The Physiology and Immunology Behind Lupus

    For years my brother has been struggling with major fatigue and weakness, and most recently his doctors have been testing him for lupus. Therefore, I wanted to look into what this would mean for him in a bit more detail than I already had.

    Lupus is an autoimmune disease that is caused by anti-nuclear antibodies. I know that is a lot of jargon, so I’ll break it down in a way that is hopefully easier to understand. Patients who have lupus experience their immune system inappropriately attacking proteins that the body makes normally. Specifically, Lupus is characterized by antibodies that attack DNA, histones, and ribosomes ultimately causing a wide range of symptoms. These symptoms can range from mild to life threatening and multi-organ. The most common symptoms found in about 90% of cases include fatigue, malaise, fever, anorexia, and weight loss.

    The goal for treatment of lupus is to prevent further organ damage. In mild cases, the use of NSAIDs (non-steroidal anti-inflammatory drugs) helps to prevent damage by decreasing inflammation by inhibiting COX. You may recognize COX from class, as this is the enzyme that turns into thromboxanes, prostacyclins, and prostaglandins. Aspirin is an example of NSAIDs that we discussed as a COX inhibitor, so other NSAIDs are used following the same ideology to prevent inflammation and further tissue damage in Lupus patients. In severe cases, corticosteroids may be prescribed. Interestingly, these are synthetic drugs that mimic cortisol. These drugs help patients with lupus because cortisol suppresses the immune system and prevents inflammation, ultimately preventing further tissue damage.

    The prognosis for someone with Lupus is enhanced by early diagnosis and treatment, but high morbidity and mortality does still exist among these patients. This is because such tissue damage can cause cardiovascular disease among other major organ diseases. One can hope that future research of potential cures will increase the survival rate of this autoimmune disorder.

References:

Justiz Vaillant, A. A., Goyal, A., & Varacallo, M. A. (2025). Systemic Lupus Erythematosus. In    

StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK535405/