LUPUS – Systemic lupus erythematosus

LUPUS
Definition

Lupus, Systemic lupus erythematosus (SLE), is a systemic autoimmune disease, meaning that the body's natural defense system, the immune system, attacks normal, healthy tissues, resulting in inflammation. While some people with lupus may have only mild symptoms, the disease can develop over time and become a severe, even life-threatening, chronic disease affecting joints, skin, kidneys, blood, the heart, and lungs. This video gives a good overview of Lupus

Lupus is difficult to diagnose, as it can affect besides the skin, many different parts of the body like the joint, and very often the kidneys, but also the heart and lungs. There is, unfortunately, no cure for lupus, but treatments may help to control the various symptoms. Lupus may be even triggered by infections, with certain drugs or even sunlight, but specific therapies can help to manage symptoms.

Symptoms

Signs and symptoms of Lupus are very unsteady and develop slowly or even may come on suddenly in a mild or severe form, and can become permanent or only temporary, resulting in, that there are no two cases of lupus precisely alike. Patients are often affected by flairs; these are sudden worsening periods of the disease, although after that patients usually have the feeling the disease may be passed, because it may disappear entirely, however, unfortunately, its just only for a time. Although, the majority of people with lupus can expect a normal or near-normal life expectancy if they follow a healthy lifestyle and diagnosed and treated with medication on a regular basis to reduce its symptoms. Patients diagnosed with lupus have been living with the disease for up to 40 years according to research in this field.

Common symptoms and signs include:

  • Fever
  • Fatigue
  • Chest pain
  • Shortness of breath
  • Weight gain
  • Joint pain, stiffness, and swelling
  • Headaches, confusion and memory loss
  • The Raynaud's phenomenon, where Fingers and toes turn white or blue when exposed to cold or during stressful periods
  • Rashes in the form of a Butterfly on the face that bridges the nose and covers the cheeks or appear elsewhere on the body
  • Skin lesions that appear or worsen with sun exposure due to high photosensitivity of the skin
  • Dry eyes

Although the cause of lupus might be genetic, in most cases, it is however unknown. Lupus can be activated via Infections, also causing potential relapses or:

  • Sunlight, may cause skin lesions or trigger an unwanted internal immunoreaction.
  • Medications like certain types of blood pressure medications, anti-seizure medications and antibiotics can trigger lupus, and usually, patients get better when they stop taking those drugs.

Inflammation caused by lupus, unfortunately, weakens the immune system further. Due to its chronic nature, Lupus can affect many areas of a body. It potentially can cause, Kidney failure, headaches, dizziness, behavior changes, vision problems, and even strokes or seizures, lung problems and heart failure, Bone tissue death (avascular necrosis), Pregnancy complications, and even cancer.

Treatment


Because symptoms and signs vary considerably from person to person, diagnosing lupus is difficult, as it furthermore over time overlaps with those conditions of many other diseases.

Only the combination of urine and blood tests, the physical examination of signs and symptoms may lead to a correct diagnosis.  As symptoms and signs flare and subside, it is necessary to change medications or dosages over time. Most commonly used medication to control lupus include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), used to treat pain, swelling, and fever associated with lupus, unfortunately, as a side effect may result in stomach bleeding, kidney problems and an increased risk of heart problems.
  • Antimalarial drugs, may support the decrease the risk of lupus flares. Side effects can include stomach upset and, very rarely, damage to the retina of the eye.
  • Corticosteroids, like Prednisone, can reduce the inflammation of lupus. To control better serious lupus disease, that involves the kidneys and brain, often results in a higher dosage of appropriate medication and longer-term therapy. This therapy, unfortunately, comes with side effects, which may include weight gain, high blood pressure, diabetes, easy bruising, thinning bones (osteoporosis), and a further increased risk of infection.
  • Immunosuppressants may be helpful in more severe cases of lupus, and also here it is crucial to control well potential side effects, which may include liver damage, an increased risk of infection, decreased fertility and an even an increased risk of cancer.
  • Biologics (belimumab/Benlysta) usually administered intravenously, may in some cases reduce their lupus symptoms. Side effects include nausea, allergic reaction, diarrhea, and infections. Rarely, worsening of depression can occur.
  • DMARDs are disease-modifying drugs like methotrexate and are prescribed for rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, juvenile idiopathic arthritis or lupus. Side effects include inflammation of the mouth and lips, vomiting, nausea, upset stomach, dizziness, headache, tired feeling, blurred vision, and leukopenia (low number of white cells in blood).

