Systemic lupus erythematosus (SLE) is an autoimmune disease and as we know immune
system is vast and complex and presents an enormous challenge to scientists working in this field as well as presents a challenge to anyone seeking to explain where pathogenesis research stands at the end of 2011
An Integrative Approach to Environmental Intolerances, Multiple Chemical Sens...v2zq
An Integrative Approach to Environmental Intolerances, Multiple Chemical Sensitivity & Related Illnesses - Resources for Healthy Children www.scribd.com/doc/254613619 - For more information, Please see Organic Edible Schoolyards & Gardening with Children www.scribd.com/doc/254613963 - Gardening with Volcanic Rock Dust www.scribd.com/doc/254613846 - Double Food Production from your School Garden with Organic Tech www.scribd.com/doc/254613765 - Free School Gardening Art Posters www.scribd.com/doc/254613694 - Increase Food Production with Companion Planting in your School Garden www.scribd.com/doc/254609890 - Healthy Foods Dramatically Improves Student Academic Success www.scribd.com/doc/254613619 - City Chickens for your Organic School Garden www.scribd.com/doc/254613553 - Huerto Ecológico, Tecnologías Sostenibles, Agricultura Organica www.scribd.com/doc/254613494 - Simple Square Foot Gardening for Schools - Teacher Guide www.scribd.com/doc/254613410 - Free Organic Gardening Publications www.scribd.com/doc/254609890 ~
Here is a copy of the presentation that I gave to MRC CBU at Cambridge University on the 5th July 2017, essentially a summary of a book chapter of mine to be published later this year. The focus of my presentation was on connections between #self, #other and our #connections with the environment.
An Integrative Approach to Environmental Intolerances, Multiple Chemical Sens...v2zq
An Integrative Approach to Environmental Intolerances, Multiple Chemical Sensitivity & Related Illnesses - Resources for Healthy Children www.scribd.com/doc/254613619 - For more information, Please see Organic Edible Schoolyards & Gardening with Children www.scribd.com/doc/254613963 - Gardening with Volcanic Rock Dust www.scribd.com/doc/254613846 - Double Food Production from your School Garden with Organic Tech www.scribd.com/doc/254613765 - Free School Gardening Art Posters www.scribd.com/doc/254613694 - Increase Food Production with Companion Planting in your School Garden www.scribd.com/doc/254609890 - Healthy Foods Dramatically Improves Student Academic Success www.scribd.com/doc/254613619 - City Chickens for your Organic School Garden www.scribd.com/doc/254613553 - Huerto Ecológico, Tecnologías Sostenibles, Agricultura Organica www.scribd.com/doc/254613494 - Simple Square Foot Gardening for Schools - Teacher Guide www.scribd.com/doc/254613410 - Free Organic Gardening Publications www.scribd.com/doc/254609890 ~
Here is a copy of the presentation that I gave to MRC CBU at Cambridge University on the 5th July 2017, essentially a summary of a book chapter of mine to be published later this year. The focus of my presentation was on connections between #self, #other and our #connections with the environment.
Pathogenesis systemic lupus erythematosus by dr bashir ahmed dar associate pr...Prof Dr Bashir Ahmed Dar
Systemic lupus erythematosus is a chronic, multisystem, inflammatory disorder of autoimmune etiology, occurring predominantly in young women. Common manifestations may include arthralgias and arthritis; malar and other skin rashes; pleuritis or pericarditis; renal or CNS involvement; and hematologic cytopenias.
this research is made by a dental student (me) under supervision of our oral medicine specialist dr. muhassad almudhafer and this research is collected from several articles hope u like it
this my email if u would like to contact me - mnmmnz4503.mm@gmail.com
SLE is an autoimmune disease resulting in butterfly rash and various other symtoms,a brief introduction and diagnosis and causes are mentioned in this ppt.
This project was developed for a competitive intelligence company by mining data from the various information sources e.g. Company (News, Investor Section, SEC filings, Annual Reports, Presentations etc), Universities/Medical Schools/Organizations, Medical Affairs Companies, Non- Profit Medical Agency, Government Agencies, Drug Delivery Companies, Contract Manufacturing Organizations, Contract Research Organizations, Consultancies and Financial Institutions. The complete information available there complied into a single MS word document, listed in MS Excel and then by using MS publisher it was converted into the report which finally converted into PDF.
