As can be concluded from my posted pages and my general outline of what I wanted to study from reflection blog 2, I have decided to focus my research on Systemic Lupus Erythematosus. What really drew me to studying lupus is the fact that I am personally intrigued by this disease and that it is a disease of mystery. Lupus is so complex because it is multifaceted and unique to each individual; meaning, that each person diagnosed with the disease will have different symptoms and different exposures that trigger this disease. On top of this, lupus is hard to diagnose and often misdiagnosed and underrepresented in society. It is assumed that there are only 1 million cases in the United States alone; however, this number isn’t accurate because of lack of awareness about the disease and doctors not fully understanding lupus symptoms. There are a few main takeaways that I want to come from this experiment which can be broken down into the following Themes and innovations:
- I firstly want to examine the history and diagnosis/treatment process of lupus. Lupus is an incredibly old disease, with cases first being documented by Hippocrates back in 400 BCE. However, while lupus has been in literature for thousands of years, it has only recently been medically recognized as an autoimmune disorder back in the 1950s with the discovery of LE cells (specific cells generated by patients who have lupus or have a risk factor for lupus. I think highlighting the history will allow people to develop a deeper understanding on why this disease is so hard to diagnose and why patients often struggle with treatment plans; whether it be from a misdiagnosis or not identifying symptoms. This can eventually lead to the discussion on diagnosis and treatment plans and what is currently being used in the rheumatology community to treat lupus. As stated earlier there have been many innovations in the last 50 years; however, there hasn’t been much progress since this “research boom.” Also understanding chemical drug interaction with lupus inflammation can help bring clarity on what exactly is being treated during these lupus onset symptoms. Also highlighting diagnosis and treatment options allows for further explanation on how doctors address and fight this disease and why it is so hard to diagnosis in people.
- I next want to evaluate the genetic polymorphisms and environmental that are involved with this disease. Lupus isn’t just triggered by one common factor; it is caused by a combination of genetic factors that once “triggered” by some environmental factor cause the onset of disease symptoms. There are multiple pathways that can start this disease but, the most common factor is that patients have genetic polymorphisms and mutations on their Toll-Like Receptors (specifically TLR7 and TLR9). These genetic factors are inherited and when combined with cell damage from the environment (whether it be from a viral infection or UV damage) start the onset of lupus flare ups. These biochemical pathways can help understand how to potentially treat this disease and also offer potential treatment options and drug alternatives for in the future. There are also other important immunological pathways that are altered during this disease like the JAK-STAT pathway and cell apoptotic pathway that lead to the onset of autoantibodies that attack healthy cell tissue.
- I lastly want to look into the overall immune response in patients with lupus and how this compares to a healthy immune response. Lupus is a chronic autoimmune disease that causes total body damage, which obviously isn’t normal compared to a healthy patient. Healthy individuals don’t produce certain self-reacting cells and have healthy normal pathways. On top of that lupus patients have an immune response called type III hypersensitivity which causes chronic inflammation in the body. I want to highlight how this does not show up in healthy patients and what this inflammation does overtime to the body.
- While lupus is an incredibly old disease, it has been poorly documented and only recently made scientific revolutions within the last 50 years. It was often misclassified as a version of Tuberculosis and not properly understood because the symptoms are so vast and varying. For starters there was a new characterization of lupus diagnosis criteria updated in 2009, which helped patients get a definitive diagnosis and led to more efficient treatment strategies. On top of that there have been a creation of new drugs, like Belimumab, that specifically target these autoantibodies that attack healthy cells. These drugs can help reduce flare ups and reduce damage on these affected tissue lines.
- As stated in the previous talking point, a surge in understanding autoantibodies is critical in treating lupus and autoimmune disorders. Using newer biochemical processes like monoclonal antibody testing and monoclonal antibody treatment will directly reduce inflammation in lupus patients. These processes are fairly new and undergoing research now to better help diagnosed patients.
- Another big takeaway is the understanding of the genetic and familial component of lupus that became prominent in research conducted in 1954. Understanding these genetic components can potentially help to lead with reducing and stopping the triggering of lupus symptoms in patients.
These themes and scientific innovations are the big takeaways with this multifaceted disease and hopefully can shine a light on treatment plans and awareness for diagnosed patients. Throughout this semester I worked on a literary review and a Mastery Capstone Assignment that is what is shaping this blog and research. I have collected over 30 key research articles about lupus and these capstone pages will incorporate the history, biochemical pathways, and overall immune response in people diagnosed with lupus. These capstone pages also review the atomic level of this inflammatory response in lupus to the broad physical symptoms that present in patients like rashes and organ failure. This will hopefully help with the main goal of understanding exactly what lupus is and raise awareness of the disease as a whole.