Vegetarian or vegan diets are okay, but you need to take a multivitamin that includes vitamin B12, as this vitamin can only be obtained through animal products. Otherwise you might develop anemia and nerve damage. Also, it’s important to mix your sources of protein so that you get complete proteins – for example rice and beans, or corn and wheat. Animal proteins, dairy, and eggs are complete proteins, but vegetable proteins are generally low in one or more amino acids, which makes them inadequate as sole sources of protein.
For arthritic symptoms, take a natural anti-inflammatory agent, containing ginger and turmeric. Get the right kind of regular exercise; swimming or water aerobics are best for those who have arthritis symptoms. Investigate traditional Chinese medicine and Ayurvedic medicine, both of which often do well with autoimmune conditions. Definitely try one or more mind/body therapies, such as hypnosis or interactive guided imagery.
Blood and urine tests. The antinuclear antibody (ANA) test can show if your immune system is more likely to make the autoantibodies of lupus. Most people with lupus test positive for ANA. But, a positive ANA does not always mean you have lupus. If you test positive for ANA, your doctor will likely order more tests for antibodies that are specific to systemic lupus erythematosus (SLE).
Lupus is an inflammatory autoimmune disease that can affect multiple parts of the body including the various organ systems. Doctors prescribe traditional pharmaceutical medications to manage symptoms and prevent flare ups of the disease that can cause more serious problems and complications. Many patients choose to supplement their pharmaceutical care with alternative treatments and lifestyle adjustments like using diet and exercise to minimize lupus symptoms. We discuss this further in our  blog, Lupus/Chronic Illness: The Mind/Body Connection. There exists two major diets widely discussed in the autoimmune world. One is the anti-inflammatory diet and one is called the Paleo Diet.

The first mechanism may arise genetically. Research indicates SLE may have a genetic link. SLE does run in families, but no single causal gene has been identified. Instead, multiple genes appear to influence a person's chance of developing lupus when triggered by environmental factors. HLA class I, class II, and class III genes are associated with SLE, but only classes I and II contribute independently to increased risk of SLE.[45] Other genes which contain risk variants for SLE are IRF5, PTPN22, STAT4,[46] CDKN1A,[47] ITGAM, BLK,[46] TNFSF4 and BANK1.[48] Some of the susceptibility genes may be population specific.[46]


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. 
JAMES M. GILL, M.D., M.P.H., is director of the Health Services Research Group and associate program director of the family practice residency program at Christiana Care Health Services, Wilmington, Del. Dr. Gill received a medical degree from the University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, Piscataway, and a master of public health degree from Johns Hopkins University, Baltimore....
You may need to see different kinds of doctors to treat the many symptoms of lupus. Once you’re diagnosed, your primary physician for lupus is usually a rheumatologist, who treats arthritis and other diseases that cause swelling in the joints. The rheumatologist may then send you to a clinical immunologist for treating immune system disorders; a nephrologist (kidney disease); a hematologist (blood disorders); a dermatologist (skin diseases); a neurologist (the nervous system); a cardiologist (heart and blood vessel problems), and an endocrinologist (glands and hormones).
Drug-induced lupus erythematosus (DIL) Some drugs can cause lupus, resulting in symptoms such as rash, arthritis, hair loss, and fever. “Once medications are discontinued, the symptoms go away,” says Roberto Caricchio, MD, the interim section chief of rheumatology at Temple University Hospital in Philadelphia and the director of the Temple Lupus Clinic at the Lewis Katz School of Medicine.
Everett adds that eating fish for protein is particularly good. Fish — especially salmon, tuna, and mackerel — contain omega-3 fatty acids, which are important because they help fight inflammation, she says. Omega-3s, which are also available as supplements, may decrease your risk for heart disease. This may be especially important for women with lupus because they have at least double the risk of heart disease compared with women who don't have lupus, according to a review of studies published in August 2013 in Seminars in Arthritis and Rheumatism. “Lupus is an independent risk factor for heart disease, so you should maintain a heart-healthy diet that helps fight inflammation and keeps you at a healthy weight," Everett says.
Systemic lupus erythematosus (SLE), commonly known as "lupus," is an autoimmune illness. The immune system, which normally protects the body from foreign invaders and infection, malfunctions and instead attacks a person's own healthy body tissues. Its cause is unknown, but most scientists believe that genetics, combined with outside triggers (such as infections, medications or other environmental factors) lead people to develop lupus. Lupus is a lifelong condition, but symptoms tend to cycle in alternate periods of "flares" (or "flares-ups") and remissions. Lupus affects women much more than men. There is no known cure, but numerous treatments are available.
Proteinuria (also called albuminuria or urine albumin) is a condition in which urine contains an abnormal amount of protein. Albumin is the main protein in the blood. Proteins are the building blocks for all body parts, including muscles, bones, hair, and nails. Proteins in the blood also perform a number of important functions. They protect the body from infection, help blood clot, and keep the right amount of fluid circulating throughout the body.