Systemic means affects multiple organs.
Lupus is the Latin word for wolf meaning disease affecting skin where the skin lesions look like wolf bite.
Erythematosus means reddening of the skin.
Systemic Lupus Erythematosus or SLE, sometimes also called just lupus is a disease that’s systemic and affects a wide variety of organs, but notably often causes red lesions on the skin.
Systemic Lupus Erythematosus(SLE) is a chronic, nonspecific autoimmune inflammatory disease that typically affects multiple organs and systems, including the skin, joints, muscles, lungs, heart, kidneys, and the CNS and circulatory system.
Individuals with SLE are noted with the production of antibodies and inflammatory responses that are mistakenly directed at their own tissue.
Similar to Research article on SLE by Prof Dr Bashir Ahmed Dar Sopore Kashmir (20)
Localization of brainstem lesion by Prof Dr Bashir Ahmed Dar Sopore KashmirProf Dr Bashir Ahmed Dar
Localizing neurological lesions in the brainstem can be very precise, it relies on a clear understanding on the functions of brainstem .Brainstem lesions usually produce cranial nerve palsy one one side and hemiplegia or hemiparesis on other side
The main aim of this slide presentation is to localize abnormal neurological findings to their main site of origin within the nervous system. After reading the presentation the doctor should be able to localise neurological disorders to their main site of origin.if you fail to identify the clinical signs correctly, then you will be unable to identify where the problem is.Read my slide presentation on localization of brainstem lesion which i will upload very soon
Taking the patient's history is traditionally the first step in virtually every clinical encounter. A thorough neurologic history allows the clinician to define the patient's problem and, along with the result of physical examination, assists in formulating an etiologic and/or pathologic diagnosis
Taking the patient's history is traditionally the first step in virtually every clinical encounter. A thorough neurologic history allows the clinician to define the patient's problem and, along with the result of physical examination, assists in formulating an etiologic and/or pathologic diagnosis
Doctors need to be aware of a rare, hard to diagnose condition called Porphyria. To reach an accurate diagnosis of Porphyria a crystal clear understanding is needed
Doctors need to be aware of a rare, hard to diagnose condition called Porphyria. To reach an accurate diagnosis of Porphyria a crystal clear understanding is needed
Thalassemia (British English: thalassaemia), also called Mediterranean anemia, is a form of inherited autosomal recessive blood disorder characterized by abnormal formation of hemoglobin
Facial nerve disorders can be caused by infection, injury or other conditions.Facial nerve disorders can cause weakness on one or both sides of the face. Those affected may experience loss of facial expression and also difficulties with eating, drinking and clarity of speech. Closing of the eye and blinking can also become difficult.
Facial nerve disorders can be caused by infection, injury or other conditions.Facial nerve disorders can cause weakness on one or both sides of the face. Those affected may experience loss of facial expression and also difficulties with eating, drinking and clarity of speech. Closing of the eye and blinking can also become difficult
OBESITY AND WEIGHT LOSS SURGERY, HOW MUCH BENEFICIAL AND SAFE?BY DR MANZOOR A...Prof Dr Bashir Ahmed Dar
Obesity is recognized as a global health crisis. Weight loss surgery offers a treatment that can reduce weight, induce remission of obesity-related diseases, and improve the quality of life. This review summarizes recent evidence related to the safety, efficacy, and metabolic outcomes of weight loss surgery for morbid obesity. The article also highlights various issues when lifestyle modifications and weight loss medications have failed to provide significant weight loss in the majority of obese people.
