AMD Triggered by Lupus

Scientists continue to find links between various diseases. How disease can manifest into others has been a research concern for decades. Recently, the disease lupus has been linked to triggering AMD (age-related macular degeneration) through similar inflammatory biomarkers. These are markers that show inflammation on a neurodegenerative level unable to be detected beforehand.

Find out how the link between lupus and AMD is expressed and some possible ways to mitigate lupus as well as detect an AMD connection well in advance for early treatment application. In addition, this link just may soon be a doorway into treating other inflammatory diseases as well.

Lupus Mechanics

Lupus is defined as an autoimmune disease where the immune system attacks healthy tissues and organs with no direct reason why. Lupus is difficult to detect because it mimics other diseases or conditions with symptoms that include:

• Fever
• Fatigue
• Joint pain
• Joint stiffness
• Chest pain
• Dry eyes
• Headaches
• Confusion
• Memory loss
• Shortness of breath
• Skin lesions that are exacerbated by sun exposure 

As stated, this list of symptoms (and some other minor ones) are often mistaken for a host of other ailments that present more at the forefront of indicators rather than being considered as the debilitating disease of lupus. However, there is one major sign of lupus that is a significant display of the disease which is a rash that appears on the face in the shape of a butterfly. It appears to cover the cheeks and the bridge of the nose as well as other rashes (sometimes in a butterfly shape and sometimes not) which inexplicably appear on other parts of the body.

Inflammation becomes a major player in lupus progression affecting:

• Joints
• Skin
• Kidneys
• Blood cells
• Brain
• Heart
• Lungs

Now, recent research of lupus out of the University of Virginia spearheaded by Dr. Jayakrishna Ambati (mentioned above) shows significant inflammatory data appearing on the retina which could lead to macular degeneration.

AMD Inflammation Triggers

It has been well known that inflammation is one of the major contributors to macular degeneration progression. Once it begins it can progress to the point of severe ocular damage. A study of ocular inflammation titled, ‘Inflammation and its role in age-related macular degeneration’ published in Cellular and Molecular Life Sciences explains AMD inflammation,

“AMD is an ocular disease with inflammation strongly interwoven into its pathogenesis [disease progression]. Several PRRs [pattern-recognition receptors] become activated by endogenous [internal cause] intra- and extracellular danger signals inducing an inflammatory response beyond the homeostasis-maintaining para-inflammation [normal inflammation]. Degenerative changes in RPE [retinal pigment epithelium] cells trigger a vicious circle that promotes the development of chronic inflammation in the retina and the choroid [blood vessels]. Age-related changes in the immune system contribute to this destructive process by altering the functions of immune cells”. 

This inflammation is found throughout the optical system but it can be difficult to locate. When it is located it can be treated with anti-inflammatory medicines. However, with the current research out of the University of Virginia, a specific marker named NLRC4-NLRP3 has been located in both lupus and macular degeneration linking the two in an unexpected way. 

According to Dr. Jayakrishna Ambati of UVA’s (University of Virginia) Department of Ophthalmology and the founding director of UVA’s Center for Advanced Vision Science, 

“We were quite surprised at the common link between lupus and macular degeneration, It appears that the new inflammatory pathway we identified could be therapeutically targeted for many chronic diseases.”

Inflammasome Malfunction

Inflammasomes are innate immune system receptors and sensors that are released to prompt inflammation in response to infectious molecules and microbes. Once released however, inflammasomes can manifest out of control causing what is known as cytokine syndrome. Cytokines are major players in inflammatory response.

According to Very Well Health,

“Cytokine storm syndrome refers to a group of related medical conditions in which the immune system is producing too many inflammatory signals, sometimes leading to organ failure and death…People with certain autoimmune syndromes [like lupus] have a higher risk of getting cytokine storm syndrome.”

As cytokines storm out of control the retina can take a big hit that includes the creation of leaky blood vessels which could lead to wet macular degeneration. It was found by Dr. Ambati and his team that the discovered inflammatory marker NLRC4-NLRP3 contributes to a hyperactive immune response in lupus causing the above symptoms while at the same time destroys the “vital light-sensing cells in the eye’s retina”. 

The research found that the inflammasomes are sent into action by what is known as, “short interspersed nuclear element [SINE] RNAs,”. This has lead to the discovery of an unknown receptor for SINE RNA called DDX17 which scientists have been searching for, for decades. It is a discovery that most will never know about, but just may change the game in how to treat and possibly cure AMD. 

Overall, this link between lupus and AMD will allow for ways to interrupt such an out-of-control reaction and stop the inflammation before it starts. Once this treatment can be put into place and successfully demonstrated then diseases such as lupus, macular degeneration and others could be stopped before they start.

Dr. Ambati commented,

“These findings indicate that blocking a single inflammasome might not be enough, and that targeting both the NLRC4 and NLRP3 inflammasomes would be a superior strategy,…We’re excited to have developed drugs called Kamuvudines that block this dual inflammasome, which we anticipate will be in clinical trials next year,”

This is the research that is going on behind the scenes, deep in hospital and University laboratories (like Virginia) across the nation and the globe. Finding out how AMD is triggered by lupus will encourage more studies of cellular inflammation, which is becoming more and more responsible for the genesis of most pathologies. It is the accumulation of this inflammation over years that slowly causes the debilitation, pain and life-changing struggles associated with not only macular degeneration but so many other pathologies. It is also research such as this that makes doctors like Jayakrishna Ambati the unsung heroes of our time.

Sources:

Trigger Found for Harmful Inflammation in Lupus and Macular Degeneration

https://www.verywellhealth.com/cytokine-storm-syndrome-4842383#:~:text=Cytokine%20storm%20syndrome%20refers%20to,to%20organ%20failure%20and%20death

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4819943/

https://news.virginia.edu/content/uva-discovers-harmful-inflammation-trigger-lupus-macular-degeneration