“I have had severe lupus for over twenty years and find that diet doesn’t really change any symptoms. I eat meat, fish, dairy, gluten and sugar too…all in moderation. I eat lots of fruit and veg and avoid processed foods. The only thing I avoid is alcohol. I guess everyone is different but a well-balanced, healthy diet with exercise (when I’m up to it) is my formula.”


A. A healthy, young patient of mine once asked me what the chances were that she might one day develop a "terrible disease." When I asked her what she meant by "terrible disease," she surprised me: she didn't say a disease that could be fatal, but rather a disease that could attack every part of her body. By that definition, systemic lupus erythematosus (lupus for short) is, indeed, a terrible disease.
Systemic lupus erythematosus (SLE), a complex and heterogeneous autoimmune disease, represents a significant challenge for both diagnosis and treatment. Patients with SLE in Latin America face special problems that should be considered when therapeutic guidelines are developed. The objective of the study is to develop clinical practice guidelines for Latin American patients with lupus. Two independent teams (rheumatologists with experience in lupus management and methodologists) had an initial meeting in Panama City, Panama, in April 2016. They selected a list of questions for the clinical problems most commonly seen in Latin American patients with SLE. These were addressed with the best available evidence and summarised in a standardised format following the Grading of Recommendations Assessment, Development and Evaluation approach. All preliminary findings were discussed in a second face-to-face meeting in Washington, DC, in November 2016. As a result, nine organ/system sections are presented with the main findings; an ‘overarching’ treatment approach was added. Special emphasis was made on regional implementation issues. Best pharmacologic options were examined for musculoskeletal, mucocutaneous, kidney, cardiac, pulmonary, neuropsychiatric, haematological manifestations and the antiphospholipid syndrome. The roles of main therapeutic options (ie, glucocorticoids, antimalarials, immunosuppressant agents, therapeutic plasma exchange, belimumab, rituximab, abatacept, low-dose aspirin and anticoagulants) were summarised in each section. In all cases, benefits and harms, certainty of the evidence, values and preferences, feasibility, acceptability and equity issues were considered to produce a recommendation with special focus on ethnic and socioeconomic aspects. Guidelines for Latin American patients with lupus have been developed and could be used in similar settings.
A randomized, double-blind, placebo-controlled trial in 40 patients with juvenile-onset SLE suggests that cholecalciferol supplementation for 24 weeks is effective in decreasing disease activity and improving fatigue in these patients. Compared with the placebo group, patients receiving oral cholecalciferol 50,000 IU/week demonstrated significant improvement in Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores (P = 0.010) and European Consensus Lupus Activity Measurement (ECLAM) scores (P = 0.006), along with a reduction of fatigue related to social life, as measured by the Kids Fatigue Severity Scale (K-FSS) score (P = 0.008). [110]
The clinical manifestations of systemic lupus erythematosus are fundamentally the same in children and adults.15 In two descriptive studies25,26 of children with the disease, the most frequent manifestations were fever, rash, arthritis, alopecia, and renal involvement. Compared with adults, children have a higher incidence of malar rash, anemia, leukocytopenia,27 and severe manifestations such as neurologic or renal involvement.28
Make sure that you are drinking sufficient liquid, which may include water, coffee, tea, rooibos, fruit juice, cold drinks and moderate quantities of beer or wine. You need three litres or 10 x 300 ml cups of liquid a day in total. This does NOT mean that you should drink all your regular beverages and then add another extra three litres of water. Remember 10 cups/glasses of LIQUID a day are sufficient.

