The report below primarily addresses issues regarding the lupus disease. It identifies the various types of lupus disease and distinguishes them from each other in the lines of their causative factors and manifestation. It discusses the aetiology of the disease, its pathology and current treatment. Further, it outlines the components of ongoing research in regard to the condition and provides implications of the research. The lupus disease which is also called Systemic Lupus Erythematosus (SLE) is a disease that causes the immune system to become overactive to the point that it starts making antibodies against its own cells. This is why it’s referred to as an auto-immune disease. When the disease becomes active, immune responses can cause inflammation in cells caused by immune responses normally affects one or many body tissues such as muscles, blood cell and vessels, skin, brain, nerves, and joints. Other body organs such as lungs, heart, kidneys, gastrointestinal tract and/or the linings around internal organs are also affected (Estes, and Christian, 1971). There are a number of types of Lupus disease. They include Systemic lupus erythematosus or SLE, Drug-induced lupus, Neonatal lupus, and Cutaneous lupus erythematosus, which is further divided into Discoid lupus erythematosus and Subacute cutaneous lupus erythematosus.Lupus is a worldwide problem that affects people of all nationalities, races, ethnicities, genders and ages. Because it requires complex clinical and laboratory test, that’s why its frequency is only known among some American and west European Caucasians. Its frequency has been known to be higher in the developed world such as Sweden and some south European countries and parts of the United States. Much less is known about the frequency of lupus in Afrocaribbeans. There have been studies suggesting that lupus could also be very high in West Indies. Although most of the Afrocaribbeans in the United States and in the West indies have racial origins in Africa, the disease is extremely rare there The age standardisation lupus incidence in the UK during the 1990s was 7.89 per 100, 000 for females and 1.53 per 100, 000 males with in overall female: male ratio of 5.2:1. The prevalence in Chinese and Asians is 1 in every 1000 while in Afrocaribbeans it is 1 in every 500. The tables below the prevalence of the lupus disease in the UK by gender.The actual cause of the lupus disease is actually unknown. However medical experts argue that the disease develops out of a combination of factors originating from the inside as well as outside the body. These factors include hormones, the environment and genetic factors.Although no particular type of gene is associated with the development of the lupus diseases, medical experts note that the disease is more common in certain families of genes (Tiffin, Adeyemo and OKpechi: 2013). Usually the chances of a children of parents suffering from this condition is 20 times higher. There may be also cases where the disease may develop in a family with no history of it. However genetic factors do not conclusively determine whether one can develop the disease or not. This is because there are some cases where one of the identical twins gets it and the other doesn’t despite the fact that they have been raised in the same environment.Hormones are the chemical substances that are usually released by the body so as to regulate functions of certain body organs or cells. Research shows that females are at a higher risk of contracting the disease more than males. Medical doctors have been trying to carry out studies to ascertain whether a relationship exists between estrogen and the lupus disease. Of course estrogen production is higher in women as compared to men. An interesting observation among the female lupus patients is that they usually have flare ups during pregnancy as well as just before menstruation (Wasef and Yacoub, 2004).According to the Lupus Foundation of America researchers, environmental factors have a way of triggering the development of the lupus disease especially in those individual that are genetically susceptible. Examples of environmental agents that are known to cause lupus include; exposure to ultraviolet lights from bulbs and the sun, smoking, silica dust, antibiotics such as penicillin, fatigue and psychological stress to name but a few.
