Oct 15, 2020 in Medicine

A group of specific diseases is characterized by abnormalities and impairments in the immune system response. Such disorders are specified as autoimmune diseases. Unfortunately, the majority of people are hardly aware of the immune failures, such as lupus erythematosus. The current paper provides an accurate overview of systematic lupus erythematosus disease, including the clinical manifestations, treatment modalities, and their efficiency. Simultaneously, the work represents new experimental treatment options that relieve the symptomatic picture of the indicated affliction. 

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Systemic lupus erythematosus (SLE)  is the vivid illustration of the incurable autoimmune diseases that cause “acute or chronic inflammation” of various tissues in the human body (Shiel, 2016). The human immune system should detect suppress and defeat the multitude of viruses, pathogen microorganisms, toxins, and bacteria. However, a definite group of diseases makes the immune system behave hostile and unpredictable towards a human body. It not only attacks infectious agents and foreign substances but also considerably damages healthy tissues and cells as well. The immune system protects by “producing antibodies” that attach to the alien microbes to destroy them (Shiel, 2016). People with systematic lupus erythematosus disease produce abnormal antibodies circulation in the blood. Consequently, such mutated antibodies start impairing human tissues inside the body more significantly than infectious agents. Such abnormal antibodies transform into autoantibodies. The so-called antinuclear antibodies and inflammatory cells circulate inside the body and can affect any organ. Thus, the internal cellular mutations make the immune system misbehave, function erroneously and improperly that result in the progression of “systemic autoimmune connective tissue disease” with diverse symptoms called systematic lupus erythematosus (SLE) (Muangchan, et al, 2015).  

The autoimmune disease can be a triggering factor for the severe medical conditions and simultaneously cause various complications. The systematic lupus erythematosus seriously affects internal organs and gradually deteriorates the health of a person. SLE relates to the autoimmune disorders that can equally influence people of different ages, ethnic group, and gender. Though, “more than 90% of new patients presenting with SLE are women in the childbearing years” (Wright & Bharadwaj, 2010).  

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The etymology of the disease remains unknown. However, researchers specify that  genetic and environmental factors may contribute to the formation of the SLE-related antibodies that deteriorate medical conditions. Hormones, genetic predisposition, viral and bacterial infections, exposure to ultraviolet light, certain drugs and chemicals, stress, and pregnancy are the possible causative factors that may lead to the progression of systemic lupus erythematosus symptoms. Genetic predisposition may include several genes responsible for SLE. Researchers indicate that there are up to 100 different genetic factors which raise one’s risks of acquiring SLE (“Systemic lupus erythematous,” 2016). 

Systemic lupus erythematosus occurs in various, extremely variable clinical conditions that have both constitutional and specific symptoms depending on the affected organ. The symptoms of the disorder either develop gradually or, on the contrary, progress unexpectedly. They can be mild and periodically vanish, but severe forms of SLE result in the multitude of complications. Fatigue or extreme tiredness, low-grade fever, breathlessness, poor appetite, weight loss, and muscle pain may accompany the progression of systematic lupus erythematosus.  This medical condition frequently develops the symptoms similar to arthritis. In this case, the patients may suffer from pain in the joints. The extremities could become swollen and stiff. In the case of a stressful situation or exposure to cold, fingers and toes could turn violet or white. People could even experience deformation of the small joints (Shiel, 2016). The majority of the SLE patients develop a butterfly-shaped red rash over the bridge of the nose that is primarily painless and not scratchy. Furthermore, such symptoms and signs as alopecia, photosensitivity, and mucus damage contribute to the appearance of ulcers in the mouth and nose, the number of which will increase with disease progression. SLE is frequently associated with “skin inflammation and skin lesion” that intensify when exposed to ultraviolet radiation (“New York Times,” 2016).  Besides, the disease may ignite inflammatory processes inside the tissues of the brain, blood vessels, respiratory system, digestive one, and kidneys. Systemic lupus erythematosus strikes different organs and leads to inflammation that aggravates the progression of the disease. Thus, chest pain “caused by inflammation of pleura or pericardium” indicates the development of either the respiratory or heart complications (Shiel, 2016). Brain damage caused by SLE results in headaches, mental confusion, amnesia, depression, and seizures. Furthermore, SLE interferes with proper kidney functioning and develops their inflammation or even kidney failure. The irregularities related to the kidney, specify lupus nephritis that is common for many people with SLE, are extremely harmful (“Cleveland Clinic,” 2016). It is also evident that such immune abnormality worsens blood count leading to leukopenia and thrombocytopenia. The presentation of such blood impairments can increase the risk of contamination and bleeding. Therefore, systematic lupus erythematosus occurs in the diverse clinical manifestations that can aggravate associated dermatological, musculoskeletal, pulmonary, cardiac, neurologic and renal problems. Other severe medical conditions intensively develop due to systematic lupus erythematosus. 