Simple measures can help you to reduce lupus flares like:

  • Having regular medical reviews instead of only seeing your physician when your symptoms worsen. This may help your doctor to potentially prevent flare-ups, by addressing early health concerns, such as stress, by reviewing diet and exercise that may be helpful in avoiding lupus-related problems.
  • Because ultraviolet light can trigger a flare in lupus patients, it is important to be sun smart by wearing protective clothing, such as long pants, long-sleeved shirt, and a hat. Also, the use of sunscreens will support your skin when taking a sun protection factor (SPF) of at least 55 always when going outdoors.
  • Regular exercise may help to keep bones healthy, reduce the risk of heart failures and promote general well-being.
  • A healthy diet emphasizing on fruits, vegetables, and whole grains can be supportive of controlling Lupus.
  • As smoking increases the risk of cardiovascular disease and can worsen the effects of lupus on your heart and blood vessels, it is highly suggested to quit smoking.
  • Reviewing regularly the Vitamin D level and use supplements rich in vitamin D and calcium are considered supportive to lupus condition. According to the Coimbra therapy, it is even recommended that people with lupus may benefit from taking a high dosage of vitamin D.

Sometimes patients with difficult to treat conditions, like lupus seek help in alternative or complementary medicine. Most of these therapies are, however, still under investigation, although some may help to ease symptoms of the disease.

It is always recommended to discuss these treatments with your doctor before initiating them as it is crucial to review benefits and risks carefully and see if such a treatment will interfere adversely with the current lupus therapy. Complementary and alternative treatments for lupus may include:

  • Fish oil supplements, containing omega-3 fatty acids have shown in preliminary studies, that it may be beneficial for patients with lupus. Only a few, less serious side effects of fish oil supplements had been reported, which may include belching, nausea, and a fishy taste in the mouth.
  • Dehydroepiandrosterone (DHEA) is a hormone which may help fatigue and muscle pain. Such a hormone therapy may, however, lead to acne in women.
  • Acupuncture is using tiny needles, which may help ease the muscle pain associated with lupus.
  • Cellular therapy, by using Mesenchymal stem cells had been investigated in the last years with interesting results, which improved the conditions in anecdotal studies without serious side effects.
Cellular Treatments

Stem cells, serve as the repair system of our cellular structure, as they have the natural capability to differentiate into various types of cells in the body.  Adult stem cells, so-called Mesenchymal stem cells are found in many mature tissues, like fat or bone marrow, but also in umbilical cord tissues and blood.  In recent years clinical research and investigational treatment for Systemic lupus erythematosus often involves mesenchymal stem cells.

In our treatment concept, we are using Mesenchymal stem cells and inject them intravenously into the bloodstream and in accordance with the medical review also via lumbar puncture placed in the spinal column.

Our tentative protocol for Lupus conditions is as follows and will be reconfirmed upon the clinical evaluation of the patient at the time of admission.

  • 1st day – Admission process, ICF process, Basic Investigative tests and one Intravenous injection (IV)
  • 2nd day – one injection as Lumbar puncture (LP)
  • 3rd day – Rest day
  • 4th day - one injection as Lumbar puncture (LP)
  • 5th day - rest day
  • 6th day - one injection as Lumbar puncture (LP)
  • 7th day - rest day/discharge

This schedule is based on a general preliminary medical evaluation, but may be changed and fine-tuned in the final review on the day of admittance to the hospital.

About Mesenchymal Stem Cells

Mesenchymal stem cells (MSC) are anti-inflammatory which makes them interesting as therapy for autoimmune diseases, as they miss the properties that enable the immune system to detect them as being foreign. Umbilical cord-derived stem cells, which we use in our therapy, are more naïve and have more proliferative nature and regeneration power as compared to any other source, resulting in:

  • Recipients of MSCs do not need to ablate (remove) their cells with chemotherapy, reducing their risk of infection.
  • There is no need that Donors and recipients have to match for successful treatment, which is reducing the risk of rejection and complications at the recipient considerably.