Generally speaking the lupus disease still remains by and large a mystery that demand that medical doctors give it maximum attention. To begin with, the disease has been labelled as great imitator which simply means that its symptoms are so similar to those of other diseases (Tiffin, Adeyemo and OKpechi: 2013). Therefore, it is very easy for a lupus patient to be mistaken for other infections. Closely related to this point is the fact that the chances of being misdiagnosed for lupus are so high. According to James, Berger and Elston (2005) it might even take approximately 6 years before a lupus patient is correctly diagnosed. This leads us to the next point whereby the diseases has no specific diagnosis methods. It require a combination of many tests such as genetic, hormonal, blood etc. Another mystery about lupus is the fact that no two cases are exactly the same. It affect different individuals in a different manner even making it more complicated. Moreover ignorance among manty who are thehigh risk age bracket of 15-44 is wanting (Wasef and Yacoub, 2004). More research needs to be done and masses educated about this life threatening condition. Lastly as of now the condition is classified as incurable and so great medical attention is required so as to find way and means on how to manage the condition.The following are the main three stages of the lupus disease according to a research conducted by lupus UKat this stage the individual may just have some mild symptoms such as pains in the joints and fatigue. Usually the symptoms are not life threatening but are unpleasant. Such cases are not serious and medication is administered to deal with the pains.At this stage some inflammation may occur in some parts from the body in addition to the skin and joints. Examples of such inflammation that is experienced here include; mild kidney inflammation, pericarditis and pleurisyAt this stage individuals suffer from severe organ damage as a result of the inflammation. The most affected body organs include the kidneys, lungs, the heart and the brain.
Notably, there are cases where the symptoms may worsen and the patient experiences flare up for several days and even longer. The relapses tend to alternate especially during remission. This presents a difficult trend because now the reasons behind flare ups and remissions are not yet known. This explains why it’s difficult to manage the disease. It is vital that you take an active role in your treatment.
Given the complexity of this disease, the available treatment options are aimed at reducing body organ damage. Some of the available treatment as noted by Neuwelt and Young (2009) include;Usually the type of medication to be used is determined by the clinical manifestations of an individual patient and severity of symptoms. Finding the most effective type of medication with less side effects requires that a patients tries out several of them before settling for one.These are used for mild but painful symptoms such as pleurisy, headaches, pain in the joints and muscle pain. Notably when a patient suffers from the kidney disease the non-steroidal anti-inflammatories should be avoided.is a drug that is mainly used to treat malaria. However lupus patients can also use it especially at the mild and moderate stage. It takes care of joint pains, the skin and pleurisy. Its effectiveness is normally realised after several months of use.They are generally reserved for more serious symptoms of the lupus disease such as kidney inflammation, vasculitis and the central nervous system breakdown. However it can be used in when life threatening symptoms like arthritis and pleurisy are realised. Steroids have adverse side effects and that’s why only small doses are to be administered at a time. These type of drugs are specifically used in the moderate to severe stage cases which either require prolonged treatments, are not responsive to first line treatments or require prolonged use of excessively high doses of steroids. Examples of such drugs include: Myfortic, Mycophenolate Mofetil, Azathioprine and Cyclophosphamide. Individuals who are under such medication require regular medical check-ups by specialists so as to identify any side effects early enoughcurrently there are two biologic drugs being used to treat lupus. They include Rituximab and Belimumab which are the newest therapies used to treat moderate to severe stage of the lupus disease. The good thing about Rituximab is that it’s selective in the way it works as it targets and depletes cells which play a major role in autoantibody production. Belimumab on the other hand, is a monoclonal antibody which works by inhibiting B-Lymphocyte stimulator (BLyS) which stimulates antibody production Some of these measures as suggested by Tiffin, Adeyemo and Okpechi (2005) include;
➢ Adequate rest during the days and taking regular meals is very important. There is need to pace your daily activities and have adequate sleep as well as making necessary adjustments during remissions and flare ups.
➢ Stress management by developing good relations with close friends, colleagues and family as well as regular gentle exercise which helps improve fatigue.
➢ Patients should minimise exposure to excess heat and the sun. Treatment of infections should be timely. Research shows that the use of non-live vaccinations is good especially at the mild stage. However such vaccines should be avoided when the disease is active.
➢ Early reporting of the possible symptoms of a flare makes the management of the diseases much easier.
➢ Stop smoking should be stopped because it reduces the effects of Hydroxychloroquine.
➢ Individual patients should make an arrangement with lupus medical experts for personalised treatment.
