Systemic Lupus Erythematosus

This is a publication of the National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases

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Systemic Lupus Erythematosus

This booklet is for people who hold systemic lupus erythematosus, commonly called SLE or lupus, as powerfully as for their family and friends and others who want to better construe the disease. The booklet describes the disease and its symptoms and contains information about diagnosis and treatment as all right as current research efforts supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and other components of the National Institutes of Health (NIH). It also discusses issues such as condition care, pregnancy, and talent of life for race with lupus. If you hold further questions after reading this booklet, you may aspiration to discuss them with your doctor.

Defining Lupus

Lupus is a type of immune system disorder prearranged as an autoimmune disease. In autoimmune diseases, the body harms its own healthy cell and tissues. This leads to inflammation and disrupt of various body tissues. Lupus can affect copious parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessel, and brain. Although people next to the disease may have tons different symptoms, some of the most common ones include extreme fatigue, uncomfortable or swollen joints (arthritis), unexplained disorientation, skin rashes, and kidney problems. Lupus is also set as a rheumatic disease. The rheumatic diseases are a group of disorders that cause ache, pain, and stiffness contained by the joints, muscles, and bones.

At present, in that is no cure for lupus. However, the symptoms of lupus can be controlled with appropriate treatment, and most those with the disease can organize active, able-bodied lives. Lupus is characterized by periods of syndrome, called flares, and period of wellness, or remission. Understanding how to prevent flares and how to treat them when they do occur help people beside lupus maintain better robustness. Intense research is underway and scientists funded by the NIH are continuing to produce great strides in kindness the disease, which ultimately may lead to a cure.

Two of the question researchers are studying are who gets lupus and why. We know that tons more women than men have lupus. Lupus is three times more adjectives in black women than within white women and is also more common surrounded by women of Hispanic, Asian, and Native American descent. In addition, lupus can run within families, but the risk that a child or a brother or sister of a lenient also will have lupus is still pretty low. It is difficult to estimate how many relatives in the United States hold the disease because its symptoms vary widely and its start is often rock-hard to pinpoint.

Although "lupus" is used as a broad term, within actually are several kind of lupus:

* Systemic lupus erythematosus (SLE), which is the form of the disease that most people are referring to when they speak "lupus." The word "systemic" means the disease can affect various parts of the body. The symptoms of SLE may be mild or serious. Although SLE usually first affects people between the ages of 15 and 45 years, it can go off in childhood or subsequently in enthusiasm as well. This booklet focuses on SLE.

* Discoid lupus erythematosus primarily affects the skin. A red, raise rash may appear on the frontage, scalp, or elsewhere. The raised areas may become glutinous and scaly. The impulsive may last for days or years and may recur. A small percentage of individuals with discoid lupus following develop SLE.

* Drug-induced lupus refers to a form of lupus caused by medication. It cause some symptoms similar to those of SLE (arthritis, rash, confusion, and chest pain, but not kidney disease) that progress away when the drug is stopped. Common medications that may create drug-induced lupus include hydralazine (Apresoline), procainamide (Procan, Pronestyl), methyldopa (Aldomet), quinidine (Quinaglute), isoniazid (INH), and some anti-seizure medications such as phenytoin (Dilantin) or carbamazepine (Tegretol).

* Neonatal lupus can affect some newborn babies of women beside SLE or certain other immune system disorders. Babies near neonatal lupus may have a serious heart irregularity. Other affected babies may hold a skin rash, liver abnormality, or low blood counts. Physicians can now identify most at-risk SLE patients, allowing for prompt treatment of the infant at birth. Neonatal lupus is severely rare, and most infants of mothers beside SLE are entirely healthy.

Understanding What Causes Lupus

Lupus is a complex disease whose lead to is unknown. It is likely that within is no single cause but a bit a combination of genetic, environmental, and possibly hormonal factors that work together to grounds the disease. The exact cause may differ from one personality to another. Scientists are making progress in understanding the cause of lupus, as described here and in the Current Research part of this booklet. Research suggests that genetics plays an impressive role; however, no specific "lupus gene" has be identified. Instead, it appears that several genes may increase a person's susceptibility to the disease.

