Lupus is a lifelong autoimmune disorder that occurs when the body, for unknown reasons, becomes allergic to itself. Normally, immune cells protect the body against bacteria, viruses and other foreign invaders. After the onset of lupus, these same cells mistakenly attack the body’s own tissue and organs, including the joints, kidneys, heart, lungs, brain, blood and skin.
The symptoms of lupus include fatigue, fevers, swollen glands and weight loss. Sun sensitive rashes, mouth sores, arthritis, muscle aches and pain on taking a deep breath are part of the non-organ threatening components of the disease. Half of those suffering from lupus have organ threatening disease which includes inflammation of the heart, lung, kidney or liver.
Lupus symptoms can be managed by drugs that fight inflammation, like aspirin or ibuprofen for mild symptoms. Anti-malarial drugs (hydroxychloroquine) are used for more severe but non-organ threatening disease, and corticosteroids are used when organs are also affected. Almost half of those with lupus require the addition of cancer-like chemotherapy drugs. In spite of this rigorous therapy, fatal organ damage remains a serious problem for lupus patients, and there is no cure.
Human and Social Costs
Ninety percent of the 1.5 million Americans battling lupus are women, the vast majority of whom are attacked during their reproductive years. This time period, between ages 25-40, represents the peak of these women’s career and family responsibilities. The lifelong drug therapy endured by lupus patients helps manage the symptoms of the disease but can itself diminish overall quality of life. Lupus is two to three times more prevalent among African-Americans, Hispanic/Latino-Americans, Asian-Americans and Native Americans.
Lupus exacts a terrible toll on patients’ internal organs by inducing chronic inflammation and scarring. 30-50% of patients suffer from debilitating kidney damage, and only 50% of patients with organ threatening disease live 20 years past diagnosis.
Patients undergoing long-term, supportive treatment for lupus face
daunting medical bills. The annual cost for the frequent hospital
stays, dialysis, organ transplants, and partial or total disability
averages $5100 per patient, a price that stretches family budgets
and raises individual insurance premiums. In total, lupus costs our
country an estimated $20 billion.
The Potential for Stem Cell Cures and Therapies
One promising new approach to the treatment of lupus involves “autologous” stem cell transplantation, or the use of a patient’s own stem cells to treat their disease. Essentially, a lupus patient is given a new immune system by replacing their existing pool of disease-fighting stem cells with healthy new ones. However, even these healthy cells contain the inherent defects which give rise to lupus, perhaps explaining the relapses observed in patients 1-2 years after transplantation. Research on embryonic stem cells may lead to improvements in the transplant procedure which would enable the restoration of a healthy immune system free of any lupus-causing traits.
Still, stem cell transplantation shows tremendous promise for the treatment of lupus. Early clinical results indicate that the majority of transplant recipients experience disease remission for at least one year. Given that the patients enrolled in these early trials represent a very sick group of lupus sufferers, these initial results demonstrate a significant step forward and suggest that stem cell transplantation may one day provide a cure for lupus. Even in its current form, this procedure may push the course of the disease towards a milder and more treatable direction. This scenario is analogous to the discovery of human insulin, which made Type 1 diabetes a much more manageable disease.
That’s why lupus patients and their families and groups like
the California Chapter of the Lupus Foundation of America, Inc., and
Lupus LA strongly support stem cell research - and have endorsed Proposition
71, the California Stem Cell Research and Cures Initiative.
Partial list of sources:
Wallace DJ. The Lupus Book: A Guide for Patients and their Families, Oxford University Press, 2001.
Lupus Foundation of America, Inc.
California Chapter of Lupus Foundation of America, Inc.
Lupus Tutorial, National Library of Medicine
Jayne D, Tyndall A. Autologous stem cell transplantation for systemic
lupus erythematosus. Lupus (2004) 13: 359-65.
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt= Abstract&list_uids=15230293
Clarke AE, et. al. The systemic lupus erythematosus Tri-nation Study:
absence of a link between health resource use and health outcome.
Rheumatology (2004) 43: 1016-24.
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt= Abstract&list_uids=15173602