Research article on anti aging tool by Prof Dr Bashir Ahmed Dar Sopore KashmirProf Dr Bashir Ahmed Dar
A research article HbA1c:A Biomarker of Anti Aging By Prof Dr Bashir Ahmed Dar Chinki Pora Sopore Kashmir
Glycosylated hemoglobin (HbA1c) is a marker of evaluation of long-term glycemic control in diabetic patients that predict risks for the development and progression of diabetic complications. The aim of this study is to evaluate the significance of Glycosylated hemoglobin (HbA1c) in relation to aging
A research article Fountain of Youth by Prof Dr Bashir Ahmed Dar Sopore KashmirProf Dr Bashir Ahmed Dar
Calorie restriction (CR) is as close to a real fountain of youth as any known technique is. Caloric restriction known to extend the human lifespan by up to five years has quietly become accepted among leading researchers. Even scientists who are cautious about anti-aging hype say it works
HYPERTHYROIDISM PART-2 BY DR BASHIR ASSOCIATE PROFESSOR MEDICINE SOPORE KASHMIRProf Dr Bashir Ahmed Dar
Read hyperthyroidism part-1 and part-2 for better understanding of the subject.Consulted many books and available litrature on the subject
brought their points together to produce precise simple easy to understand slide presentation.Thankful to all these masters.If you need a copy to download just message me on the email drbashir123@gmail.com.Your comments on the site is highly appreciable and welcome, gives me some feedback to improve my work in future
HYPERTHYROIDISM PART-1 BY DR BASHIR ASSOCIATE PROFESSOR MEDICINE SOPORE KASHMIRProf Dr Bashir Ahmed Dar
This slide presentation on hyperthyroidism is divided into two parts.Part-1 deals with causes of hyperthyroidism.I have tried to explain and give clear understanding about the causes of hyperthyroidism which to my knowledge is made very simple and easily understandable.
Part-2 deals with signs symptoms and treatment.Treatment part has been explained in detail.I hope you will enjoy reading it.
ANTI THYROID DRUGS BY DR BASHIR ASSOCIATE PROFESSOR MEDICINE SOPORE KASHMIRProf Dr Bashir Ahmed Dar
The thyroid gland is the biggest gland in the neck. It is situated in the anterior part of the neck below the skin and muscle layers. The thyroid gland takes the shape of a butterfly with the two wings being represented by the left and right thyroid lobes which wrap around the trachea. The sole function of the thyroid is to make thyroid hormone. This hormone has an effect on nearly all tissues of the body where it increases cellular activity. The function of the thyroid, therefore, is to regulate the body's metabolism
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
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Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Research article on SLE by Prof Dr Bashir Ahmed Dar Sopore Kashmir
1. Contents lists available at BioMedSciDirect Publications
Journal homepage: www.biomedscidirect.com
International Journal of Biological & Medical Research
Int J Biol Med Res. 2012; 3(4):2671-2674
Poorly understood pathogenesis of Systemic Lupus Erythematosus
Bashir Ahmed Dar
A R T I C L E I N F O A B S T R A C T
Keywords:
Review Article
Pathogenesis
SLE
Controversies
BioMedSciDirect
Publications
International Journal of
BIOLOGICAL AND MEDICAL RESEARCH
www.biomedscidirect.comInt J Biol Med Res
Volume 3, Issue 1, Jan 2012
Department of Medicine, Melaka Manipal Medical College, Jalan Batu Hampar, Bukit Baru, Melaka, Malaysia -75150
1. Introduction
Review criteria
Differences in research results
An autoimmune disorder like SLE is a growing problem
worldwidedueitscomplexaetiologyandpathogenesis.Geneticand
exogenous factors such as the stress, trauma, drugs and
environmental toxins are associated with pathogenesis of SLE.
Often linked to hormonal imbalances and chronic inflammation
that stress the immune system and cause improper immune
responses. These improper immune responses are directed to the
endogenous normal cells and tissues. Pathogenic mechanisms are
poorly understood. Nonetheless, increasing evidence suggests that
many of these illnesses result from large number of factors in
geneticallysusceptibleindividuals.
Lupus is a life-altering and life-threatening disease” says
Catherine Madden, Executive Director of Lupus Canada. “This
incurable disease impacts and destroys many organs in the body.
Lupus is seriously fatal disease, but dedication to new research
fuels our hope for a cure. Known as the “disease with 1000 faces, its
symptoms vary so greatly from person to person. The symptoms of
lupus often mimic other illnesses, and it can attack any tissue or
organ in the body including skin, muscles, joints, blood and blood
vessels, lungs, heart, kidneys and the brain. Common and often
chronic symptoms of lupus include joint pain and inflammation,
skin rashes, sun sensitivity, extreme fatigue, fever, chest pain and
hair loss. Because of the varied symptoms, lupus can be extremely
difficulttodiagnose.
This review highlights different contradictory research results
that form the basis why there is no complete cure of the disease.
