Decorin is a protein coded for by the DCN gene. This protein is a component of the extracellular matrix, which is the intricate lattice of proteins and other molecules that forms in the spaces between cells. Decorin is found in the extracellular matrix of a variety of connective tissues, including skin, tendon, bone, and cartilage. Connective tissues support the body’s joints and organs. Decorin is involved in the organization of proteins called collagens. Collagens strengthen and support connective tissues throughout the body. Collagens also play an important role in the cornea, which is the clear outer covering of the eye. Bundles of collagen called fibrils must be strictly organized for the cornea to be transparent. Decorin ensures that these collagen fibrils are uniformly sized and regularly spaced.
A substance that blocks a type of enzyme called a kinase. Human cells have many different kinases, and they help control important functions, such as cell signaling, metabolism, division, and survival. Certain kinases are more active in some types of cancer cells and blocking them may help keep the cancer cells from growing. Kinase inhibitors may also block the growth of new blood vessels that tumors need to grow.
For reasons that doctors still don't understand, the immune system sometimes becomes confused, attacking the body itself, a condition known as autoimmune disease. With lupus,the immune system can attack any organ of the body, including the kidneys and brain, although skin and joints are often most affected, he said. Like many autoimmune diseases, it's more common in women.
Lupus nephritis is managed with a combination of glucocorticoids  and immunosuppressive agents to slow the progression to end-stage renal disease (ESRD), along with maintaining normal blood pressure levels (ie, target of ≤130/80 mm Hg). [61, 96] In general, individuals with class I or II lupus nephritis do not need management with immunosuppression. 
Disease that results when the immune system mistakenly attacks the body’s own tissues. Examples include multiple sclerosis, type 1 diabetes, rheumatoid arthritis, and systemic lupus erythematosus. Autoimmune diseases can affect almost any part of the body, including the heart, brain, nerves, muscles, skin, eyes, joints, lungs, kidneys, glands, the digestive tract, and blood vessels. The classic sign of an autoimmune disease is inflammation, which can cause redness, heat, pain, and swelling.
Toxic molds (mycotoxins) and heavy metals such as mercury are the two main toxins I see in those with autoimmune conditions. Mycotoxins are highly toxic substances produced by toxic molds. Only about 25% of the population carries the genes to be susceptible to the effects of mycotoxins.3 Conventional environmental mold testing only tests for levels of mold spores and does not test for mycotoxins. I use a urine mycotoxin test in my clinic to determine if someone has been exposed to toxic molds.
Peripheral neuropathy describes damage to the peripheral nervous system, the vast communications network that transmits information from the brain and spinal cord (the central nervous system) to every other part of the body. Peripheral nerves also send sensory information back to the brain and spinal cord, such as a message that the feet are cold or a finger is burned. Damage to the peripheral nervous system interferes with these vital connections. Like static on a telephone line, peripheral neuropathy distorts and sometimes interrupts messages between the brain and the rest of the body.
Lupus, a chronic autoimmune disorder that causes inflammation, creates a wide range of signs and symptoms. Systemic lupus erythematosus, the most common form of the condition, can potentially involve any major organ system of the body, says Neil Kramer, MD, co-medical director at the Institute for Rheumatic and Autoimmune Diseases at Overlook Medical Center in Summit, New Jersey. “Therefore, the first signs and symptoms vary from patient to patient.”
One common early symptom that can be indicative of lupus is a photosensitive rash, meaning a rash that develops in response to sun exposure, particularly on the face and upper arms, says Dr. Kramer. Other early symptoms are unexplained fever and pain, swelling, and stiffness of multiple joints. Complications such as inflammation of the lining surrounding the lungs or heart can also occur early on, he adds.
Patients with SLE should be educated to avoid triggers for flare. Persons with SLE should avoid ultraviolet light and sun exposure to minimize worsening of symptoms from photosensitivity. Diet modification should be based on the disease activity. A balanced diet is important, but patients with SLE and hyperlipidemia, for example, should be placed on a low-fat diet. Many patients with SLE have low levels of vitamin D because of less sun exposure; therefore, these patients should take vitamin D supplements. Exercise is important in SLE patients to avoid rapid muscle loss, bone demineralization, and fatigue. Smoking should also be avoided.