The certainty that lupus can run in family indicates that development of this disease have a genetic basis. In mixing, studies of identical twins own shown that lupus is much more likely to affect both member of a pair of compatible twins, who share the exact same set of genes, than two nonidentical twins or other siblings. Because the risk for identical twins is far less than 100 percent, however, scientists focus that genes alone cannot account for who get lupus. Other factors must also play a role.

Some of the factor that scientists are studying include sunlight, stress, certain drugs, and infectious agents such as virus. Even though a virus might trigger the disease in susceptible individuals, a entity cannot "catch" lupus from someone else.

In lupus, the body's immune system doesn't work as it should. A robust immune system produces antibodies, which are special proteins that help scrap and destroy virus, bacteria, and other foreign substances that invade the body. In lupus, the immune system produces antibodies against the body's on form cells and tissues. These antibodies, call autoantibodies ("auto" means self), contribute to the inflammation of many parts of the body, causing swelling, reddishness, heat, and aching. In addition, some autoantibodies bind with substances from the body's own cell or tissues to form molecules called immune complexes. A buildup of these immune complexes surrounded by the body also contributes to inflammation and tissue injury in people beside lupus. Researchers do not yet apprehend all of the factor that cause inflammation and tissue lay waste to in lupus, and this is an live area of research.

Symptoms of Lupus

Each character's experience with lupus is different. Symptoms can capacity from mild to severe and may come and go over time. Common symptoms of lupus include extreme fatigue, sore or swollen joints, unexplained disorientation, and skin rashes. A all your own skin rash may appear across the antenna and cheeks - the so-called butterfly or malar rash. Other rash occur elsewhere on the frontage and ears, upper arms, shoulders, chest, and hands.

Other symptoms of lupus include chest strain, hair loss, sensitivity to the sun, anemia (a condense in red blood cells), and whitish or purple fingers and toes from cold and stress. Some people also experience headache, dizziness, depression, or seizures. New symptoms may verbs to appear years after the initial diagnosis, and different symptoms can occur at different times.

Common Symptoms of Lupus

* Painful or swollen joint and muscle pain

* Unexplained restlessness

* Extreme fatigue

* Red rash or color transform on the face

* Chest spasm upon deep breathing

* Unusual loss of mane

* Pale or purple fingers or toes from cold
or stress (Raynaud's phenomenon)

* Sensitivity to the sun

* Swelling (edema) in legs or around eyes

* Swollen glands

In some people next to lupus, only one system of the body such as the skin or joint is affected. Other citizens experience symptoms in various parts of their body. Just how seriously a body system is affected also vary from person to human being. Most commonly, joints and muscles are artificial, causing arthritis and muscle anguish. Skin rashes also are fairly common. The following systems in the body also can be artificial by lupus.

* Kidneys:

Inflammation of the kidneys (nephritis) can impair their ability to effectively achieve rid of waste products and other toxins from the body. Because the kidneys are so earth-shattering to overall health, lupus contained by the kidneys generally requires intensive drug treatment to prevent unwavering damage. There is usually no torment associated with kidney involvement, although some patients may identify that their ankles swell. Most often the solely indication of kidney disease is an abnormal urine examination.

* Central nervous system:

In some patients, lupus affects the brain or internal nervous system. This can do headaches, dizziness, memory disturbances, daydream problems, stroke, or changes within behavior. Some of these symptoms, however, also can be caused by some treatments of lupus or by the intense stress of dealing with the disease.

* Blood vessel:

Blood vessels may become inflamed (vasculitis), affecting the route blood circulates through the body. The inflammation may be mild, and may not require treatment.

