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[Lupus & KCR 2023] Lupus, a disease with 1,000 faces

Experts discuss latest strategies in winning the war against the chronic autoimmune disease at Lupus 2023

By Kim Hoo-ran

Published : May 19, 2023 - 09:47

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Systemic lupus erythematosus (SLE) is often referred to as a disease with thousand faces, reflecting the wide spectrum of diverse clinical manifestations of the disease. It can be fatal with major organ involvement.

Basically an autoimmune disease, the immune system that is supposed to protect you turns against SLE patients. While autoimmune diseases are usually organ-specific and usually involve one organ, SLE is typically non-organ specific and can attack any organ and thus can lead to many diverse manifestations.

With 20 to 150 patients per 100,000, SLE is not an uncommon disease.

The disease can strike any gender at any age but women of child-bearing age make up the vast majority of patients. The female to male ratio is known to be greater than 10 to 1. The cause of SLE is unknown, but multiple genetic and environmental factors have been shown to play a role.

Delay in diagnosis

Systemic lupus erythematosus can have various manifestations and can cause serious illness and death when major organs are involved, but its diagnosis and treatment are a challenge. While classification criteria for SLE continue to improve, it is still a classification criteria, not a diagnostic criteria. In the absence of a diagnostic criteria, expert opinion remains the most important thing in diagnosing SLE, and may lead to a delay in diagnosis. The tools to measure disease activity and outcomes are also limited.

There are ongoing efforts to develop safe and effective treatment for SLE, but they have not been as successful as hoped. There is still no safe and effective treatment for SLE and some patients do not respond to the current treatments.

Sharing latest research

The latest research on pathophysiology, diagnosis and treatment of SLE is being presented at the 15th International Congress on SLE taking place in Seoul, Wednesday through Saturday.

Speakers offering new insights on the pathogenesis of SLE include Dr. George Tsokos of Harvard University, presenting his work on mechanisms of kidney damage in lupus nephritis, and Dr. Joe Craft from Yale University, sharing evidence that T-cell activation plays a major role in initiating and continuing cellular damage in the disease.

At a session on cytokines and cell signaling, Dr. Marina Botto from Imperial College London is presenting a “Type 1 IFN and T-cell mechanism in SLE.” A session on immune cells includes a presentation by Dr. Kwok Seung-ki from the Catholic University of Korea on myeloid-derived suppressor cells in SLE.

Discussing strategies to improve diagnosis and treatment of SLE is an important part of the congress.

Ways to improve clinical trials, precision medicine, and new drugs for SLE, including the results of clinical trials will also be presented at the Seoul gathering.

Therapeutic strategies for SLE that can be used in daily practice are also introduced. For example, Dr. Chi-Chiu Mok of Tuen Mun Hospital in Hong Kong presents a new treatment paradigm that adds voclosporin or belimumab to standard care. Dr. Ian Bruce of the University of Manchester, England, introduces strategies to minimize the risk of organ damage when treating lupus patients.

Attention to policy

In Seoul, lupus experts present priority policy tasks that need to be addressed in order to overcome lupus. They include the establishment of a global cooperation system to resolve imbalances in health care systems, efforts to reduce the disease burden of women of child-bearing age with lupus and efforts to establish an appropriate management system for accompanying diseases such as COVID-19, infections and cardiovascular diseases that increase the risk of death.

Patient-centered approach

A unique feature of Lupus 2023 is the involvement of lupus patients, reflecting the role of the patients in the treatment of the disease. Two sessions address lupus patients directly, including a presentation by Kim Jin-hye, president of Korean Lupus Support Group, who shares patients’ experiences of living with SLE.