Key Statistics

Global incidence: An estimated 5 million people living with a form of lupus worldwide 

U.S. incidence: An estimated 1.5 million people in the U.S. live with a form of lupus 

Immunology and Lupus

There are four different forms of lupus: 

• Systemic lupus erythematosus (SLE) is the most common. 
• Cutaneous lupus only affects the skin. 
• Drug-induced lupus is caused by high doses of certain medications and usually goes away when the medication is stopped. 
• Neonatal lupus is rare but occurs when the mother’s antibodies affects the fetus. Symptoms usually disappear after birth. 

Normally, the immune system can tell the difference between harmful pathogens and the body’s own healthy cells. In lupus, this process breaks down. Immune cells called B cells produce autoantibodies, antibodies that mark parts of the body for attack by the immune system. Detection of different autoantibody levels is one of the markers used to diagnose lupus. Other immune cells, such as dendritic cells, neutrophils, and T cells, play a role in supporting the B cells that make autoantibodies or causing the inflammation associated with lupus flares. 

Researchers aren’t sure what causes the immune system to start attacking the body. However, they do know that genetics and environmental triggers play a role in developing lupus. Many of the genetic mutations or changes associated with lupus are related to processes of the immune system. However, it is important to remember, that no single gene or mutation causes lupus, and scientists think a combination of factors contribute to the disease.  

What’s Next for Lupus?

Advances in immunology are transforming how researchers understand lupus and are opening the door to more personalized treatments. Rather than broadly suppressing the immune system or just addressing symptoms, current research is trying to identify and correct the specific immune pathways that drive lupus. 

CAR T cell therapy is a promising area of lupus research. First used as a cancer treatment, CAR T cell therapy is a personalized treatment that genetically modifies a patient’s own T cells to improve their function. In clinical trials to treat lupus, CAR T cell therapy modifies a patient’s T cells to attack B cells that produce autoantibodies. The therapy causes a depletion of B cells and when the body makes more, the B cells no longer make autoantibodies that cause lupus. This treatment helps to reset the immune system and address the cause of autoimmunity.  

Lupus is increasingly understood as a spectrum of related immune disorders. Large-scale studies looking at genetics and autoantibody profiles to help scientists classify patients into distinct groups based on what is going wrong in their immune system. This approach may allow clinicians to better predict disease course, organ involvement, and treatment response for patients.