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  • Our immune system is an incredible thing.

  • It's a complex, disease-fighting machine, capable of fending off attacks from bacteria

  • and viruses.

  • But what happens when that same incredible system stops fighting diseases, and starts

  • attacking you?

  • Lupus has been around for a very long time.

  • Symptoms were first described back in the nineteenth century, specifically a butterfly

  • rash that appears on the face.

  • It was later discovered that lupus causes many, seemingly unrelated symptoms.

  • But although we've known about the disease for years, there's still much about lupus

  • we don't fully understand.

  • I'm Ali Duarte, I'm a physician and researcher.

  • I'm also the co-director of the Lupus Program here at Mayo Clinic in Rochester.

  • Lupus is an autoimmune disease so this means that your immune system that is in charge

  • of defending you against microbes sort of bacteria starts to attack itself.

  • It's, for example when you have a dog that protects you against all the bad guys and

  • then this dog starts to bite you.

  • Autoimmune diseases aren't uncommon, and there are many different types.

  • Even lupus has four variations.

  • But for now, we'll be focusing on this type, systemic lupus.

  • And that's because...

  • When people talk about lupus they're usually referring to systemic lupus the type of lupus

  • that affects the internal organs.

  • So, what would cause the immune system, or the body's guard dog, to turn against its owner?

  • We don't know.

  • Which, is kind of the story behind lupus.

  • There's a lot we don't understand.

  • But, thanks to specialists like Dr. Duarte, we know a lot more than we used to.

  • So what do we know right now is or what we think is that there is a genetic component

  • and an environmental component.

  • In order to begin to show the symptoms of lupus, two things need to happen.

  • First, since lupus isn't contagious, you have to have a genetic predisposition to the disease.

  • The genetic factor that causes lupus is currently unknown, but doctors do know that certain

  • demographics are more at risk than others.

  • So Lupus is a disease typically of young women.

  • It affects a women 10 times more frequently than males.

  • And you usually see the disease between the ages of 20 and 50.

  • Because of the much higher rates of female patients, researchers suspect that the disease

  • is associated with the number of X-chromosomes one has, since women have 2 x-chromosomes

  • and men usually have only one.

  • But simply having the genetic predisposition is only the first part of the puzzle.

  • And then if you were born with this a very active immune system and you are exposed to

  • the right stimuli which can be maybe a drug or can be the UV light or something that we

  • have any identified yet it starts and perpetuates the disease.

  • So what happens to your body when it encounters a trigger?

  • Well in lupus what happens is that something like UV light may trigger cell death.

  • So these cells start to die and they'd release DNA and the DNA then is taken by one of the

  • cells of the immune system called dendritic cells, and then these cells take the DNA and expose it and

  • activate other cells called lymphocytes so the T cells or the B cells.

  • Normally, immune cells would just get rid of a dead cell and move on.

  • But in lupus patients, these cells are slow at clearing the death cells and start to create

  • an antibody against the cell's DNA.

  • Which is a big problem, because there are a lot of healthy cells in your body that have

  • that same DNA, which these immune cells now want to destroy.

  • This results in chronic inflammation and potentially damage to internal organs like the kidneys

  • or brain and can even lead to organ failure and death.

  • So even though we haven't we haven't had a significant drug break through discoveries

  • in the last 60 years we have learned how to manage the disease better and in the last

  • Just over half-a-century ago patients were expected to live a few years

  • Now, lifespans are close to average.

  • Of course, there are still many unanswered genetic questions.

  • Lupus affects African Americans 3 to 4 times more than caucasians, for example, and there

  • is no identifiable genetic reason why this should be the case.

  • And while there is strong evidence that environmental factors could be the culprit, the environmental

  • triggers aren't fully understood.

  • So, while outcomes for patients diagnosed with lupus are much better than they have

  • ever been in the past, when it comes to exactly how the disease works, the answer is still usually...

  • We don't know.

  • So, while more women are at risk of developing lupus than men, men tend to have worse outcomes.

  • Like other aspects of the disease, this is another unknown, but there are some theories...

  • Maybe one of the components is just that males take longer to go to the doctor and they may

  • just delay going for looking for care so that may change the prognosis of the disease

  • So, maybe get a checkup every now and then, ok?

Our immune system is an incredible thing.

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狼瘡とは何か? (What Exactly is Lupus?)

  • 5 1
    林宜悉 に公開 2021 年 01 月 14 日
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