How does this happen?

The pathophysiology of Lupus as stated in previous posts is an autoimmune disease. Studies suggest that heredity plays an important role in the development of this disease. Many biochemical studies have shown abnormalities in T and B cell function, programmed cell death or apoptosis, immune complex clearance, complement function and deficiencies, and nucleosome processing.  With these problems in the immune system they lead to the abnormal functioning and thus the host’s immune system does not recognize itself and therefore attacks its own healthy cells. It still is not clear exactly what starts the immune dysregulation, but it does appear to require a genetically susceptible host affected by either a exogenous trigger meaning a trigger that is outside the body or an endogenous metabolic disturbance meaning a disturbance that comes from within the body that causes the loss of tolerance to self-antigen.

Ultimately the body attacks itself, but how? The immune complex which is when an antibody binds to an antigen once this happens then the immune complex is subject to any number of responses. In this disease the immune complex deposits in various organs, which trigger chemical mediators that cause inflammation and injury. A host with Lupus has antibodies that are going to be directed in the nuclear self-antigen including different parts of DNA, histones, proteins, and ribosomes. Specifically this disease targets double-stranded DNA so when looking to diagnose this disease looking for these specific autoantibodies. There are antibodies called anti-Ro and anti-La which are suspected to play a role in the system of photosensitivity, skin rashes, and response to ultraviolet light. Antiphospholipid antibodies which attack the phospholipids of the cell membrane may be the cause of why some patients develop blood clots that cause stroke and heart attacks.

Lupus is a disease that has a lot of unknowns about why autoantibodies target perfectly normal cells and why the disease manifests in the first place, but there is a lot of research being done to figure out this disease and to help those that suffer from it. 

This is a quick diagram to help understand how lupus attacks the body

References: 

https://www.google.com/search?q=pathophysiology+of+lupus&espv

http://www.clevelandclinicmeded.com/

http://www.britannica.com/

Epidemiology of Lupus

The epidemiology of lupus is obscure and hard to track because this disease is often diagnosed to late or not diagnosed at all.  The systems of lupus mimic other diseases therefore it is hard to pinpoint exactly if a patient has lupus or not. Lupus is an autoimmune disease with a wide range of clinical manifestations such as: rashes, photo sensitivity, kidney problems, arthritis, seizures, psychosis, and blood cell abnormalities.  Lupus may also present itself with other autoimmune diseases and not get recorded as the patient having lupus on their record. The prevalence estimates span over a wide range due to this inconsistency of recording. “The range is as high as 161,000 with definite lupus in 2005 and 322,000 with definite or probable lupus” (CDC.gov). 

Congress has recently been able to fund two population based Lupus registries with the purpose of generating better prevalence estimates for Caucasian and African Americans. One of these registries is set up in Michigan and the other is in Georgia focusing on the two races stated above. There are also two newer registries in California and New York City and are set up to predict estimates for Hispanics and Asians. This registries will give us a better idea about the spread of lupus and possibly give us a better idea as to what populations are most affected by this disease. We may also be able to look at or track the genetic component of this disease as well.

The number of hospitalizations have increased and this increase was recorded in 1998 through 2000 with about 60,000 a year to about a 100,000 a year. The mortality rates for lupus were also tracked from 1979 to 1998 and the number increase from 879 to 1406 with women being five times higher than men and African Americans three times higher than Caucasians (CDC.gov). Why this increase in the number of hospitalization and mortality rates from lupus is unknown, but we hope that the registries that are currently collecting data will be able to map out the increase in cases and come up with a conclusion as to why this autoimmune disease has become more prevalent in our society. 

What is this Lupus thing?

Lupus is an autoimmune disease that can damage the skin, joints, or organs inside the body. This disease is Chronic so that means that it often lasts for many years. Being that Lupus is an autoimmune disease the body's antibodies produced by white blood cells which are usually used to fight foreign infections like viruses and bacteria aren't able to recognize the difference between when something in the body is foreign or not. The result is that these antibodies start to attack perfectly healthy tissue. This causes pain, inflammation, and damage to various parts in the body. Lupus is a disease that goes in cycles so there can be periods of flare up ( where the disease is extremely painful) or periods of remission ( where symptoms of the disease are improving and you start to feel better. These antibodies that attack the body are known as autoantibodies and they circulate in the blood, but some of the body’s cell walls are permeable so that they autoantibodies get through to certain places in the body. This is why during flare ups that certain areas of the body are worse at some points than others.

Some people are born with more likely tendencies to have Lupus which later on in life can be initiated by certain drugs, infections, and even sunlight. The origin of this disease is unknown, but it does occur most often in women. Some research has been done to link estrogen and Lupus together, but nothing definite is available yet.  There is no specific group of genes that cause lupus sometimes it can run in families, but no conclusive findings about what type of gene has been established. Unfortunately, there is no cure for Lupus, but there are treatment plans available to help with the symptoms of this disease.