Day 3 Lupus Awareness

 Hi Everyone!

If you don't want to read the whole post please read the last part starting with 1951.  

image made by me

I was going to do a history of lupus and thought I should see what day 3 of lupus month is. OMG! It is the history. Ya know great minds and all. However, lupus history goes back farther than 1828.

lupus in color

In fact lupus affected people in ancient Greece and Egypt.  Let me back up. There are 4 types of Lupus. The most common and serious is Systemic lupus erythematosus (SLE) This can affect every part of your body.

Then there is Cutaneous (discoid) lupus erythematosus (CLE) this affects the skin. There are 2 more but we can get into that later. Also, the history of lupus is divided into 3 time zones.

• The Classical Period spans thousands of years, from the first descriptions of lupus as a skin condition in ancient Greece and Egypt to the mid-19^th century –  when dermatology was the  field of medicine to research and treatment the disease. 
• In 400 B.C., the Greek physician Hippocrates described what is thought to be the first case of lupus as a skin ulcer. However, he used the term herpes esthiomenos, which means “gnawing skin disease.”

The earliest known use of the term “lupus” appeared in a 10th-century account of Eraclius, the Bishop of Liege, who, the story goes, was healed when praying at the shrine of St. Martin.

The 12^th century physician, Rogerius Frugard, an Italian surgeon, was the first to coin the term “lupus” in the medical sense.

In 1230 AD, Rolando de Parma, a pupil of Rogerius Frugard, described two forms of lupus:  lupula (or “small she-wolf), referring to lesions on the lower limbs, and noli me tangere (meaning “don’t touch me”) for lesions on the face. It took another 300 years before the facial rashes alone were proven to be associated with lupus.

In 1790, lupus is listed in Dr. Robert Willan’s book, On Cutaneous Diseases. This was the first atlas of skin diseases and contained the first illustration of a patient with lupus lesions of the face.

In 1846, Ferdinand von Hebra, a Viennese physician, was the first to describe the distinctive facial rash of lupus as a “butterfly.” Hebra was also the first to describe lupus as a chronic condition that could remain dormant for years.

In 1850, French dermatologist Pierre Cazenave was one of the first to describe lupus in a truly modern way. He coined the term lupus erythemateux (which later became erythematosus) and was the first to document both discoid lupus and that alopecia (hair loss) was a symptom.

 

 

The Neoclassical Period begins in 1872 when lupus was finally identified as a systemic condition of the entire body, not just related to skin rashes and ulcerations. In 1895, Sir William Osler was the first to identify how lupus could affect internal organs as well as the skin.  He added the word “systemic” to lupus erythematosus to distinguish it from discoid lupus erythematosus – creating the term that we use today – systemic lupus erythematosus (SLE)!  He was also one of the first to document “lupus flares” and describe how SLE could affect the nervous system.  Peruvian mummy of a 14 year old girl (dating around 890 AD)  who was believed to have lupus has been documented and studied!  

 Borrowed from 100 years of lupus

The Modern Period starts in 1948 with the discovery of the first lupus erythematosus cell (LE cell), which led to the understanding of lupus as an autoimmune condition and the subsequent revolution in treating the disease.

image from google

In 1951, the antimalarial drug, quinacrine, was first used to treat discoid lupus erythematosus.  This would lead to the use of hydroxychloroquine (Plaquenil), which would become one of the most important medications in the treatment of lupus – changing the lives of so many even today.

In 1952, researchers Kendal and Hench discovered cortisone, which would lead to the corticosteroids that are so also commonly prescribed today.

In 1954, Dr. Peter Miescher discovered antinuclear antibodies (ANAs), which would lead to the recognition that lupus is largely autoantibody driven. ANAs have since become an important and relatively easy diagnostic test for SLE – much easier than a bone marrow biopsy.

In 1971, the American College of Rheumatology established the first clinical and immunological criteria to help identify lupus based on a better,  and wider group of symptoms.

In the late 1990’s, Genentech’s CellCept (mycophenolate mofetil), an immunosuppressant developed for organ transplant patients, was introduced to treat severe SLE.

In 2011, belumimab (Benlysta), a GSK’s biologic, was the first drug specifically approved by the FDA and EMA to treat systemic lupus erythematosus!  This opened the door to the promise of more targeted medications, with fewer systemic side effects.

In 2021, Aurinia’s voclosporin (Lupkynis), an oral medication, was given FDA approval for treating lupus nephritis – the first for that specific condition of SLE.

Later that same year (2021), the FDA approved Saphnelo (anifrolumab-fnia), a biologic from Astra Zeneca,  becoming only the third drug in history to be approved for treating some forms of SLE.

 

As of now, along with other medical research, the "thing" in the white house and doge has cut staff and funding for any further advancements for lupus.  

If you have read to the end of this post. I thank you.

Nicole 

Images and test provided by Kaleidoscope