According to investigation data, stem cells, harvested from adipose tissue have in the average 15 to 20 Million stem cells for treating various conditions via injections.  According to multiple scientific data, harvested stem cells from fatty tissue, are about 500 times higher than those from bone marrow. Expanded, save passage 2, Mesenchymal stem cells have potentially, however, the highest therapeutic effect, as each injection contains about 20 Million stem cells and in one treatment usually approximately 100 Million cells are injected.

Mesenchymal Stem Cells in Lupus

Systemic lupus erythematosus (SLE) is, as mentioned before, an autoimmune disease that can affect any part of the body. Recent findings demonstrated several defects in the hematopoietic system of SLE patients, probably due to the unbalanced expression of cytokines and other growth factors.

Mesenchymal stem cell treatment had been studied in over 200 people with lupus who did not respond to mainstream lupus therapies. First results of this investigational research showed:

“Three out of every four study participants, about 75 %, benefited from the stem cell treatment, indicating clearly a much higher response rate than current therapies provide for lupus condition. Even 24 months after the stem cell treatment, conditions at the participants had been significantly improved.”

Very few minor adverse reactions had been noted, but there were no severe reactions to the stem cell treatment.
Link: https://www.lupus.org/research/stem-cells-and-lupus-research

Treatment costs

Please note that treatment costs are depending on the medical history and condition. For further details we suggest to please complete our Patient Application Form, - see under contact - stipulating your condition and treatment request, and send it to our Delhi or Europe office. We actively strive to reply to any request either immediate or latest within two working days with details.

Quality of Stem Cells

Licensed physicians administer the stem cells intravenously (IV), and intrathecal for this condition. Stem cells used are highly qualified and certified by the lab providing the cells to our partner clinics.

Medical Procedure Treatment

As with any medical procedure, a consent form between the clinic and the patient has to be signed at the time of the procedure.

Side effects and Follow up

When it comes to side effects, our patients have not experienced serious side effects from the stem cells treatment, and we are monitoring the well-being of our patients in the first 24 to 48 hours by a dedicated patient coordinator.

Our stem cell treatment does not end furthermore with the procedure in our partner clinics. As we care about how you are doing after you return home, we will also monitor your post-treatment progress on a regular basis. The proper follow-up, i.e., reviews at 1, 3, 6, 12, 24 months, also supports us to evaluate the effectiveness of our treatments and improve our protocols based on observed outcomes even further.

Clinical Trials, Studies & General Information

According to ClinicalTrials.gov statistic, in August 2017 there had been 591      trials for Lupus Erythematosus registered out of it 20 are Stem Cell Lupus related treatment studies.

Slide Show:

Systemic Lupus Erythematosus
https://www.slideshare.net/FurqanKhan1/systemic-lupus-erythematosus

LUPUS - Stem Cell Research & Medical Publication

Stem Cells and Lupus Research - Lupus Foundation of America

We are devoted to solving the mystery of lupus, one of the world's cruelest, most unpredictable, and devastating diseases, while giving caring support to those who suffer from its brutal impact.

https://www.lupus.org/research/stem-cells-and-lupus-research

LUPUS - Stem Cell Research & Medical Publication

Mesenchymal Stem Cells in the Treatment of Systemic Lupus Erythematosus
By: Dr. Neil Riordan
http://www.faim.org/mesenchymal-stem-cells-in-the-treatment-of-systemic-lupus-erythematosus

LUPUS - Stem Cell Research & Medical Publication

Sun L, Akiyama K, Zhang H, Yamaza T, Hou Y, Zhao S, Xu T, Le A, Shi S. Mesenchymal stem cell transplantation reverses multiorgan dysfunction in systemic lupus erythematosus mice and humans. Stem Cells. 2009 Jun;27(6):1421-32.
https://www.ncbi.nlm.nih.gov/pubmed/19489103