Once a patient is diagnosed with it, the medical doctor comes up with a plan on how to manage it. This plan will depend on the individual patient needs and the stage of the lupus disease. Generally speaking the effectiveness of the two forms (medical and non-medical) of medication is dependable on various factors. First and foremost since lupus disease varies from case to case; it’s not automatic to say that such a medication is far more effective than the other. That’s why as earlier aforementioned, a patient has to always try a variety of them before a decision is made on what works and what doesn’t. Secondly it’s about the commitment of the patient in taking the medication. Take an example of hydro chloroquine which is said to start being effective after several months of intake. Others like anti-flammatory agents, steroids and immunosuppressive drugs are to be used with restrictions because they cause serious side effects. They require the patient to be closely monitored by medical experts. The only exception that seems to be more effective that the other types of drugs is the biological agents. The agents have a unique way of working which causes less damage to body organs. The non-medical measures are the most effective in managing the condition but unfortunately they cannot be used in isolation. A patient needs to balance the medical and non-medical measures in order to manage the disease wellAccording to Medical News Today (2016), one of the most current treatment that was approved after intensive research is the belimumab drug. This drug was a product of a study dubbed the BLISS-76. It is a fully human monoclonal anti-BAFF antibody. What the BAFF does is that it stimulates and extends the life of B lymphocytes which produce antibodies against foreign and self-cells. In two recently announced phase III trials, the drug significantly reduced disease activity and increased time to flare compared to placebo. The participants also experienced less fatigue. While the drug hasn’t been proved to work, the current results of it faring better than other medications is a good sign. More research needs to be done so as to improve its efficiency.
Nalidomide is another invention by the medical experts for treating lupus. It’s a drug that is used to eat multiple mylema and rare blood disorders (Lupus UK). In its initial trials, study results showed that four in every five patients showed significant improvement. However one of the four had to stop using the drug because they developed new symptoms. Therefore the study went ahead to identify biomarkers that could serve as assessment tools for patients response in the future. While this drug may be an option in treating lupus, more intensive studies are required to assess its efficacy and safety
Lupus disease treatments are mainly drugs that have adverse side effects on the patient. However a current study by researchers from Houston University is working on a possible drug made from plant material that has no side effect (The Lupus Foundation of America, 2016). The researchers argue that the current medications such as corticosteroids usually have negative side effects including the suppression of the immune system and increases the risk infection of a lupus patient. The plant substance known as CCDO has been successfully tested in mice but not yet been used in human beings. The CDDO compound successfully stopped lupus development in mice. If the drug succeeds to stop the lupus disease in human that will be a huge medical milestone in the history of lupus disease management.
While there are no known root causes or cure, the progress of recent treatments and discoveries in development is encouraging. Many of the current therapeutic options are in many ways ineffective because of the toxity levels, accrual of organ damage and insufficient control of the underlying disease pathology. Therefore improved understanding of the lupus pathogenesis and immunology will lead to the identification of new treatment targets. Additionally, research shows the outlook for patients has improved in the recent years and the 5 year survival rate hitting 85%. It has been reported that the cause of death in the first years is as a result of active infections and diseases; while in the last years patients commonly die of cancer and atherosclerosis. In my opinion new medical inventions should ensure we have treatment that not only focuses on the initial stages of the diseases but the latter years as well. This means individual uniquely tailored treatment is the way to go. In the world today we have 5 million cases which is far much higher has compared to the 1990s where the cases were about less than 2 million. This increase is attributed to the better detection techniques that have been developed. While this is commendable, lupus diagnosis requires sophisticated technological equipment which many parts of the developing world cannot afford. Which means that there could be higher cases of lupus than we are aware about. Therefore better and cost effective techniques and tools should be developed so as to diagnose and treat the lupus disease.The chronic aspect of the disease means that the signs and symptoms of the illness last for more than six weeks and more often than not lasts for many years, of not a lifetime (A.D.A.M, 2008). The autoimmune aspect of the infection means that the immune system of a person fails to tell the difference between the healthy tissues and cells in the body and unhealthy invaders. Thus it fights them all. In most cases, the lupus disease develops rather slowly and displays signs and symptoms that come and go as time goes. The disease happens both in childhood and in later life (Estes, and Christian, 1971).According to Lupus UK a charitable organisation that helps people with the lupus in the UK, the growth and development really varies from case to case. In some cases the symptoms take quite sometime before showing up while in others in progresses faster. In the beginning it’s very possible to confuse this disease with other conditions because the common symptom would be fatigue and joint pains. There are also instances where several symptoms which range from mild to severe may occur at once.