Lupus is a form of cancer

Pathogenesis

In lupus erythematosus, antigen-specific T and B lymphocytes lead to pathological (pathological) immune responses, which in turn lead to the formation of autoantibodies (antibodies that bind an endogenous antigen).

A possible trigger for systemic lupus erythematosus could be Enterococcus gallinarum. This is a motile bacterium belonging to the enterococcal genus. The intestinal bacterium was found in the liver, where it promotes the production of proteins that could trigger the autoimmune disease [1], Note: No human study; Model: mouse

Etiology (causes)

Biographical causes

  • Genetic strain
    • In juvenile systemic lupus erythematosus there is an index case (first documented case of a disease) in approx. 15% of the cases and a familial burden for autoimmune diseases in 40%
    • Genes / SNPs (single nucleotide polymorphism):
      • Genes: HLA-DQ1, IRF5, STAT4
      • SNP: rs7574865 in the STAT4 gene
        • Allele constellation: GT (1.55-fold)
        • Allele constellation: TT (2.4-fold)
      • SNP: rs2187668 in the HLA-DQ1 gene
        • Allele constellation: AG (2.3-fold)
        • Allele constellation: AA (2.3-fold)
      • SNP: rs2004640 in the IRF5 gene
        • Allele constellation: GT (1.4-fold)
        • Allele constellation: TT (1.4-fold)
        • Allele constellation: GG (0.9-fold)
      • SNP: rs13192841 in an intergenic region
        • Allele constellation: AG (0.7-fold)
        • Allele constellation: AA (0.5-fold)
    • Genetic factors, unspecified (systemic lupus erythematosus)

The following trigger factors (possible triggers) are known:

Behavioral trigger factors

  • nutrition
    • Micronutrient deficiency (vital substances) - see Prevention with micronutrients
  • Consumption of luxury foods

Disease-related trigger factors

Infectious and parasitic diseases (A00-B99)

  • Viral infections, unspecified

Neoplasms - tumor diseases (C00-D48)

  • Paraneoplastic - subacute cutaneous lupus erythematosus can occur in the context of cancer, especially gastric carcinoma, liver carcinoma, breast carcinoma (breast cancer), prostate carcinoma (prostate cancer), uterine carcinoma (uterine cancer), cancer of the head and neck, Hodgkin's skin lymphoma

Pregnancy, childbirth and the puerperium (O00-O99)

  • A worsening of the diagnostic situation during pregnancy is possible.

Other causes

  • Irritant stimuli
  • UV light - exposure to the sun, artificial light sources (solarium)

Drugs that are said to be associated with lupus erythematosus:

  • ACE inhibitors (antihypertensive drugs) - captopril, enalapril, lisinopril, cilazapril
  • Anti-estrogens such as anatrozole or tamoxifen
  • Beta blockers (antihypertensive drugs) - Acebutol, Oxprenolol, Practolol
  • Biopharmaceuticals (synonyms: Biopharmaka, Biologicals, Biologika or Biologics) - Etanercept, Efalizumab, Adalimumab, Infliximab
  • Bupropion (nicotine cessation drug)
  • Calcium channel blockers (antihypertensive agents) - diltiazem, verapamil, nifedipine, nitrendipine
  • Carbamazepine (anti-epileptic)
  • Quinidine
  • Chloropromazine (neuroleptic)
  • Docetaxel (chemotherapy drug)
  • D-penicillamine
  • Fluorouracil (chemotherapeutic agent)
  • Griseofulvin (mycotic)
  • Hepatitis B vaccination - said to cause cutaneous lupus erythematosus
  • HMG-CoA reductase inhibitors (statins) - simvastatin, pravastatin
  • Hydantoin (anti-epileptic) - no longer in use today
  • Hydralazine (antihypertensive)
  • Hydrochlorothiazide (HCT)
  • interferon
  • Isoniazid (tuberculostatic)
  • Live vaccines should not be used in cutaneous lupus erythematosus with immunosuppressive therapy
  • Leflunomide (immunosuppressant)
  • Leuprorelin - hormone preparation, which is mainly used in prostate cancer
  • Naproxen (analgesic)
  • Estrogens
  • Penicillamine
  • Phenytoin (anti-epileptic)
  • Piroxicam (non-steroidal anti-inflammatory drug, NSAID)
  • Procainamide (local anesthetic)
  • Proton pump inhibitors - lansoprazole, pantoprazole, omeprazole
  • Reserpine (antihypertensive)
  • Rifampicin (tuberculostatics)
  • Spironolactone (potassium-sparing diuretic)
  • Sulfasalazine
  • Terbinafine (antifungal agent) → subacute cutaneous lupus erythematosus (SCLE)
  • Ticlopidine hydrochloride (ADP-antagonizing platelet function inhibitor)

Koebner phenomenon

In the Koebner phenomenon, unspecific skin irritation triggers skin symptoms that already exist in another part of the body due to a skin disease.
The Koebner phenomenon can be triggered by the following skin irritations:

  • Argon laser treatment
  • DNCB (Dinitrochlorobenzene) sensitization
  • Performing electromyography - recording the electrical activity of the muscles can trigger the Koebner phenomenon in lupus erythematosus profundus
  • Scratch
  • Cryotherapy (cold treatment)
  • Moxibustion - a method from traditional Chinese medicine
  • Nickel contact dermatitis
  • Operative interventions
  • Smallpox vaccination
  • Radiation (radiation therapy)
  • tattoo
  • UVA emission from a photocopier
  • Burns
  • Wounds, bite wounds

literature

  1. Vieira SM et al .: Translocation of a gut pathobiont drives autoimmunity in mice and humans. Science 09 Mar 2018: Vol. 359, Issue 6380, pp. 1156-1161 doi: 10.1126 / science.aar7201
     
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