These include the complexity of the disease itself; the lack of
reliable outcome measures; our limited understanding of the
pathogenesis of the disease; the propensity of lupus patients to
have bad outcomes and to react to medicines in unusual ways; the
heterogeneity of the patient population; the unpredictable course
of disease in individual patients; and the lack of reliable
biomarkers. I systematically searched number of articles,
webpages,andmajortextbooksforpathogenesisofSLE.Allpapers
identified were English-language, full manuscripts. I also searched
the reference lists of identified articles for additional relevant
papers.
Systemic lupus erythematosus (SLE) is a chronic multisystem
autoimmune disease [1]. There are controversies and lack of
understanding in the pathogenesis of systemic lupus
erythematosus. Autoantibodies are formed in systemic lupus
erythematosus that react with self antigens of the body. Number of
challenges and controversies persist concerning their origin,
clinicalusefulnessandrelevance[2].
Systemic lupus erythematosus (SLE) is an autoimmune disease and as we know immune
system is vast and complex and presents an enormous challenge to scientists working in this
field as well as presents a challenge to anyone seeking to explain where pathogenesis research
stands at the end of 2011. Because of this vast and complex nature of immune system the
pathogenesis of SLE is incompletely defined and understood. The aim of this study is to
highlight areas of differences among researchers in explaining pathogenesis of systemic lupus
erythematosus so as to clear the confusion in future researches so as to bring a degree of
uniformity. This uniformity is vital to gain full understanding of the disease so as to design
therapiesthatmightameliorateharmfuleffectsofthisdisease.
Copyright 2010 BioMedSciDirect Publications IJBMR - All rights reserved.ISSN: 0976:6685.c
* Corresponding Author : Bashir Ahmed Dar
Melaka Manipal Medical College
Jalan Batu Hampar, Bukit Baru,
Melaka, Malaysia -75150
drbashir123@gmail.com
Copyright 2010 BioMedSciDirect Publications. All rights reserved.c
2. Bashir Ahmed Dar et.al Int J Biol Med Res. 2012; 3(4): 2671-2674
The role of IL-6 in the pathogenesis of SLE is also controversial.
Some authors found elevated IL-6 levels in cases with increased C-
reactive protein, concluding that it is part of the acute phase
response, [3]. However others found high levels in the
cerebrospinal fluid in cases with CNS involvement-3.Many authors
reported that serum TNF a - is clearly elevated and was found to
correlate with SLE disease activity, [4] others reported increased
levels only in a minority of patients with active SLE that correlates
withthrombocytopenia.
There is also silicone breast implant controversy associated
with SLE. Studies of systemic lupus erythematosus (SLE) and
systemic sclerosis did not show an association with silicone breast
implants, but studies of symptoms did [5-10]. Because of a lack of
consistency in methodology of symptom searches and in study
findingssomereviewersdonotbelievethereisfiretobefound[11].
Since then, a Dow Corning-funded study and documented that 28
symptoms were increased in silicone patients [5]. In a comparison
study, there was a statistical correlation between local problems
and systemic problems. Despite so many studies, there is no
scientific evidence that definitively links silicone or saline breast
implants with connective tissue or autoimmune diseases such as
lupus. Stress such as surgical procedures can trigger lupus flares, so
this must be factored into the assessment of risk and benefits of the
procedure.
Some authors have reported specific headache disorder in
patients suffering from SLE [11]. Critics of this concept argue that
there are no quality studies showing that headaches in patients
with SLE differ from those in the general population. A detailed
definition of the term lupus headache is lacking, since the terms
"severe" and "persistent" are not quantified. Headache due to lupus
requires evidence of a disease flare accompanying the headache,
and resolution of the headache with immunosuppressant
treatment. However, a meta-analysis found no correlation between
headachesanddiseaseactivity[12].
An additional frustration relates to the fact that many of the
symptoms of lupus are the sorts of aches, pains, and fatigue that are
common among people who don't have lupus. People with lupus
are, therefore, faced with further uncertainty: Is their symptom
related to lupus, or can it be chalked up to aging or a completely
unconnected ailment? SLE is accompanied by several features that
can be attributed to involvement of the central or peripheral
nervous system. The aetiology and pathogenesis of these
manifestations are mostly unknown. To which degree these
neuropsychiatric conditions can be explained on the basis of
chronic illness, or as part of the disease spectrum of SLE, is also a
matterofdebate.
