Systemic Lupus Erythematosus ( Sle )

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Systemic Lupus Erythematosus
Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple tissues and systems and with significant variable clinical features and organ involvement (Cava, 2010). It is characterized by a chronic, relapsing, inflammatory and often febrile multisystemic disorder of connective tissue with wide spectrum of involvement of skin, joints, kidneys and serosal membranes. The exact etiology is noknown, but it represents failure of the regulatory mechanisms of immune system in which body 's own defenses are turned against themselves (Edworthy, 2005##########).
It has a worldwide distribution with unpredictable course of flares and remissions, where a cumulative damage over time significantly
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The disease is milder and survival is higher among persons with isolated cutaneous and musculoskeletal disease than in those with renal and CNS involvement. the most frequent causes of death in SLE patients are Infections and diseases of the cardiovascular, renal, pulmonary, and central nervous systems (Bartels et al., 2012).
In spite of the improvement of the survival rate, patients with SLE still have a higher death rate (3-5 times) than that of general population (Schur, 2001).
B. Etiology:
The definite pathologic mechanisms of SLE remain elusive, and the etiology of SLE is known to be multi-factorial, involving genetic, hormonal, and environmental factors. Environmental triggers with susceptible genetic background, act on the immune system to initiate autoimmunity (Tiffin et al., 2013).
1- Genetic factors: There is a clear genetic component in SLE, with a sibling risk ratio 8- 29 folds higher than that in the general population and a 10 folds increase in disease concordance in identical twins. In addition, there is a 24-56% concordance rate in monozygotic twins, compared with a 2-5% risk in dizygotic twins (Deng and Tsao, 2010).
Many genes that may contribute to lupus have been identified by means of whole-genome scans from families in whom multiple members have SLE (Namjou et al., 2007). The genes associated
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