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RECOMMENDED READING

"New Hope for People with Lupus: Your Friendly, Authoritive Guide to the Latest in Traditional and Complementary Solutions," by Theresa Foy Digeronimo, Stephen Paget, Sara J. Henry

"The Lupus Book: A Guide for Patients and Their Families," by Daniel J. Wallace

"Lupus: Alternative Therapies That Work," by Sharon Moore

 

natural remedies, herbal remedies

Lupus Research

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a component of the National Institutes of Health (NIH), has a major program of lupus research in its intramural program in Bethesda, Maryland, and funds many individual researchers across the United States who are studying lupus.

THE FOLLOWING IS INFORMATION FROM THE NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL SKIN DISEASES AND THE NATIONAL INSTITUTES OF HEALTH.

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

To help answer these questions, scientists are developing new and better ways to study the disease. They are doing laboratory studies that compare various aspects of the immune systems of people with lupus with those of other people both with and without lupus. They also use mice with disorders resembling lupus to better understand the abnormalities of the immune system that occur in lupus and to identify possible new therapies.

To help scientists gain new knowledge, the NIAMS also has established Specialized Centers of Research devoted specifically to lupus research. In addition, the NIAMS is funding several lupus registries that will gather medical information as well as blood and tissue samples from patients and their relatives. This will give 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 development of lupus is an active area of research. For example, researchers suspect a genetic defect in a cellular process called apoptosis, or "programmed cell death," in people with lupus. Apoptosis is similar to the process that causes leaves to turn color in autumn and fall from trees; it allows the body to eliminate cells that have fulfilled their function and typically need to be replaced. If there is a problem in the apoptosis process, harmful cells may stay around and do damage to the body's own tissues. For example, in a mutant mouse strain that develops a lupus-like illness, one of the genes that controls apoptosis is defective. When it is replaced by a normal 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 important part in the immune system, is another active area of lupus research. Complement acts as a backup for antibodies, helping them destroy foreign substances that invade the body. If there is a decrease in complement, the body is less able to fight or destroy foreign substances. If these substances are not removed from the body, the immune system may become overactive and begin to make autoantibodies.

Recent large studies of families with lupus have identified a number of genetic regions that appear to confer risk of SLE. Although the specific genes and their function remain unknown, intensive work in delineating the entire human genome offers promise that these genes will be identified in the near future. This should provide knowledge of the fundamental nature of the risk factors that can lead to lupus and new insights into how these risks can be modified.

It is thought that autoimmune diseases, such as lupus, occur when a genetically susceptible individual encounters an unknown environmental agent or trigger. In this circumstance, an abnormal immune response can be initiated that leads to the signs and symptoms of lupus. Research has focused on both the genetic susceptibility and the environmental trigger. Although the environmental trigger remains unknown, microbial agents such as Epstein-Barr virus and others have been considered. Researchers also are studying other factors that may affect a person's susceptibility to lupus. For example, because lupus is more common in women than in men, some researchers are investigating the role of hormones and other male-female differences in the development and course of the disease.

A current study funded by the NIH is focusing on the safety and effectiveness of oral contraceptives (birth-control pills) and hormone replacement therapy in women with lupus. Doctors have worried about the wisdom of prescribing oral contraceptives or estrogen replacement therapy for women with lupus because of a widely held view that estrogens can make the disease worse. However, recent limited data suggest these drugs may be safe for some women with lupus. Researchers hope this study will yield options for safe, effective methods of birth control for young women with lupus and enable postmenopausal women with lupus to benefit from estrogen replacement therapy.

Promising Areas of Research

* Identifying lupus susceptibility genes
* Searching for environmental agents that cause lupus
* Developing drugs or biologic agents that cure lupus

Researchers are also focusing on finding better treatments for lupus. A primary goal of this research is to develop treatments that can effectively minimize the use of corticosteroids. Scientists are trying to identify combination therapies that may be more effective than single-treatment approaches. Researchers are also interested in using male hormones, called androgens, as a possible treatment for the disease. Another goal is to improve the treatment and management of lupus in the kidneys and central nervous system. For example, a 20-year study supported by the NIAMS and the NIH found that combining cyclophosphamide with prednisone helped delay or prevent kidney failure, a serious complication of lupus.

On the basis of new information about the disease process, scientists are using novel "biologic agents" to selectively block parts of the immune system. Development and testing of these new drugs, which are based on compounds that occur naturally in the body, comprise an exciting and promising new area of lupus research. The hope is that these treatments not only will be effective, but also will have fewer side effects. Other treatment options currently being explored include reconstructing the immune system by bone marrow transplantation. In the future, gene therapy also may play an important role in lupus treatment.

Hope for the Future

With research advances and a better understanding of lupus, the prognosis for people with lupus today is far brighter than it was even 20 years ago. It is possible to have lupus and remain active and involved with life, family, and work. As current research efforts unfold, there is continued hope for new treatments; improvements in quality of life; and, ultimately, a way to prevent or cure the disease. The research efforts of today may yield the answers of tomorrow, as scientists continue to unravel the mysteries of lupus.

Additional Resources

Alliance for Lupus Research, Inc.
1270 Avenue of the Americas, Suite 609
New York, NY 10020
(212) 218-2840

The Alliance for Lupus Research, Inc. (ALR), is a nonprofit organization devoted exclusively to the support of promising research for the prevention, treatment, and cure of lupus. Through accelerated, focused, goal-oriented research programs, the ALR aims to promote basic and clinical sciences to achieve major advances leading to a better understanding of the cause of lupus. Additional information and research updates can be found on the NIAMS Web site at http://www.niams.nih.gov

National Institute of Arthritis and Musculoskeletal
and Skin Diseases Information Clearinghouse
NIAMS/National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675

This is a publication of the National Institutes of Health
NIH Publication No. 97-4178

Lupus Foundation of America (LFA), Inc.
1300 Piccard Drive, Suite 200
Rockville, MD 20850
(301) 670-9292
(800) 558-0121
Web address: http://www.lupus.org
This is the main voluntary organization devoted to lupus. The LFA assists local chapters in providing services to people with lupus, works to educate the public about lupus, and supports lupus research. Through a network of more than 500 branches and support groups, the chapters provide education through information and referral services, health fairs, newsletters, publications, and seminars. Chapters provide support to people with lupus, their families, and friends through support group meetings, hospital visits, and telephone help lines.

SLE Foundation, Inc.
330 Seventh Avenue, Suite 1701
New York, NY 10001
T: 212.685.4118 or
800.74.LUPUS (toll free)
Web address: http://www.lupusny.org
The foundation supports and encourages medical research to find the cause and cure of lupus and improve its diagnosis and treatment. It also provides a wide variety of services to help patients with lupus and their families. In addition, this voluntary organization conducts a broad-based public education program to raise awareness of lupus and increase understanding of this serious, chronic, autoimmune disease.

Part 1 - Lupus: Symptoms, Causes and Alternative Treatments
Part 2 - Diagnosing Lupus
Part 3 - Current Research

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