There are 3-8 times more women than men! Lupus erythematosus not only invades the skin, understand the signs, diagnosis, and treatment at once
There are 3-8 times more women than men! Lupus erythematosus affects more than just the skin
“Systemic lupus erythematosus” (SLE) is one of the common autoimmune diseases (rheumatism). The so-called autoimmune disease means that the substances that cause the inflammatory reaction are produced by oneself. Specific antibodies against the surface of autologous cells in the circulation will bind to cell surface components and initiate an inflammatory response, which not only causes cell and tissue damage, but also forms soluble immune complexes that are deposited in blood vessels and tissues.
Since self-antigens are constantly detected by the own immune system, they can cause persistent and chronic inflammatory symptoms. Patients with systemic lupus erythematosus will have different symptoms caused by autoantibodies against different parts of the body, including joint pain, nephritis, carditis, erythrocytopenia, serositis and other symptoms. It is particularly common among Asian women, and is 3-8 times more common in women than in men.
Systemic lupus erythematosus is highly related to family inheritance. The main affected group is young women aged 15-40. Antinuclear antibodies (ANA) can often be detected in the blood when suffering from this disease, and it is often accompanied by other immune systems. Diseases such as hemolytic anemia, thyroiditis, and idiopathic platelet purpura co-occur, and may invade parts of the blood, joints, skin, kidneys, and serosa.
Fever, hair loss, discoloration of hands and toes? What are the signs of lupus erythematosus?
The clinical symptoms of lupus erythematosus are quite diverse, including unexplained fever, myalgia, hair loss, Raynaud’s phenomenon (color change or paleness of hands and toes when exposed to cold), red spots on the skin, and severe gastrointestinal perforation. In the most serious cases, it may cause vasculitis in the digestive organs with a high mortality rate, or myocarditis causing heart failure.
According to the diagnostic criteria established by the Systemic Lupus Erythematosus International Cooperation (SLICC), more than 4 of the 17 standards (including 11 clinical standards and 6 immunological examination standards) must be met, or lupus nephritis, and Having antinuclear antibodies (ANA) or anti-double-stranded DNA (anti-dsDNA) antibodies and reaching a certain score will meet the diagnostic criteria.
Due to the variable nature of lupus erythematosus, most cases have recurring symptoms, good and bad, and renal failure and infections may pose a threat to the patient’s life. Current treatments include non-steroidal anti-inflammatory drugs, steroids, immunosuppressants, biological agents, etc., of which steroids are the most commonly used. Only when vital organs are invaded, large amounts of steroid treatment and immunosuppressants are sometimes required to control the disease.
Personalizing medication? Immune checkpoints promising for lupus erythematosus
“Immunotherapy” has been regarded as an important breakthrough in medicine in recent years. Its principle is to turn off the brake of “acquired immune cells” - the immune checkpoint, so as to activate the ability of immune cells to detect and attack cancer cells. The latest research by the Rongyangjiao research team points out that specific immune checkpoints may be applied as biomarkers of lupus erythematosus to help personalize the selection of lupus erythematosus medications.
Chen Siting, associate professor at Yangming Jiaotong University’s Institute of Clinical Medicine, pointed out that the human body’s monocytes, macrophages, and dendritic cells are the body’s first line of defense and can be called “innate immune cells” and have an immune check called NLRP12. point. In the immune cells of the peripheral blood of 68 lupus patients, the expression level of NLRP12 was significantly lower than that of 34 healthy adults. In patients with relatively high disease activity, the expression amount of NLRP12 will gradually increase after treatment. The study was also published in the February 2023 issue of the Journal of Clinical Investigation.
Associate Professor Chen Siting said that activation of immune cells by type 1 interferon is an important cause of lupus erythematosus. The research team found that low expression of NLRP12 is accompanied by high expression of type 1 interferon, and high expression of interferon will reduce the amount of NLRP12 expression. , forming a vicious cycle in the patient, causing the immune system to be destroyed, and the patient’s immune resilience is poor, creating an unstable inflammatory constitution.
Lupus erythematosus is considered one of the most complex rheumatic diseases due to its diverse manifestations. It may range from mild skin symptoms to severe organ failure. There is still a lack of biomarkers to evaluate patients’ response to drug treatment. In the future, it is expected to develop NLRP12 expression quantity as a personalized drug selection for patients.
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