Lupus: A disease with many faces

Approximately one in every thousand people suffers from lupus. It is an autoimmune disease, in which the immune system attacks the person's own body. It primarily affects women (in a ratio of 9:1), and leads to inflammatory responses, which can affect every organ in the body. "No other disease has such a broad spectrum of clinical expressions," explains Josef Smolen, Director of MedUni Vienna Department of Internal Medicine III at Vienna General Hospital, "it can affect all organs, joints and muscles. This makes it all the more difficult to diagnose and to find the most appropriate form of treatment. Hence lupus is the most complex disease in the world."

Medicine has made great advances over the last few years. Thanks to modern drugs, sufferers have a longer life expectancy and a better quality of life. "Although cortisone is still a mainstay of treatment, new therapeutic approaches often have fewer side effects and so improve quality of life," explains Georg Stummvoll of the Department of Rheumatology at MedUni Vienna Department of Internal Medicine III in Vienna General Hospital. "It is important to diagnose it correctly at an early stage, because, if it goes untreated, lupus can be fatal, ultimately leading to organ failure. The earlier it is detected, the more successfully it can be treated."

Individually tailored immunotherapy

"The treatment of autoimmune diseases such as lupus requires therapies that interfere with the actual genesis of the disease," explains Smolen, speaking of the new therapeutic approaches, "targeted therapies are directed at cell receptors on a molecular level. The therapy primarily targets active B lymphocytes in the immune system. In future this should be specifically tailored to the patient."

Pending the development of perfectly tailored individual therapy on a molecular level, one of the research aims is to optimize existing therapies and to minimize side effects. It is difficult to conduct large-scale clinical studies because of the relatively small number of patients affected (around 8,000 -- 10,000 in Austria). Specialist centers are required to collate the relevant patient data and the Department of Rheumatology at MedUni Vienna has one such centre.