and lupus. In a
study of 117 patients with systemic lupus, the researchers found
99 percent previously had an Epstein-Barr virus infection.
The study provides a basis for further
With Lupus, a number of systems are under attack, as in
Autoimmune responses can lead to a number of different
results: slow destruction of a specific type of cell or tissue,
overstimulation of an organ or interference with its function.
Most autoimmune diseases trigger inflammation-the reddening and
swelling that normally indicates the body is fighting off an
invader. In systemic lupus, the inflammation symptoms can appear
in a number of places: in the joints, in the membranes that line
different organs like the lungs and heart, on the skin and in
the mouth, or even in the kidneys.
Many systemic lupus patients say there are subtle daily
reminders that all is not perfect for them, even in periods of
remission-they have days of extreme fatigue, for example, or
pains that appear and disappear with no seeming cause.
A prolonged new symptom generally indicates a "flare up"-a
period of active immune reaction triggered by some "event," such
as stress, surgery, drugs or even exposure to sunlight.
A mild inflammation can be suppressed with omega-3, turmeric.
Stop the immune reaction by
corticosteroids (prednisone is the most often prescribed),
anti-malarials (chloroquine or hydroxychloroquine) and
cytotoxic,( cyclophosphamide, azathioprine
and methotrexate.) IVIG is the best drug to help all symptoms
and the disease process.
For many, the serious side effects of the drugs or simply
having to commit to long periods on medication can be difficult
or demoralizing. Some lupus patients, already having a hard time
reducing the stress and other factors that could trigger
flare-ups, find the weight gain or acne from the steroids make
it difficult to continue with their prescribed regimens.
But the goal of drug therapies, says Kitridou, is to
"minimize damage during an active phase and add to the patient's
quality of life. Lupus is not a 'life sentence,'" since most
people go into extended periods of remission and, thanks to
improved therapies, individuals with lupus are living normal
physicians have to engineer the remission." The earlier the
symptom is recognized and treated, the better the outcome, she
Kitridou is hopeful about new immuno-modulating drugs, like
mycophenolate, , and there is a trial involving DHEA that "suggests this steroid may help in improving mild
While the investigation into these therapies continues,
however, says Kitridou, "We can control lupus to a great extent.
I'm hopeful there will eventually be a cure."
She adds: "In the meantime, research has made many inroads.
Patients should know lupus can be managed."
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