* Blood:

People with lupus may develop anemia or leukopenia (a decrease number of white blood cells). Lupus also may cause thrombocytopenia, a decrease number of platelets in the blood that contributes to an increased randomness of bleeding. Some people beside lupus may have an increased risk for blood clots.

* Lungs:

Some associates with lupus develop pleuritis, an inflammation of the inside layer of the chest cavity that causes chest dull pain, particularly near breathing. Patients with lupus also may procure pneumonia.

* Heart:

In some people next to lupus, inflammation can occur surrounded by the arteries that supply blood to the heart (coronary vasculitis), the heart itself (myocarditis and endocarditis), or the membrane that surrounds it (pericarditis), causing chest pains or other symptoms.

Diagnosing Lupus

Diagnosing lupus can be difficult. It may run months or even years for doctors to piece together the symptoms to accurately diagnose this complex disease. Making a correct diagnosis of lupus requires knowledge and awareness on the section of the doctor and good communication on the element of the patient. Telling the doctor a complete, accurate medical history (for example, what vigour problems you have have and for how long) is critical to the process of diagnosis. This information, along with a physical nouns and the results of laboratory tests, help the doctor consider other diseases that may mimic lupus, or determine if the patient truly have the disease. Reaching a diagnosis may take time and come to pass gradually as brand new symptoms appear.

No single test can determine whether a soul has lupus, but several laboratory test may help the doctor to create a diagnosis. The most useful test identify certain blood autoantibodies commonly present in family with lupus. For example, the antinuclear antibody (ANA) assessment is commonly used to look for autoantibodies that react against components of the nucleus, or "command center," of the merciful's own cells. Many family with lupus check positive for ANA; however, some drugs, infections, and other diseases also can cause a positive result. The ANA question paper simply provides another clue for the doctor to consider in making a diagnosis. There are also blood test for individual types of autoantibodies that are more specific to people near lupus, although not all family with lupus try-out positive for these. These antibodies include anti-DNA, anti-Sm, anti-RNP, anti-Ro (SSA), and anti-La (SSB). The doctor may use these antibody tests to give a hand make a diagnosis of lupus.

Some test are used less frequently but may be functional if the cause of a human being's symptoms remains unclear. The doctor may direct a biopsy of the skin or kidneys if those body systems are affected. Some doctors may direct a syphilis test because some lupus antibodies contained by the blood may cause the assessment to be falsely positive. A positive exam does not mean that a tolerant has syphilis. Again, adjectives these tests merely serve as tools to pass the doctor clues and information in making a diagnosis. The doctor will look at the entire picture - medical history, symptoms, and test results - to determine if a soul has lupus.

Other laboratory test are used to monitor the progress of the disease once it has be diagnosed. A complete blood count (CBC), urinalysis, blood chemistries, and erythrocyte sedimentation rate (ESR) test can provide prized information. (The ESR is a measure of inflammation in the body. It test how quickly red blood cell drop to the bottom of a tube of unclotted blood.) Another common oral exam measures the blood level of a group of proteins call complement. People with lupus repeatedly have low complement level, especially during flares of the disease.

Diagnostic Tools for Lupus

* Medical history

* Complete physical examination

* Laboratory test:

Complete blood count

Erythrocyte sedimentation rate (ESR) - an
elevated ESR indicates inflammation
in the body

Urinalysis

Blood chemistries

Complement levels - habitually low in associates
with lupus, especially during a flare

Antinuclear antibody question paper (ANA) - positive
in most lupus patients, but a positive
ANA question paper can have other cause

Other autoantibody tests (anti-DNA,
anti-Sm, anti-RNP, anti-Ro [SSA], anti-La
[SSB]): One or more of these test
may be positive in some relatives with
lupus

Syphilis trial - may be falsely positive within
people next to lupus

* Skin or kidney biopsy

Treating Lupus

Diagnosing and treating lupus is often a troop effort between the lenient and several types of health attention to detail professionals. A person can move about to his or her family doctor or internist, or can call in a rheumatologist. A rheumatologist is a doctor who specializes in arthritis and other diseases of the joint, bones, and muscles. Clinical immunologists (doctors specializing in immune system disorders) may also treat people beside lupus. As treatment progresses, other professionals often give support to. These may include nurses, psychologists, social workers, and specialists such as nephrologists (doctors who treat kidney disease), hematologists (doctors specializing in blood disorders), dermatologists (doctors who treat skin disease), and neurologists (doctors specializing in disorders of the nervous system).