If your CBC comes back with high numbers of RBCs or a high hematocrit, it could indicate a number of other issues including lung disease, blood cancers, dehydration, kidney disease, congenital heart disease, and other heart problems. High WBCs, called leukocytosis, may indicate an infectious disease, inflammatory disease, leukemia, stress, and more. 
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Moderate use of alcohol is usually not a problem for people with lupus, but alcohol can lower the effectiveness of some medications, cause new health problems, and/or can make existing problems worse. For example, non-steroidal anti-inflammatory drugs -- such as aspirin, ibuprofen (Motrin®), naproxen (Naprosyn®), and celecoxib (Celebrex®) -- can cause ulcers and bleeding in the stomach and intestines at any time during treatment; the chance of developing an ulcer or internal bleeding increases with alcohol use. Also, anticoagulant medicines such as warfarin (Coumadin®) and the chemotherapy drug, methotrexate, may not be as effective if you are drinking alcohol.
Prednisone is used alone or with other medications to treat the symptoms of low corticosteroid levels (lack of certain substances that are usually produced by the body and are needed for normal body functioning). Prednisone is also used to treat other conditions in patients with normal corticosteroid levels. These conditions include lupus, certain types of arthritis; severe allergic reactions; multiple sclerosis (a disease in which the nerves do not function properly); and certain conditions that affect the lungs, skin, eyes, kidneys blood, thyroid, stomach, and intestines. Prednisone is also sometimes used to treat the symptoms of certain types of cancer.
Not all fats are unhealthy. Polyunsaturated fats and monounsaturated fats are the healthier fats compared to saturated fats. Some of these fats are high in anti-inflammatory properties and have a rich source of Vitamin E. Foods that contain unsaturated fats include; nuts, seeds, avocados, olive oil, soybean oil, and canola oil. It is important to understand that these fats are still high in calories - therefore, portions should be monitored. These fats, however, are preferred over saturated fats.
The panel decided to use the body of evidence provided by observational studies because it probably better reflects reality as the RCTs are severely flawed (indirectness of population as most patients were inadequately diagnosed with APS). The panel judged the observed reduction in arterial thrombosis with high-intensity AC as a large benefit, and the bleeding increase as a large harm. Also, it was noted that the observed basal risk (risk with LDA) of thromboembolic recurrence in patients with APS and arterial events was particularly high, compared with the risk of recurrence in patients with VTD.
Contraception and family planning are important considerations given the risks of disease flare with exogenous estrogens and pregnancy and with the teratogenic risks of some SLE drugs. Estrogen therapies have typically been avoided to prevent disease flares; progesterone-only contraception is more often considered. [144] However, studies have suggested that oral estrogen-containing contraceptives may not be associated with disease flares or thrombosis risk in patients with mild lupus without antiphospholipid antibodies. [52, 145]
Disease-modifying antirheumatic drugs (DMARDs). DMARDs do more than just treat the symptoms of lupus. Research has shown that they can modify the course of the disease, prevent progression and slow joint damage. DMARDs are often used with NSAIDs. Hydroxychloriquine commonly is prescribed for people with lupus. It can cause vision changes in some people, so it is important to have regular vision examinations. Hydroxychloriquine is effective in preventing flares.
  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
Angiogenesis is the growth of blood vessels from the existing vasculature. It occurs throughout life in both health and disease, beginning in utero and continuing on through old age. No metabolically active tissue in the body is more than a few hundred micrometers from a blood capillary, which is formed by the process of angiogenesis. Capillaries are needed in all tissues for diffusion exchange of nutrients and metabolites. Changes in metabolic activity lead to proportional changes in angiogenesis and, hence, proportional changes in capillarity. Oxygen plays a pivotal role in this regulation. Hemodynamic factors are critical for survival of vascular networks and for structural adaptations of vessel walls.
When Griffiths et al compared the corticosteroid-sparing effect of cyclosporine with azathioprine in patients with severe SLE, they concluded that azathioprine may be considered first-line therapy, whereas cyclosporine requires close monitoring of blood pressure and serum creatinine. However, the investigators noted that in patients who are unable to tolerate azathioprine, cyclosporine may be considered. [136]
Get involved in your care. Learn as much as you can about lupus, your medications, and what kind of progress to expect. Take all your medications as your doctor prescribes, and visit your rheumatologist often to prevent serious problems. This lets your doctor keep track of your disease and change your treatment as needed. If you do not live near a rheumatologist, you may need to have your primary care doctor manage your lupus with the help of a rheumatologist.
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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.
Dermatomyositis (DM) and polymyositis (PM): While almost all people with lupus have a positive ANA test, only around 30 percent of people with DM and PM do. Many of the physical symptoms are different as well. For instance, people with DM and PM don't have the mouth ulcers, kidney inflammation, arthritis, and blood abnormalities that people with lupus do.
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