Describes a clinical study in which groups of participants receive one of several combinations of interventions. For example, a two-by-two factorial design involves four groups of participants. Each group receives one of the following pairs of interventions: 1) drug A and drug B, 2) drug A and a placebo, 3) a placebo and drug B, or 4) a placebo and a placebo. So during the trial, all possible combinations of the two drugs (A and B) and placebos are given to different groups of participants.
Systemic lupus erythematosus (SLE) is a complex multisystemic autoimmune disease resulting, oftentimes, in irreversible damage, diminished quality of life and reduced life expectancy.1–3 Genetic and environmental factors play important roles in its pathogenesis.4–8 Disease manifestations and severity vary according to the patients’ racial/ethnic background and socioeconomic status (SES).1 9 10 Data from Grupo Latino Americano de Estudio del Lupus (GLADEL), Lupus in Minorities: Nature vs Nurture (LUMINA) and the Lupus Family Registry and Repository cohorts have demonstrated that Latin American and North American Mestizo patients (mixed Amerindian and European ancestry), African descendants and Native Americans develop lupus earlier11 12 although diagnostic delays may occur.1 They also experience more severe disease, have higher disease activity levels,1 accrue more organ damage2 and have higher mortality rates,1 succumbing mainly to disease activity and/or infections.1 3 13–15
If you have lupus, you may experience dry mouth. Your eyes may feel gritty and dry, too. That’s because some people with lupus develop Sjogren’s disease, another autoimmune disorder. Sjogren’s causes the glands responsible for tears and saliva to malfunction, and lymphocytes can accumulate in the glands. In some cases, women with lupus and Sjogren’s may also experience dryness of the vagina and skin.
The authors reviewed the influence of nutritional factors on systemic lupus erythematosus (SLE) and discussed an alternative treatment option. The autoimmunity and inflammatory process of SLE are related to the presence of dyslipidemia, obesity, systemic arterial hypertension, and metabolic syndrome, which should be properly considered to decrease cardiovascular risk. A diet with moderate protein and energy content, but rich in vitamins, minerals (especially antioxidants), and mono/polyunsaturated fatty acids can promote a beneficial protective effect against tissue damage and suppression of inflammatory activity, in addition to helping the treatment of those comorbidities. Diet therapy is a promising approach and some recommendations may offer a better quality of life to patients with SLE.
According to the Mayo Clinic, “People with lupus should eat plenty of fruits, vegetables and whole grains. These foods are rich in vitamins, minerals and essential nutrients that benefit overall health and can help prevent high blood pressure, heart disease, kidney disease, cancer and digestive disorders. Plant-based diets also support a healthy weight because they are naturally low in calories, fat and cholesterol. Fruits and vegetables are particularly high in antioxidants. Antioxidants protect the body by destroying harmful substances that damage cells and tissue and cause heart disease and cancer.” Take a look at our blog, Lupus: the Diet Dilemma for some great tips. While these diets, or eating plans, may have some merit, individual foods should not be the focus. Pay attention to your overall pattern of nutrition. Reducing inflammation is not just about what you eat. Patients should also know that these diets are never meant to be a replacement for the lupus treatments they may already be taking under the close supervision of a medical professional. Until more research is in on the effectiveness of these diets, be practical by getting enough sleep and exercise, and try to maintain a healthy weight. Back to top
Researchers have made great progress in identifying people at-risk for lupus and the molecular markers (something found in cells that can predict lupus flares) that appear before the onset of symptoms. From these advances, scientists hope to generate early-intervention or even disease-prevention strategies. For people with established lupus, research is focused on designing new clinical trials that test drug candidates, which, if successful, could be combined with existing therapies. The Lupus Research Alliance is funding the most innovative research in the world, with the hope of finding better diagnostics, improved treatment and, eventually, a cure.
However, the mainstays of treatment are corticosteroids such as prednisone (Deltasone), hydrocortisone, methylprednisolone (Medrol), and dexamethasone (Decadron, Hexadrol). These drugs heavily suppress inflammation but can cause short-term side effects including swelling, increased appetite, and weight gain and long-term side effects including stretch marks on the skin, weakened or damaged bones, high blood pressure, damage to the arteries, diabetes, infections, and cataracts.