Better understanding of the pathogenesis of cerebral lupus will
comefromthestudyofexperimentalmodels,asithasbeenpossible
to develop an antiphospholipid antibody syndrome in mice.
Because no specific laboratory test for CNS lupus is yet
available, diagnosing the condition remains a challenge to every
clinician. Techniques including neuropsychometric testing,
quantitative EEG, and SPECT scans have taught us more about
cognitive dysfunction and psychosis in patients with SLE. These
categoriesremainthemostdifficulttodefine[13].
In the present literature there is still controversy as to whether
patients with SLE are at increased risk of developing malignant
diseases. In recent years a number of epidemiological studies have
been conducted and some have suggested an association between
SLEandmalignantdiseaseswhileotherstudieshavenot[14].
One of the hallmarks of SLE is the lossof tolerance to chromatin.
Thegenesandmechanismsthattriggerthislossoftoleranceremain
unknown[15].
One important feature of this disease is a strong female
predominance with female to male ratio of approximately 9:1 [16].
This ratio is reduced in pre-adolescent and post-menopausal
females, suggesting a critical role for sex hormones [17-18] .Studies
haveshownthat femalesexhormonesincludingoestrogenincrease
the incidence and severity of disease whereas loss of oestrogen
and/or the addition of androgens alleviate or reduce clinical
features of the disease. To date it remains unclear what cellular
events distinguish the female immune response from the male
immuneresponseresultinginthissex-baseddisparity[17].
Shrinking lung syndrome (SLS) is an infrequently reported
manifestation of systemic lupus erythematosus (SLE). However
Pathogenesis is not fully understood [19]. Clearly SLE is a largely
genetically based, as has been apparent for a number of decades
based on identical twin studies [20]. Nevertheless, these important
advances have so far not allowed us to clarify the underlying
pathogenic mechanisms. Thus, the genetic analyses, in their
complexity, have failed to give us clear directions for targeted
therapydevelopment.
What else then contributes to disease development, beyond the
underlying genetic risks? The textbooks always list environment as
an important factor, but in fact only UV light has been generally
accepted as a contributing element, although recent data also
suggest that a nearly–ubiquitous virus, EBV, might also play a
facilitatingrole[21-26].
There is a paradoxical role for complement in lupus
pathogenesis. On one hand, active disease is associated with
activation of the classical complement pathway [27, 28]. It is
generally believed that autoantibodies within circulating immune
complexes fix and activate complement, contributing to tissue
damage. Similarly, in murine models of the disease IgG2a
autoantibodies are of particular importance to disease pathology
because of their ability to fix complement [29]. Conversely, it has
2672
3. been shown that individuals with a homozygous deficiency in
componentsoftheclassicalpathwayofcomplementactivationare
at increased risk of developing SLE. Specifically, individuals who
arehomozygousdeficientfortheC1complexproteins(C1q,C1r,or
C1s), and C4 have a greater prevalence of disease and develop a
more severe disease [30, 31]. Individuals deficient for C2 are at
greater risk for SLE, though less so than those deficient in C1 or C4
[32]. Additionally, other health conditions that result in very low
complement levels may predispose individuals to SLE [33]. It is
not clear how complement can have these two contradictory roles
inlupuspathogenesis.
To make matters even worse, not only are lupus patients
complicated, diverse, and difficult to predict, but as a group they
seem to respond differently to new therapies. Our experience with
rituximabisillustrative[34,35].
The development of several novel compounds has been
pursued for lupus, but so far nothing has been proven to be
curative.
The reason being poorly understood pathogenesis of SLE as
notedintheabovestudies.
It requires significant additional research efforts and
dedicated resources over an extended period; this will eventually
provide the understanding of pathogenesis of SLE and ultimately
enablethecureofthedisease.
· Immune system is vast and complex and presents an
enormouschallengetoscientistsworkinginthisfield.
· SLE is auto-immune disease with thousands of faces of
presentation; Pathogenesis of SLE is not clearly understood as
evidentinthisarticle.
· Unanimous opinion regarding is pathogenesis is father
neededinfuture
Current Research Questions
Key Messages
References
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