History of Lupus in Timeline
Lupus, or systemic lupus erythematosus (SLE), is an autoimmune disease where the immune system attacks healthy tissues. Symptoms vary in severity and include joint pain, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, fatigue, and a facial rash. The disease is characterized by flares (periods of intense symptoms) and remissions (periods with few symptoms).
1903: Osler's Third Paper on SLE
In 1903, Osler published his third paper on SLE, documenting various afflictions observed in patients diagnosed with the disease. These included arthritis, pneumonia, cognitive impairment, delirium, and central nervous system damage.
1920: Modern Research into Discoid and Systemic Lupus Begins
The modern era of research into the causes and treatments for discoid and systemic lupus commenced in 1920.
1948: Discovery of the LE Cell
A team of researchers at the Mayo Clinic made a groundbreaking discovery in 1948: the LE cell (lupus erythematosus cell). This discovery involved the observation of white blood cells containing the nucleus of another cell pushing against the white blood cell's own nucleus.
1955: FDA Approval of Hydroxychloroquine for Lupus
In 1955, the FDA approved the use of Hydroxychloroquine for treating lupus.
1955: Increase in SLE Rates in the United States
The rate of SLE in the United States rose from 1.0 in 1955 to 7.6 in 1974. It is uncertain whether this increase was due to improved diagnosis or a genuine rise in the disease's frequency.
1971: ACR Establishes Criteria for Diagnosing SLE
The American College of Rheumatology (ACR) created a list of clinical and immunologic criteria in 1971 to ensure accurate diagnosis of lupus and distinguish it from other autoimmune diseases. These criteria included identifiable symptoms like pain and signs detectable by physicians during physical examinations and laboratory tests.
1974: Significant Rise in SLE Rates in the United States
The rate of SLE in the United States increased significantly from 1.0 in 1955 to 7.6 in 1974. The reason for this increase, whether due to better diagnostic methods or a higher incidence of the disease, remains unknown.
1982: American College of Rheumatology (ACR) Establishes Criteria for SLE
In 1982, the American College of Rheumatology (ACR) set forth eleven criteria to be used as a classificatory instrument for defining Systemic Lupus Erythematosus (SLE) in clinical trials. These criteria were not designed for diagnosing individuals.
1982: Initial Revision of ACR Criteria for Diagnosing SLE
The American College of Rheumatology (ACR) made the first revision to its list of criteria for diagnosing SLE in 1982.
1997: Revision of ACR Criteria for SLE
The American College of Rheumatology (ACR) revised the eleven criteria in 1997 that were initially established in 1982. These criteria are used for classifying SLE in clinical trials.
1998: Alternative Criteria for SLE Proposed
In 1998, alternative criteria for SLE, such as the St. Thomas' Hospital "alternative" criteria, were suggested.
2009: Further Revision and Improvement of ACR Criteria for Diagnosing SLE
The ACR further revised and enhanced the list of criteria for diagnosing SLE in 2009, building upon previous revisions in 1971 and 1982.
November 2010: FDA Advisory Panel Recommends Belimumab for Lupus
An FDA advisory panel recommended approving belimumab (Benlysta) for the treatment of pain and flare-ups associated with lupus in November 2010.
2010: Review Challenges Assertions about Race and SLE Rates
In 2010, a review of studies examining the correlation between race and SLE identified several methodological and systematic errors. This suggested that the link between race and SLE might be misleading, and factors like social support could be confounding variables.
March 2011: FDA Approval of Belimumab Based on BLISS-76 Study
Belimumab, a fully human monoclonal anti-BAFF (or anti-BLyS) antibody, received FDA approval in March 2011 following the BLISS-76 study. BAFF stimulates B lymphocytes, which are responsible for producing antibodies against foreign and self-protein, and extends their lifespan.
March 2011: FDA Approval of Belimumab for Lupus
The FDA approved belimumab (Benlysta) as a treatment for lupus in March 2011.
2019: Genetically Engineered Immune Cells Studied for Lupus
As of 2019, researchers were studying genetically engineered immune cells in animal models as a potential treatment for lupus.
September 2022: Promising Results with Genetically Altered Immune Cells for Lupus Treatment
In September 2022, researchers at the University of Erlangen-Nuremberg published encouraging results from using genetically altered immune cells to treat severely ill lupus patients. Five patients, four women and one man, received transfusions of CAR T cells engineered to attack their B cells, eliminating the malfunctioning ones. This therapy successfully led to remission in all five patients, who have remained off lupus medication for several months following the treatment.