LUPUS - Stem Cell Research & Medical Publication

Liang J, Zhang H, Hua B, Wang H, Lu L, Shi S, Hou Y, Zeng X, Gilkeson GS, Sun L. Allogenic mesenchymal stem cells transplantation in refractory systemic lupus erythematosus: a pilot clinical study. Ann Rheum Dis. 2010 Aug;69(8):1423-9.https://www.ncbi.nlm.nih.gov/pubmed/20650877

LUPUS - Stem Cell Research & Medical Publication

Sun L, Wang D, Liang J, Zhang H, Feng X, Wang H, Hua B, Liu B, Ye S, Hu X, Xu W, Zeng X, Hou Y, Gilkeson GS, Silver RM, Lu L, Shi S. Umbilical cord mesenchymal stem cell transplantation in severe and refractory systemic lupus erythematosus. Arthritis Rheum. 2010 Aug;62(8):2467-75.
https://www.ncbi.nlm.nih.gov/pubmed/20506343

LUPUS - Stem Cell Research & Medical Publication

Shi D, Wang D, Li X, Zhang H, Che N, Lu Z, Sun L. Allogeneic transplantation of umbilical cord-derived mesenchymal stem cells for diffuse alveolar hemorrhage in systemic lupus erythematosus. Clin Rheumatol. 2012 May;31(5):841-6.
https://www.ncbi.nlm.nih.gov/pubmed/22302582

LUPUS - Stem Cell Research & Medical Publication

Wang D, Zhang H, Liang J, Li X, Feng X, Wang H, Hua B, Liu B, Lu L, Gilkeson GS, Silver RM, Chen W, Shi S, Sun L. Allogeneic mesenchymal stem cell transplantation in severe and refractory systemic lupus erythematosus: 4 years experience. Cell Transplant. 2012 Oct 31. [Epub ahead of print]
https://www.ncbi.nlm.nih.gov/pubmed/24388428

LUPUS - Stem Cell Research & Medical Publication

Akawatcharangura, P, N Taechakraichana, and M Osiri. 2015. Prevalence of premature ovarian failure in systemic lupus erythematosus patients treated with immunosuppressive agents in Thailand. Lupus, no. 4 (November 29). doi:10.1177/0961203315617539.
http://www.ncbi.nlm.nih.gov/pubmed/26621134.

LUPUS - Stem Cell Research & Medical Publication

Liang, Jun, and Lingyun Sun. 2015. Mesenchymal stem cells transplantation for systemic lupus erythematosus. International journal of rheumatic diseases, no. 2 (January 22). doi:10.1111/1756-185X.12531.
http://www.ncbi.nlm.nih.gov/pubmed/25611801.

LUPUS - Stem Cell Research & Medical Publication

Mohara, Adun, Román Pérez Velasco, Naiyana Praditsitthikorn, Yingyos Avihingsanon, and Yot Teerawattananon. 2013. A cost-utility analysis of alternative drug regimens for newly diagnosed severe lupus nephritis patients in Thailand. Rheumatology (Oxford, England), no. 1 (October 4). doi:10.1093/rheumatology/ket304.
http://www.ncbi.nlm.nih.gov/pubmed/24097289.

LUPUS - Stem Cell Research & Medical Publication

Siripaitoon, B, S Lertwises, P Uea-Areewongsa, and B Khwannimit. 2014. A study of Thai patients with systemic lupus erythematosus in the medical intensive care unit: epidemiology and predictors of mortality. Lupus, no. 1 (August 22). doi:10.1177/0961203314548884.
http://www.ncbi.nlm.nih.gov/pubmed/25149601.

LUPUS - Stem Cell Research & Medical Publication

Wang, Q, S Qian, J Li, N Che, L Gu, Q Wang, Y Liu, and H Mei. 2015. Combined transplantation of autologous hematopoietic stem cells and allogeneic mesenchymal stem cells increases T regulatory cells in systemic lupus erythematosus with refractory lupus nephritis and leukopenia. Lupus, no. 11 (April 24). doi:10.1177/0961203315583541.
http://www.ncbi.nlm.nih.gov/pubmed/25914407.