While there are no hard and fast rules when it comes to designing a lupus diet for yourself, try to include a wide-range of foods that contain antioxidants and fatty acids. Make sure you get enough iron and vitamins, especially vitamins C and D. Use coffee and tea in moderation. Avoid highly processed and preserved foods, and keep track of foods that seem to trigger your lupus symptoms.
Corticosteroids and immune suppressants: Patients with serious or life-threatening problems such as kidney inflammation, lung or heart involvement, and central nervous system symptoms need more “aggressive” (stronger) treatment. This may include high-dose corticosteroids such as prednisone (Deltasone and others) and drugs that suppress the immune system. Immune suppressants include azathioprine (Imuran), cyclophosphamide (Cytoxan), and cyclosporine (Neoral, Sandimmune). Recently mycophenolate mofetil has been used to treat severe kidney disease in lupus – referred to as lupus nephritis.
SLE is chronic and complex, and is often difficult to diagnose. First, there is no single laboratory test that can determine if a person has SLE. Second, many symptoms of SLE are similar to those of other diseases, and can come and go over weeks and months. Finally, doctors must look at a person’s medical history, rule out other diseases, and consider both physical and laboratory evidence before a SLE diagnosis. The symptoms of SLE vary from patient to patient.
Approximately 20% of people with SLE have clinically significant levels of antiphospholipid antibodies, which are associated with antiphospholipid syndrome. Antiphospholipid syndrome is also related to the onset of neural lupus symptoms in the brain. In this form of the disease the cause is very different from lupus: thromboses (blood clots or "sticky blood") form in blood vessels, which prove to be fatal if they move within the blood stream. If the thromboses migrate to the brain, they can potentially cause a stroke by blocking the blood supply to the brain.
Dozens of medications have been reported to trigger SLE. However, more than 90% of cases of "drug-induced lupus" occurs as a side effect of one of the following six drugs: hydralazine (Apresoline) is used for high blood pressure; quinidine (Quinidine Gluconate, Quinidine Sulfate) and procainamide (Pronestyl; Procan-SR; Procanbid) are used for abnormal heart rhythms; phenytoin (Dilantin) is used for epilepsy; isoniazid (Nydrazid, Laniazid) is used for tuberculosis; and d-penicillamine (used for rheumatoid arthritis
Arthritis is inflammation of one or more joints and it involves the breakdown of cartilage. Cartilage normally protects a joint, allowing it to move smoothly. Cartilage also absorbs shock when pressure is placed on the joint, such as when you walk. Without the normal amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness. Usually the joint inflammation goes away after the cause goes away or is treated. Sometimes it does not. When this happens, you have chronic arthritis. Arthritis may occur in men or women. Osteoarthritis is the most common type.
Acute cutaneous LE typically presents in the third decade of life and is frequently associated with active SLE. There are localized and generalized forms of ACLE. The localized form is the frequently described malar, or “butterfly” rash, which refers to erythema that occurs over both cheeks, extends over the nasal bridge, and spares the nasolabial folds. These lesions are classically transient, sun-induced, and non-scarring, although dyspigmentation can occur. Patients may initially mistake this rash for a sunburn, and only seek medical attention when it persists for several days. A fine surface scale and/or edema may be associated with the erythema. Malar rashes have been reported to be present in up to 52% of SLE patients at the time of diagnosis, with clinical activity of the rash paralleling that of the systemic disease. This rash can be confused with acne rosacea and seborrheic dermatitis, however the former is associated with the formation of papules and pustules, and the latter occurs within the nasolabial folds.
The GRADE approach was followed in the process (http://www.gradeworkinggroup.org) answering the clinical questions voted most relevant by the panel. The description of the methodology followed to develop these guidelines has already been published.29 All authors listed in this manuscript have participated in planning, drafting, reviewing, final approval and are accountable for all aspects of the manuscript. No ethical approval was required by institutions. We present the final recommendations and their supporting information. Comments from three patients with SLE were also considered.