The selection and effectiveness of treatments for lupus enjoy increased dramatically, giving doctors more choices in how to treat the disease. It is important for the tolerant to work closely with the doctor and thieve an active role contained by treatment. Once lupus has be diagnosed, the doctor will develop a treatment plan based on the long-suffering's age, gender, robustness, symptoms, and lifestyle. Treatment plans are tailored to the individual's needs and may vary over time. In developing a treatment plan, the doctor has several goal: to prevent flares, to treat them when they do occur, and to minimize complications. The doctor and long-suffering should reevaluate the plan regularly to ensure that it is as effective as possible.

Several types of drugs are used to treat lupus. The treatment the doctor chooses is base on the patient's individual symptoms and wishes. For people next to joint aching, fever, and swelling, drugs that fall off inflammation, referred to as nonsteroidal anti-inflammatory drugs (NSAIDs), are often used. While some NSAIDs are available over the counter, a doctor's prescription is required for others. NSAIDs may be used alone or in combination beside other types of drugs to control pain, swelling, and frenzy. Even though some NSAIDs may be purchased without a prescription, it is meaningful that they be taken under a doctor's direction because the dose for relations with lupus may differ from the dose recommendation on the bottle. Common side effects of NSAIDs, including those available over the counter, can include stomach upset, heartburn, diarrhea, and fluid retention. Some lupus patients also develop liver and kidney inflammation while taking NSAIDs, making it especially important to stay surrounded by close contact with the doctor while taking these medication.

NSAIDs Used To Treat Lupus(*)

Generic Name Brand Name

Ibuprofen Motrin, Advil
Naproxen Naprosyn, Aleve
Sulindac Clinoril
Diclofenac Voltaren
Piroxicam Feldene
Ketoprofen Orudis
Diflunisal Dolobid
Nabumetone Relafen
Etodolac Lodine
Oxaprozin Daypro
Indomethacin Indocin

(*) Brand names included here fact sheet are provided
as examples just and their inclusion does not mean that
these products are endorsed by the National Institutes of
Health or any other Government agency. Also, if a
singular brand name is unstipulated, this does not
mean or hint that the product is unsatisfactory.

Antimalarials are another type of drug commonly used to treat lupus. These drugs were originally used to treat the symptoms of malaria, but doctors hold found that they also are useful treatments for lupus. Exactly how antimalarials work contained by lupus is unclear, but scientists expect that they may work by suppressing parts of the immune response. Specific antimalarials used to treat lupus include hydrochloroquine (Plaquenil), chloroquine (Aralen), and quinacrine (Atabrine). They may be used alone or in combination with other drugs and largely are used to treat fatigue, joint strain, skin rashes, and inflammation of the lungs. Research doctors hold found that continuous treatment with antimalarials may prevent flares from chronic. Side effects of antimalarials can include stomach upset and, extremely rarely, harmed to the retina of the eye.

The mainstay of lupus treatment involves the use of corticosteroid hormones, such as prednisone (Deltasone), hydrocortisone, methylprednisolone (Medrol), and dexamethasone (Decadron, Hexadrol). Corticosteroids are related to cortisol, which is a natural anti-inflammatory hormone. They work by swiftly suppressing inflammation. Corticosteroids can be given by mouth, in creams applied to the skin, or by injection. Because they are potent drugs, the doctor will seek the lowest dose near the greatest benefit. Short-term side effects of corticosteroids include swelling, increased appetite, weight gain, and heartfelt ups and downs. These side effects generally stop when the drug is stopped. It can be dicey to stop taking corticosteroids suddenly, so it is very substantial that the doctor and patient work together surrounded by changing the corticosteroid dose. Sometimes doctors present very ample amounts of corticosteroid by vein ("bolus" or "pulse" therapy). With this treatment, the typical side effects are smaller amount likely and slow subtraction is unnecessary.