“There are no foods that cause lupus and no foods that cure it, but eating a well-balanced diet may help combat some of the side effects of medications, as well as alleviate symptoms of the disease,” said Laura Gibofsky, MS, RD, CSP, CDN, a clinical nutritionist at the Hospital for Special Surgery in New York, New York. First, the “Western diet,” consisting of an excess of fatty, salty, sugary foods, has been implicated in autoimmune diseases overall.2 Proper nutrition can also help improve the risk of comorbid diseases that commonly affect patients with SLE.
The word Paleo means ancient or older. The Paleo diet, as its name states, is a diet based around focusing on foods that have been eaten by humans for thousands of years during their evolution. Foods that existed before the introduction of agriculture. These foods are fresh and free of any added preservatives, mainly consisting of vegetables and meats. Paleo advocates claim that this way of eating can improve all aspects of your health, including your weight, reduction of disease activity and prevention of some chronic diseases like heart disease and type 2 diabetes. The Paleo diet provides that we should be eating what heals and supports our immune system. This diet includes diet the following diet recommendations as shown in the above graphic:
Lupus is an autoimmune disease characterized by acute and chronic inflammation of various tissues of the body. Autoimmune diseases are illnesses that occur when the body's tissues are attacked by its own immune system. The immune system is a complex system within the body that is designed to fight infectious agents, such as bacteria and other foreign microbes. One of the ways that the immune system fights infections is by producing antibodies that bind to the microbes. People with lupus produce abnormal antibodies in their blood that target tissues within their own body rather than foreign infectious agents. These antibodies are referred to as autoantibodies.

Antimalarials are another type of drug commonly used to treat lupus. These drugs prevent and treat malaria, but doctors have found that they also are useful for lupus. A common antimalarial used to treat lupus is hydroxychloroquine. It may be used alone or in combination with other drugs and generally is used to treat fatigue, joint pain, skin rashes, and inflammation of the lungs. Clinical studies have found that continuous treatment with antimalarials may prevent flares from recurring.
Your gut is somewhat permeable to allow very small molecules (micronutrients) pass through the intestinal wall. It’s how you absorb your food. Many factors can damage your gut, including gluten, infections, medications and stress. This damage allows much larger particles such as toxins, microbes, and undigested food particles to “leak through” your gut and enter your bloodstream, triggering an immune response. We know from the research of Dr. Alessio Fasano that leaky gut is a necessary precursor to autoimmunity, meaning if you’re dealing with lupus, you also have a leaky gut. Not to mention, your gut is where nearly 80% of your immune system lives. So in order to overcome lupus, you must first repair your gut.
Limited evidence suggests that supplementation may be clinically beneficial in SLE patients with low levels of vitamin D. In Mediterranean patients,  female patients who were not receiving supplemental vitamin D showed more fatigue and received more oral corticosteroids than those with normal levels of vitamin D. [109] In Australian patients, an increase in serum vitamin D levels was associated with reduced disease activity over time. [152]
This diet is not intended for weight loss (although that can be a side effect). The anti-inflammatory diet is intended to provide steady energy, plenty of vitamins and minerals, and the essential fatty acids needed to maintain optimum health. You could look at this more like an eating plan for life as opposed to a diet per se. It is based on the general concept that eating to avoid inflammation promotes better health and can ward off diseases. According to Dr. Andrew Weil, the Harvard trained natural and preventative medicine physician (as seen on Oprah, and the Dr. Oz show,) there is clear evidence to support that inflammation can be very damaging to the body and he therefore openly supports the Anti-Inflammatory Diet. “We all know inflammation on the surface of the body as local redness, heat, swelling and pain. It is the cornerstone of the body’s healing response, bringing more nourishment and more immune activity to a site of injury or infection. But when inflammation persists or serves no purpose, it damages the body and causes illness. Stress, lack of exercise, genetic predisposition, and exposure to toxins (like secondhand tobacco smoke) can all contribute to such chronic inflammation, but dietary choices play a big role as well.” Both he and Barry Sears, MD, the author of the well-known Zone Diet both agree that this diet can have significant positive results on many diseases. Here are the basics of the anti-inflammatory diet (all versions vary, but this is the general proposal for all:
Alfalfa seeds and sprouts, green beans, peanuts, soybeans, and snow peas contain a substance that has been shown to trigger lupus flare-ups in some patients (although not all). Negative reactions caused by these foods experienced by lupus patients can include antinuclear antibodies in the blood, muscle pains, fatigue, abnormal immune system function and kidney abnormality. These symptoms are believed to be caused by the amino acid L-canavanine. (7)

