Lupus

If our immune system attacks the insulin-producing cells in our pancreas, we can end up with type 1 diabetes. If it attacks our thyroid gland, we can end up with hypothyroidism. But, in the autoimmune disease lupus, our immune system attacks the very nucleus of our cells, often producing antibodies and attacking our DNA itself. So, lupus can damage any organ system and result in almost any complication. Women are nine times as likely to get it, and the peak age of diagnosis is too often at the peak of life. Hundreds of thousands, or even millions, of Americans suffer from this dreaded disease. One of the most common organ-threatening manifestations is kidney inflammation, occurring in as many as half of the patients.

Kidney inflammation is also one of the most serious effects of lupus, caused by the disease itself “or as a result of intense immunosuppressive drug toxicity.” Chemotherapy drugs like Cytoxan (cyclophosphamide), for example, can have severe, life-threatening side effects that may include leukemia and bladder cancer, and many women lose their hair and become permanently infertile. There is a desperate need for better treatment options.

vAutoimmun Rev. 2012 Dec;12(2):174-94. doi: 10.1016/j.autrev.2012.08.018. Epub 2012 Sep 8.

Lupus nephritis: a critical review.

Borchers AT1, Leibushor N, Naguwa SM, Cheema GS, Shoenfeld Y, Gershwin ME.

Author information

Abstract

Lupus nephritis remains one of the most severe manifestations of systemic lupus erythematosus associated with considerable morbidity and mortality. A better understanding of the pathogenesis of lupus nephritis is an important step in identifying more targeted and less toxic therapeutic approaches. Substantial research has helped define the pathogenetic mechanisms of renal manifestations and, in particular, the complex role of type I interferons is increasingly recognized; new insights have been gained into the contribution of immune complexes containing endogenous RNA and DNA in triggering the production of type I interferons by dendritic cells via activation of endosomal toll-like receptors. At the same time, there have been considerable advances in the treatment of lupus nephritis. Corticosteroids have long been the cornerstone of therapy, and the addition of cyclophosphamide has contributed to renal function preservation in patients with severe proliferative glomerulonephritis, though at the cost of serious adverse events. More recently, in an effort to minimize drug toxicity and achieve equal effectiveness, other immunosuppressive agents, including mycophenolate mofetil, have been introduced. Herein, we provide a detailed review of the trials that established the equivalency of these agents in the induction and/or maintenance therapy of lupus nephritis, culminating in the recent publication of new treatment guidelines by the American College of Rheumatology. Although newer biologics have been approved and continue to be a focus of research, they have, for the most part, been relatively disappointing compared to the effectiveness of biologics in other autoimmune diseases. Early diagnosis and treatment are essential for renal preservation.

PMID: 22982174 DOI: 10.1016/j.autrev.2012.08.018

[Indexed for MEDLINE]

https://www.ncbi.nlm.nih.gov/pubmed/22982174

Holistic Solution

oral supplementation of turmeric decreases proteinuria, hematuria, and systolic blood pressure—the cardinal clinical manifestations in patients suffering from relapsing or refractory (meaning, untreatable) lupus kidney inflammation––according to a randomized, double-blind, placebo-controlled study. The study looked at proteinuria, the spilling of protein into the urine, “an ominous prognostic sign.” In the control group, three people got better, three people got worse, and the rest pretty much stayed the same. In the turmeric group, one got worse, one stayed the same, but the rest all got better.

Note that the researchers used turmeric, the whole spice, and not curcumin, which is an extracted component often given in pill form. They took women with out-of-control lupus and had them take a quarter teaspoon of turmeric with each meal for three months. From my local supermarket, that would come out to be about a nickel a dose, compared with $35,000 a year for one of the latest lupus drugs. Which of the two treatments do you imagine doctors are more likely to be told about?

J Ren Nutr. 2012 Jan;22(1):50-7. doi: 10.1053/j.jrn.2011.03.002. Epub 2011 Jul 13.

Oral supplementation of turmeric decreases proteinuria, hematuria, and systolic blood pressure in patients suffering from relapsing or refractory lupus nephritis: a randomized and placebo-controlled study.

Khajehdehi P1, Zanjaninejad B, Aflaki E, Nazarinia M, Azad F, Malekmakan L, Dehghanzadeh GR.

Author information

Abstract

OBJECTIVE:

Despite highly expensive treatments, lupus nephritis remains a major cause of morbidity and mortality in patients with relapsing or refractory lupus nephritis. Meanwhile, experimental studies indicate that curcumin attenuates both the binding of autoantibodies from systemic lupus erythematosus patients to their cognate antigens and also the inflammatory responses of tumor necrosis factor-alpha-stimulated human endothelial cells. Therefore, in this study we investigated effect(s) of oral curcumin supplementation on patients suffering from relapsing or refractory lupus nephritis.

DESIGN:

A randomized and placebo-controlled study was carried out.

SETTING:

The present study was conducted in Lupus clinic of Hafez Hospital, Out-Patient Department of Shiraz University of Medical Sciences.

PATIENTS:

A total of 24 patients with relapsing or refractory biopsy-proven lupus nephritis, who were randomized in 2 groups (trial [n = 12] and control [n = 12] groups) were included in this study.

INTERVENTION:

With each meal, each patient in the trial group received 1 capsule for 3 months, which contained 500 mg turmeric, of which 22.1 mg was the active ingredient curcumin (3 capsules daily). The control group received 3 capsules (1 with each meal) for the same period, which contained starch and were identical in color and size to capsules given to patients in the trial group. MAIN AUTOMATIC MEASURE: Data were analyzed using Statistical Package for the Social Sciences software version 15.0.

RESULTS:

A significant decrease in proteinuria was found when comparing pre- (954.2 ± 836.6) and 1, 2, and 3 months supplementation values (448.8 ± 633.5, 235.9 ± 290.1, and 260.9 ± 106.2, respectively) in the trial group. Also, systolic blood pressure and hematuria were found to decrease significantly when pre- and post-turmeric supplementation values were compared in the trial group. However, placebo capsules did not exert any statistically significant effect on measured variables in the control group over 3 months of the study. No adverse effect related to turmeric supplementation was observed during the trial.

CONCLUSION:

Short-term turmeric supplementation can decrease proteinuria, hematuria, and systolic blood pressure in patients suffering from relapsing or refractory lupus nephritis and can be used as an adjuvant safe therapy for such patients.

Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

PMID: 21742514 DOI: 10.1053/j.jrn.2011.03.002

[Indexed for MEDLINE]

https://www.ncbi.nlm.nih.gov/pubmed/21742514

C W Schmidt. Questions persist: environmental factors in autoimmune disease. Environ Health Perspect. 2011 Jun;119(6):A249-53. Environ Health Perspect. 2011 Jun;119(6):A249-53.

A T Borchers, N Leibushor, S M Naguwa, G S Cheema, Y Shoenfeld, M E Gershwin. Lupus nephritis: a critical review. Autoimmun Rev. 2012 Dec;12(2):174-94.

E G Boyce, B E Fusco. Belimumab: review of use in systemic lupus erythematosus. Clin Ther. 2012 May;34(5):1006-22.

P Khajehdehi, B Zanjaninejad, E Aflaki, M Nazarinia, F Azad, L Malekmakan, G R Dehghanzadeh. Oral supplementation of turmeric decreases proteinuria, hematuria, and systolic blood pressure in patients suffering from relapsing or refractory lupus nephritis: a randomized and placebo-controlled study. J Ren Nutr. 2012 Jan;22(1):50-7.

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