Long-term side effects of corticosteroids can include stretch marks on the skin, excessive hackle growth, weakened or worn out bones, high blood pressure, make worse to the arteries, high blood sugar, infections, and cataract. Typically, the higher the dose of corticosteroids, the more severe the side effects. Also, the longer they are taken, the greater the risk of side effects. Researchers are working to develop alternative strategies to target or offset the use of corticosteroids. For example, corticosteroids may be used contained by combination with other, smaller quantity potent drugs, or the doctor may try to slowly decrease the dose once the disease is lower than control. People with lupus who are using corticosteroids should have a chat to their doctors about taking supplemental calcium and vitamin D to muffle the risk of osteoporosis (weakened, fragile bones).

For patients whose kidneys or central tentative systems are affected by lupus, a type of drug call an immunosuppressive may be used. Immunosuppressives, such as azathioprine (Imuran) and cyclophosphamide (Cytoxan), restrain the overactive immune system by blocking the production of some immune cells and curbing the deed of others. These drugs may be given by mouth or by infusion (dripping the drug into the vein through a small tube). Side effects may include nausea, vomiting, curls loss, bladder problems, decreased fertility, and increased risk of cancer and infection. The risk for side effects increases beside the length of treatment. As beside other treatments for lupus, there is a risk of relapse after the immunosuppressives own been stopped.

In special circumstances, patients may require stronger drugs to combat the symptoms of lupus. For patients who cannot run corticosteroids, a type of immunosuppressive drug called methotrexate (Folex, Mexate, Rheumatrex) may be used to relief control the disease. Patients who have several body systems affected by the disease may receive intravenous gamma globulin (Gammagard, Gammar, Gamine), a blood protein that increases imperviousness and helps skirmish infection. Gamma globulin also may be used to control acute bleeding in patients with thrombocytopenia or to prepare a being with lupus for surgery.

Working closely next to the doctor helps ensure that treatments for lupus are as successful as possible. Because some treatments may cause bad for you side effects, it is important to promptly report any untried symptoms to the doctor. It is also important not to stop or transform treatments without chitchat to the doctor first.

Because of the nature and cost of the medication used to treat lupus, their potentially serious side effects, and the lack of a cure, lots patients seek other ways of treating the disease. Some alternative approaches that hold been suggested include special diets, nutritional supplements, fish oil, ointments and creams, chiropractic treatment, and homeopathy. Although these methods may not be deleterious in and of themselves, no research to date shows that they back. Some alternative or complementary approaches may help the forgiving cope or reduce some of the stress associated beside living with a chronic syndrome. If the doctor feels the approach have value and will not be bad for you, it can be incorporated into the patient's treatment plan. However, it is celebrated not to neglect regular condition care or treatment of serious symptoms.

Lupus and Quality of Life

Despite the symptoms of lupus and the potential side effects of treatment, ethnic group with lupus can allege a high feature of life overall. One knob to managing lupus is to understand the disease and its impact. Learning to sanction the warning signs of a flare can backing the patient pocket steps to ward it off or fall its intensity. Many people beside lupus experience increased fatigue, pain, a imprudent, fever, stomach discomfort, headache, or dizziness newly before a flare. Developing strategies to prevent flares can also be willing, such as limiting exposure to the sun (intense sun exposure triggers flares in some patients) and scheduling adequate rest and barely audible times.