Steroid medications such as prednisone can also cause significant weight gain and redistribution of fat stores in the body. While taking steroids, your cholesterol, triglyceride, and blood sugar (glucose) levels may increase. For these reasons, it is absolutely essential that you follow a low-fat, low-cholesterol diet. You do not need to cut out all of the foods you love, but concentrate on eating whole grain breads and cereals and lean sources of protein such as chicken and fish. When you need a snack, look to raw vegetables—they are low in sugar and calories and provide the perfect food for “grazing.” Try to eat them without Ranch dressing or vegetable dip, because these items carry lots of fat and calories. If you need something to accompany your vegetables, try lighter dips like hummus. It is also important that you minimize alcohol intake ,because combining alcohol with corticosteroids, Tylenol, warfarin, and other lupus medications could be very harmful to your liver and stomach. For those taking methotrexate, alcohol is never allowed.


(C) Positive finding of antiphospholipid antibodies based on (1) an abnormal serum level of IgG or IgM anticardiolipin antibodies, (2) a positive test result for lupus anticoagulant using a standard method, or (3) a false-positive serologic test for syphilis known to be positive for =6 months and confirmed by Treponema pallidum immobilization or fluorescent treponemal antibody absorption tests
Because lupus can produce a variety of symptoms in different individuals, it may take some time for a physician to actually make the diagnosis. Often a doctor will say that lupus might be present, but that the current symptoms are insufficient to signify a firm diagnosis. In this event, s/he will likely monitor the patient’s symptoms, signs, and lab tests closely over time and have him/her return for regular visits.
Alfalfa seeds and sprouts, green beans, peanuts, soybeans, and snow peas contain a substance that has been shown to trigger lupus flare-ups in some patients (although not all). Negative reactions caused by these foods experienced by lupus patients can include antinuclear antibodies in the blood, muscle pains, fatigue, abnormal immune system function and kidney abnormality. These symptoms are believed to be caused by the amino acid L-canavanine. (7)

Whole foods, especially the kinds high in probiotics, antioxidants and prebiotic fiber, can lower inflammation by increasing “good bacteria” in the gut, which help with absorption and defending against toxins or bad bacteria. High-antioxidant foods also have anti-aging effects even for those without lupus or another immune disorder because they fight free radical damage that degenerates cells and tissues.


As required by Section 801 of the Food and Drug Administration Amendments Act, in general, a description of any agreement between the sponsor of a clinical study and the principal investigator (PI) that does not allow the PI to discuss the results of the study or to publish the study results in a scientific or academic journal after the trial is completed. (This does not apply if the PI is an employee of the sponsor.)
B cells are essential for the development and pathogenesis of both systemic and organ-specific autoimmune diseases. Autoreactive B cells are typically thought of as sources of autoantibody, but their most important pathogenetic roles may be to present autoantigens to T cells and to secrete proinflammatory cytokines. A rate-limiting step in the genesis of autoimmunity then is the activation of autoreactive B cells. Here, mechanisms are discussed that normally prevent such activation and how they break down during disease. Integrating classic work with recent insights, emphasis is placed on efforts to pinpoint the precursor cells for autoantibody-secreting cells and the unique stimuli and pathways by which they are activated.

MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.


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