MECHANISM OF DISEASE

Learn more about the mechanism underlying lupus

  • TRANSCRIPT

    NARRATOR:

    Systemic lupus erythematosus, commonly referred to lupus or SLE, is the most common form of lupus.    

    REFERENCE: 

    1. Maidhof W, Hilas O. Lupus: An overview of the disease and management options. Pharm Ther. 2012;37(4):240.

    NARRATOR:

    Patients suffer from a range of debilitating effects of this autoimmune disease . . . each and every day.

    REFERENCE: 

    1. Anders HJ, Saxena R, Zhao MH, et al. Lupus nephritis. Nat Rev Dis Primers. 2020;6(1):1- 25.
    2. Cancro MP, D’Cruz DP, Khamashta MA. The role of B lymphocyte stimulator (BLyS) in systemic lupus erythematosus. J Clin Investig. 2009;119(5):1066-1073. 3. Maidhof W, Hilas O. Lupus: An overview of the disease and management options. Pharm Ther. 2012;37(4):240.

    NARRATOR:

    Lupus may manifest in 1 or multiple body systems, . . . such as the skin, . . . cardiovascular, pulmonary, . . . musculoskeletal, and renal systems, to name a few. Permanent organ damage can occur if lupus is not treated appropriately, which can have serious consequences for patients.

    ON-SCREEN TEXT: Skin Cardiovascular Pulmonary Musculoskeletal Renal

    REFERENCE: 

    1. American College of Rheumatology Ad Hoc Committee on Systemic Lupus Erythematosus Guidelines. Guidelines for referral and management of systemic lupus erythematosus in adults. Arthritis Rheum. 1999;42(9):1785-1796.
    2. Anders HJ, Saxena R, Zhao MH, et al. Lupus nephritis. Nat Rev Dis Primers. 2020;6(1):1-25.
    3. Cancro MP, D’Cruz DP, Khamashta MA. The role of B lymphocyte stimulator (BLyS) in systemic lupus erythematosus. J Clin Investig. 2009;119(5):1066-1073. 4. Heinlen LD, McClain MT, Merrill J, et al. Clinical criteria for systemic lupus erythematosus precede diagnosis, an associated autoantibodies are present before clinical symptoms. Arthritis Rheum. 2007;56(7):2344-2351.
    5. Lopez R, Davidson JE, Beeby MD, et al. Lupus disease activity and the risk of subsequent organ damage and mortality in a large lupus cohort. Rheumatol. 2012;51(3):491-498.

    NARRATOR:

    Inside the body, . . . B cells produce antibodies to help fight off infection. In lupus, autoreactive B cells produce autoantibodies that attack and destroy healthy tissues and organs, causing widespread inflammation.

    ON-SCREEN TEXT:

    Pathogen Antibodies B cell
    Inflammation Autoantibodies Autoreactive B Cell

    REFERENCE: 

    1. Cancro MP, D’Cruz DP, Khamashta MA. The role of B lymphocyte stimulator (BLyS) in systemic lupus erythematosus. J Clin Investig. 2009;119(5):1066-1073. 2. Maidhof W, Hilas O. Lupus: An overview of the disease and management options. Pharm Ther. 2012;37(4):240.
    3. Marieb EN, Hoehn K, eds. Human Anatomy & Physiology. 11th ed. Pearson Education, Inc; 2019.
    4. Mok CC, Lau CS. Pathogenesis of systemic lupus erythematosus. J Clin Pathol. 2003;56(7):481-490. 5. Murphy K, Weaver C. Janeway's Immunobiology. 9th ed. Garland Science; 2008.

    NARRATOR:

    In lupus nephritis, the immune system attacks and damages nephrons. Let’s take a closer look at how this happens.

    ON-SCREEN TEXT:

    Nephrons

    REFERENCE: 

    1. Anders HJ, Saxena R, Zhao MH, et al. Lupus nephritis. Nat Rev Dis Primers. 2020;6(1):1- 25.

    NARRATOR:

    In the blood, autoantibodies bind to anti-dsDNA and form immune complexes. One mechanism of tissue damage in lupus nephritis is the formation of immune complexes that accumulate and deposit in the filtration membrane formed by podocytes in the glomeruli, which impairs kidney function. The resulting inflammation leads to a buildup of waste in the blood and protein excreted in the urine (or proteinuria), which is a defining feature of lupus nephritis. This may ultimately lead to end-stage kidney disease that requires dialysis or kidney transplant. Low levels of complement proteins in lupus nephritis make it difficult to clear immune complex deposits.

    ON-SCREEN TEXT:

    Autoantibodies Plasma cells Immune complexes Podocytes
    Immune complex deposit Damage
    Complement

    REFERENCE:  

    1. Almaani S, Meara A, Rovin BH. Update on lupus nephritis. Clin J Am Soc Nephrol. 2017;12(5):825-835.
    2. Anders HJ, Saxena R, Zhao MH, et al. Lupus nephritis. Nat Rev Dis Primers. 2020;6(1):1-25.
    3. Crow MK. Etiology and pathogenesis of systemic lupus erythematosus. Kelley and Firestein's Textbook of Rheumatology. Elsevier; 2017;1329-1344.
    4. Davidson A, Berthier C, Kretzler M. Pathogenetic mechanisms in lupus nephritis. In: Dubois' Lupus Erythematosus and Related Syndromes. WB Saunders; 2013: 237-255.
    5. Lech M, Anders HJ. The pathogenesis of lupus nephritis. J Am Soc Nephrol. 2013;24(9):1357-1366.
    6. Marieb EN, Hoehn K, eds. Human Anatomy & Physiology. 11th ed. Pearson Education, Inc; 2019.
    7. Song K, Liu L, Zhang X, Chen X. An update on genetic susceptibility in lupus nephritis. Clin Immunol. 2020;210:108272.
    8. Toong C, Adelstein S, Phan TG. Clearing the complexity: immune complexes and their treatment in lupus nephritis. Int J Nephrol Renovasc Dis. 2011;4:17.

    NARRATOR:

    In treating lupus, with or without lupus nephritis, steroids can help control symptoms, but long-term use may also contribute to further organ damage. As a result, guideline and treatment recommendations suggest limiting their use or minimizing their dosage, leaving patients with few treatment options.

    ON-SCREEN TEXT:

    Continued damage

    REFERENCE: 
    1. American College of Rheumatology Ad Hoc Committee on Systemic Lupus Erythematosus Guidelines. Guidelines for referral and management of systemic lupus erythematosus in adults. Arthritis Rheum. 1999;42(9):1785-1796.
    2. Anders HJ, Saxena R, Zhao MH, et al. Lupus nephritis. Nat Rev Dis Primers. 2020;6(1):1-25.
    3. Fanouriakis A, Kostopoulou M, Alunno A, et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis. 2019;78(6):736-745.

    ON-SCREEN TEXT:

    BENLYSTA (belimumab) Intravenous Use 120 mg/vial Subcutaneous Use 200 mg/mL

    ©2021 GSK or licensor. BELVID220008 March 2022
    Produced in USA.
    Trademarks owned by or licensed to the GSK group of companies.

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