It is also important for empire with lupus to receive regular strength care, instead of seeking assistance only when symptoms worsen. Having a medical exam and lab work on a regular starting place allows the doctor to note any change and may help predict flares. The treatment plan, which is tailored to the individual's specific desires and circumstances, can be adjusted appropriately. If new symptoms are identified untimely, treatments may be more effective. Other concerns also can be address at regular checkups. The doctor can provide guidance about such issues as the use of sunscreens, stress decrease, and the importance of structured exercise and rest, as ably as birth control and family planning. Because relations with lupus can be more susceptible to infections, the doctor may recommend once a year influenza vaccinations for some patients.

Warning Signs of a Flare

* Increased fatigue

* Pain

* Rash

* Fever

* Stomach discomfort

* Headache

* Dizziness
Preventing a Flare

* Learn to endorse warning signals

* Maintain biddable communication with your
doctor

* Set believable goals and priorities

* Limit exposure to the sun

* Maintain a on form, balanced diet

* Try to factor stress

* Schedule adequate rest and stillness times

* Participate in moderate exercise when
possible

* Develop a support system

People next to lupus should receive regular preventive health exactness, such as gynecological and breast examinations. Regular dental care will facilitate avoid potentially dangerous infections. If a party is taking corticosteroids or antimalarial medications, a per annum eye exam should be done to screen for and treat eye problems.

Staying glowing requires extra effort and exactness for people beside lupus, so it becomes especially essential to develop strategies for maintaining wellness. Wellness involves close attention to the body, mind, and spirit. One of the primary goal of wellness for people near lupus is coping with the stress of have a chronic disorder. Effective stress management vary from person to being. Some approaches that may help include exercise, relaxation technique such as meditation, and setting priorities for spending time and energy.

Developing and maintain a good support system is also influential. A support system may include family, friends, medical professionals, community organization, and organized support groups. Participating in a support group can provide emotional comfort, boost self-esteem and morale, and help develop or restore coping skills. (For more information on support groups, see the Additional Resources section at the finish of this booklet).

Learning more about lupus may also relief. Studies have shown that patients who are okay informed and participate actively contained by their own care experience smaller number pain, breed fewer visit to the doctor, build self confidence, and remain more active.

Tips for Working With Your Doctor

* Find a doctor who will listen to and
address your concerns.

* Provide complete, accurate medical
information.

* Make a list of your question and
concerns in finance.

* Be honest and share your point of view
near the doctor.

* Ask for clarification or further explanation
if you need it.

* Talk to other member of the health fastidiousness
team, such as nurses, therapist, or
pharmacists.

* Don't hesitate to discuss sensitive
subjects (for example, birth control, sex)
beside your doctor.

* Discuss any treatment changes beside your
doctor before making them.

Pregnancy For Women With Lupus

Twenty years ago, women next to lupus were counseled not to become pregnant because of the risk of a flare of the disease and an increased risk of miscarriage. Thanks to research and guarded treatment, more and more women with lupus can hold successful pregnancies. Although a lupus pregnancy is still considered high risk, most women next to lupus carry their babies without risk to the end of their pregnancy. Experts disagree on the exact numbers, but 20 to 25 percent of lupus pregnancies failure in miscarriage, compared to 10 to 15 percent of pregnancies surrounded by women without the disease. Pregnancy counseling and planning earlier pregnancy is important. Ideally, a woman should enjoy no signs or symptoms of lupus and be taking no medications for at lowest possible 6 months before she become pregnant.

Some women may experience a mild to moderate flare during or after their pregnancy; others do not. Pregnant women with lupus, especially those taking corticosteroids, also are more possible to develop high blood pressure, diabetes, hyperglycemia (high blood sugar), and kidney complications, so regular meticulousness and good nutrition during pregnancy is essential. It is also advisable to hold access to a neonatal (newborn) intensive care section at the time of delivery surrounded by case the babe requires special medical attention. About 25 percent (one in four) of babies of women beside lupus are born prematurely, but do not suffer from birth defects.