A normal-range ANA titer in the context of organ system involvement that suggests systemic lupus erythematosus should prompt a work-up for alternative diagnoses. If no other cause is identified, the diagnosis of ANA-negative systemic lupus erythematosus and consultation with a rheumatologist should be considered. If patients with a normal ANA titer develop new clinical features that are consistent with systemic lupus erythematosus, ANA testing should be repeated.46 [Evidence level C, consensus/expert guidelines]
Processed foods Think of these as any food that comes from a box or a can. Processed foods are higher in fat, sugar, and salt (check the nutritional information for amounts). Refined foods are on this list, too — typical white bread, pasta, and white rice. Goldman Foung says that “by replacing processed goods, packaged foods, and takeout food with meals full of fresh ingredients,” her diet is “tastier and healthier.”
Mortality rates for systemic lupus erythematosus are particularly high in children. In a retrospective study26 of Brazilian children, overall mortality during 16 years of follow-up was 24 percent. Death occurred because of infection (58 percent), central nervous system disease (36 percent), and renal disease (7 percent). When disease onset was before the age of 15 years, renal involvement and hypertension predicted mortality.
Inflammation associated with lupus and other autoimmune reactions largely stems from an overactive immune system and poor gut health. Leaky gut syndrome can develop in those with lupus, which results in small openings in the gut lining opening up, releasing particles into the bloodstream and kicking off an autoimmune cascade. This inflammatory process can wind up increasing the risk for many conditions, including heart disease or hypertension, weight gain, joint deterioration, and bone loss, just to name a few. (5)
Inflammation of the kidneys caused by an autoimmune disease called systemic lupus erythematosus. The condition can cause hematuria and proteinuria, and it may progress to end-stage renal disease. The most severe form of lupus nephritis, called diffuse proliferative nephritis, can cause scars to form in the kidneys. Scars are permanent, and kidney function often declines as more scars form. Early diagnosis and treatment may help prevent long-lasting damage.
Most autoimmune diseases affect one specific system. For example, Rheumatoid Arthritis involves the joints, and Multiple Sclerosis affects the brain and spinal cord. Lupus, on the other hand, affects more than one system simultaneously. No matter what organ or system is being attacked, all autoimmune diseases are similar in that they are an immune response caused by systemic inflammation that leads your body to attack itself.
Environment Researchers suspect environmental factors may increase the risk of developing lupus. For example, exposure to sun can cause a lupus rash and some systemic lupus activity, says Stacy Ardoin, MD, a rheumatologist at the Ohio State University Wexner Medical Center in Columbus. Other environmental factors that may contribute to lupus can include some drugs, viral infections, exhaustion, stress, and anything that can cause physical stress to the body (such as surgery, physical harm, injury, pregnancy, or giving birth).
Lupus is a serious disease that can affect anyone. It is most often diagnosed in young women, between the ages of 15 and 44. While the cause is not known, lupus is an autoimmune disease – in which your immune system attacks healthy cells by mistake – that can potentially damage many parts of the body. There is no known cure for lupus, though effective treatments are available.
Foot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout), viruses, fungi, and bacteria (plantar warts and athlete's foot), or even ingrown toenails. Pain and tenderness may be accompanied by joint looseness, swelling, weakness, discoloration, and loss of function. Minor foot pain can usually be treated with rest, ice, compression, and elevation and OTC medications such as acetaminophen and ibuprofen. Severe pain should be treated by a medical professional.
However, this type of “specialized” treatment ignores the reality that all of your bodily systems are interconnected. Functional medicine, on the other hand, looks at the health of the entire body based on the fact that the health of one organ affects the function of the others. Rather than simply treating the symptoms, functional medicine aims to get at the underlying root causes of disease.
Elevation of the antinuclear antibody (ANA) titer to 1:40 or higher is the most sensitive of the ACR diagnostic criteria. More than 99 percent of patients with systemic lupus erythematosus have an elevated ANA titer at some point,21,41 although a significant proportion of patients may have a negative ANA titer early in the disease.2 However, the ANA test is not specific for systemic lupus erythematosus. A study41 involving 15 international laboratories found that ANA tests in the general population were positive in 32 percent of persons at a 1:40 dilution and in 5 percent of persons at a 1:160 dilution. Rates of positive ANA tests were not affected by age up to 60 years (the upper age limit of the study).41
In addition to prescribing medications, doctors may also recommend lifestyle changes to help manage lupus. These may include avoidance of sun exposure and paying more attention to managing stress to prevent lupus flares (periods of time when symptoms become problematic). People with lupus should also avoid smoking to help with heart and lung health, Kramer says.
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