Lupus and the Brain
Public Lecture
John Hanly, Dalhousie University, Canada
12 May 2015, 11h00
Forum of the Faculty of Medicine, University of Strasbourg
Systemic lupus erythematosus, often abbreviated as SLE or lupus, is a systemic autoimmune disease in which the body’s immune system mistakenly attacks healthy tissue. When the immune system is functioning normally, it makes proteins called antibodies that protect against pathogens such as viruses and bacteria. Lupus is characterized by the presence of antibodies against a person's own proteins; these are most commonly anti-nuclear antibodies, which are found in nearly all cases. These antibodies lead to inflammation. Although the underlying cause of autoimmune diseases is unknown, most believe that lupus results from both genetic and environmental stimuli.
SLE often mimics or is mistaken for other illnesses. SLE symptoms vary widely and come and go unpredictably. Diagnosis can thus be elusive, with some people suffering unexplained symptoms of untreated SLE for years. SLE most often harms the heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system. The course of the disease is unpredictable, with periods of illness (called flares) alternating with remissions. The disease occurs nine times more often in women than in men. In France, nearly 50 people per 100 000 inhabitants is affected by Lupus, and there are an estimated 20,000 to 50,000 patients. SLE can be fatal, and there is no real cure; it is treated with immunosuppression and pain relief, to keep symptoms under control.
In about 75% of Lupus patients the brain is affected. The effects of Lupus on the brain are complex. They include headaches, cognitive dysfunction, depression, cerebrovascular events (i.e., stroke), seizures, polyneuropathy, anxiety, and psychosis. There are likely numerous different causes and pathways underlying these problems, including the effect of Lupus on blood vessels, which can affect blood flow to the brain. The blood/brain barrier that typically protects the brain against invasion of antibodies is weaker in patients with lupus, enabling certain autoantibodies to penetrate into the brain.
Due to technological innovations (e.g., in neuroimaging) the complex effects of Lupus on the brain can be studied in promising new ways. This will lead to new therapeutic approaches, more specific and effective with fewer side effects. However the study of lupus and the brain requires the combination of expertise from many different disciplines and domains, which makes it particularly challenging.
John Hanly, a world-renowned expert in the area of Systemic Lupus Erythematosus, will give a broad overview of the topic and present the recent important developments in the understanding and treatment of the effects of Lupus on the brain.