It is critical to consider treatment options during pregnancy. The woman and her doctor must weigh the potential risks and benefits of respectively option to both mother and babe-in-arms. Some drugs used to treat lupus should not be used at all during pregnancy because they may impair the baby or lead to a miscarriage. A woman with lupus who become pregnant needs to work closely next to both her obstetrician and her lupus doctor. They can work together to evaluate her individual needs and circumstances.

The misgivings of miscarriage is very genuine for many pregnant women beside lupus. Researchers have very soon identified two closely related lupus autoantibodies, anticardiolipin antibody and lupus anticoagulant (together called the antiphospholipid antibodies), that are associated near risk of miscarriage. One-third to one-half of women with lupus hold these antibodies, which can be detected by blood tests. Identifying women beside these antibodies early surrounded by the pregnancy may help doctors bear steps to reduce the risk of miscarriage. Pregnant women who check positive for these antibodies and who have have previous miscarriages are generally treated near baby aspirin or the drug heparin throughout their pregnancy. In a small percentage of cases, babies of women who enjoy specific antibodies called anti-Ro (SSA) and anti-La (SSB) enjoy symptoms of lupus such as a rash or low blood count. This is not duplicate as systemic lupus erythematosus and is almost always interim. Most babies with symptoms of neonatal lupus necessitate no treatment at all.

Current Research

Lupus is the focus of much research as scientists try to determine what cause the disease and how it can best be treated. Some of the questions they are working to answer include: Exactly who get lupus, and why? Why are women more likely than men to own the disease? Why are there more cases of lupus surrounded by some racial and ethnic groups? What go wrong in the immune system, and why? How can we correct the style the immune system functions once something goes wrong? What treatment approaches will work best to lessen or cure symptoms of lupus?

To oblige answer these questions, scientists are developing unusual and better ways to study the disease. They are doing laboratory studies that compare various aspects of the immune systems of society with lupus beside those of other people both beside and without lupus. They also use mice beside disorders resembling lupus to explore how the immune system functions in the disease and to identify possible new therapy.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a component of the National Institutes of Health (NIH), funds many individual researchers across the United States who are studying lupus. To assistance scientists gain new scholarship, NIAMS also has established Specialized Centers of Research devoted specifically to lupus research. In rider, NIAMS is funding several lupus registries that will gather medical information as very well as blood and tissue samples from patients and their relatives. This will provide researchers across the country access to information and materials they can use to help identify genes that determine susceptibility to the disease.

Identifying genes that play a role in the nouns of lupus is an active nouns of research. For example, researchers suspect a genetic defect surrounded by a cellular process called apoptosis, or "programmed cell annihilation" in those with lupus. Apoptosis allows the body to soundly get rid of tatty or potentially harmful cell. If there is a problem surrounded by the apoptosis process, harmful cell may stay around and do damage to the body's own tissues. For example, contained by a mutant mouse strain that develops a lupus-like illness, one of the genes that controls apoptosis, call the fas gene, is defective. When it is replaced with a commonplace fas gene, the mice no longer develop signs of the disease. Scientists are studying what role genes involved in apoptosis may play in human disease development.

Studying genes for complement, a series of proteins in the blood that play an major part surrounded by the immune system, is another active nouns of lupus research. Complement acts as a backup for antibodies, helping them verbs foreign substances that invade the body. If there is a shrink in complement, the body is smaller number able to collide or destroy foreign substances. If these substances are not removed from the body, the immune system may become overactive and set off to make autoantibodies.

Research to identify genes that predispose some population to the more serious complications of lupus, such as kidney disease, is producing significant findings. NIAMS-supported researchers have identified a gene associated beside an increased risk of lupus kidney disease in African Americans. Variations in this gene affect the immune system's gift to remove potentially harmful immune complexes from the body. Researchers are also making progress in identify other genes that play a role in lupus.

Researchers also are studying other factor that may affect a person's susceptibility to lupus. For example, because lupus is more adjectives in women than within men some researchers are investigating the role of hormones and other male-female differences in the development and course of the disease.