Unfortunately, there is no remedy for systematic lupus erythematosus condition. The available treatment modalities of SLE are assigned for reducing the activity of the disease, minimizing discomfort, relieving symptoms and complications, and obtaining long-lasting remissions. The management of the indicated sickness is challenging and complex. Treatment depends on the organ involvement, comorbidities, side effects, medication compatibility, previous disease management, and patient’s preference (Muangchan et al, 2015). Antimalarial medication, nonsteroidal and steroidal anti-inflammatory drugs with immune suppressants are widely and intensively used in the traditional treatment. Antimalarial drugs are prescribed for relieving particular mucocutaneous symptoms as well as for controlling some constitutional manifestations such as rash, fatigue, joint ache, and ulcers in the mucous membranes. Treatment with this medication is efficient and gives a long-lasting protective effect. Corticosteroids and immunosuppressive drugs are prescribed for decreasing or suppressing inflammation. Immunosuppressant, for example, cyclophosphamide and mycophenolate mofetil, restrains the overactive immune system (“National Institute of Arthritis and Musculoskeletal and Skin Diseases,” 2016). This group of drugs is considered effective in the case of renal insufficiency and serious functional impairments in the central nervous system. The usage of corticosteroids with immunosuppressive drugs allows achieving better result due to their increased efficiency. Researchers try to find more efficient and safer treating options. Nowadays, drugs called biologics refer to the advanced treatment options. There is a recently-approved drug called Belimumab,  and it has a potential to reduce the number of abnormal B cells that can be a cause of SLE (“National Institute of Arthritis and Musculoskeletal and Skin Diseases,” 2016). The scientists have created SLE-related drugs on the ground of multiple clinical studies and trials. For example, such drugs as DNase, LJP394, and Bindarit have been carefully checked for their effectiveness and safety. Innovative medications should prevent the immune system from the erratic response. As a result, Bindarit is related to the immunomodulatory drugs that prevent the acute immune response. Treatment can be more beneficial due to the advanced medication that can help to manage the abnormalities of the immune system affected with SLE. The clinical trials and observations prove the efficacy of the indicated medicines. They have mild adverse effects and show better results. Furthermore, scientists study the alternative treatment, including phototherapy, plasmapheresis, intravenous immunoglobulins, monoclonal antibodies, dehydroepiandrosterone (DHEA), and autologous stem cell transplantation. These options can significantly reduce the severity of the SLE clinical manifestations, “block inflammatory immune factors,” or “suppress the damaging immune factors” (“Systematic lupus erythematosus,” 2016). These treatment modalities require further checking and evaluation.    

Systematic lupus erythematosus relates to the multi-system autoimmune disease accompanied with variable and diverse clinical manifestations. The symptoms depend on the part of the body which is affected. The variety of the symptoms and signs demonstrate the complexity of the SLE medical condition. Unfortunately, the disease is incurable. The drugs could only support the health. Moreover, many of them are still under investigation. Unfortunately, alternative therapies cannot provide full recovery either. However, antimalarial, anti-inflammatory, and immunosuppressive drugs are effective in providing long-term remission. Newly designed drugs should improve the medical condition and reduce side effects. Taking into consideration the fact that systematic lupus erythematosus remains for the whole life, further profound research and investigation should be conducted by specialists.

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