Introduction: Systemic lupus erythematosus (SLE) is a typical systemic autoimmune disease, which causes multiorgan disorder. SLE has variable presentation, course and prognosis including skin disease, neuropsychiatric disease (NPSLE), haematological disease, renal disease, and cardiovascular disease. The primary pathological findings in patients consist of inflammation, vasculitis, immune complex deposition, and vasculopathy. The exact aetiology of SLE is unknown. The disease shows a strong familial aggregation, with a much higher frequency among first degree relatives of patients. Moreover, in extended families, SLE may coexist with other organ specific autoimmune diseases. Genetic factors also play an important role in predisposition of the disease. However, most cases are sporadic without identifiable genetic predisposing factors, suggesting that multiple environmental or yet unknown factors may also be responsible.
Most of the clinical manifestations are associated with certain pathophysiological cascades, particularly involving the hyperactivation of the immune response and abnormality in the immune regulation system. Hence, both autoantibodies and inflammatory cytokines are responsible for aggravating the pathology of SLE.
There is no absolute treatment for this ailment. However, Current therapeutic strategies of this disease are limited to the use of steroids and cytotoxic drugs.
Methods: 1. Pathogenesis and pathology of SLE
The loss of immune tolerance, increased antigenic load, excess T cell help, defective B cell suppression, and the shifting of T helper 1 (Th1) to Th2 immune responses leads to B cell hyperactivity and the production of pathogenic autoantibodies. Also, certain environmental factors besides various genetic factors are probably required to trigger the disease. Multiple genes confer susceptibility to disease development. Interaction of sex, hormonal milieu, the HPA axis, and defective immune regulation, such as clearance of apoptotic cells and immune complexes, modify this susceptibility. The loss of immune tolerance, increased antigenic load, excess T cell help, defective B cell suppression, and shifting of Th1 to Th2 immune responses lead to cytokine imbalance, B cell hyperactivity, and the production of pathogenic autoantibodies.
Most of the clinical manifestations of the disease are associated with certain pathophysiological cascades, particularly involving the hyperactivation of the immune response and abnormality in the immune regulation system. Proinflammatory cytokines, namely IL6, IL10, IL12, IL17, IL21 and IL23, are produced in excess as mediated by rho associated protein kinase (ROCK); transcription factors, namely STAT3 and CREMα; nuclear factor NFκB and NFAT, thereby leading to the co-stimulation of B and T cells, ultimately causing the excessive production of autoantibodies.
Finally, certain environmental factors are probably needed to precipitate the onset of the disease; such as dietary factors, infectious agents, hormones and environmental oestrogens and chemical/physical factors.
2. Natural plant metabolites as remedial candidates for SLE:
Some plant species with:
Immunomodulation benefits which suppress the inflammation, inhibit the proliferation and pro-inflammatory cytokines, and down regulate Th1/Th2 cytokines expression are including Argyrolobium roseum, Camellia sinensis, and Tripterygium wilfordii.
Besides, there are some other plant species with immunomodulation and signaling regulation benefits which inhibit T cell activation and reduce the level of pro-inflammatory cytokines Allium sativum, Bupleurum falcatum, Clerodendron trichotomum, and Coriandrum sativum are categorized in this group.
Berberis aristata and Curcuma longa with signaling regulation benefits, down regulate the expression of STAT3 and ROCK.
Moreover, Acacia farnesiana, Andrographis paniculata, Angelica glauca, Arundo donax, Malus domestica, Ocimum gratissimum, Paeonia lactiflora, Picrorhiza scrophulariiflora, Salvia miltiorrhiza,and Uncaria tomentosa have anti-inflammatory benefits and decrease the nitrite level.
Results: The suggested herbal drugs, are devoid of any potential toxicity or adverse drug reactions and are completely harmless and helpful for patients suffering from SLE. There are also evidences published for analyzing toxicological effects of them which represent the safety usage of these herbal medicines.
Conclusion: Systemic lupus erythematosus (SLE), commonly referred to simply as lupus, is a chronic autoimmune disease that can cause swelling (inflammation) and pain throughout your body. The chemotherapeutic drugs used in treating SLE symptoms may have negative effects on some body organs. For this reason, utilizing medicinal plants are rising due to controlling symptoms of the disease in patients. These plants may be represented as immunomodulators such as Camellia sinensis, anti-inflammatory effects such as Acacia farnesiana, and signaling regulator such as Berberis aristata. They may also have effects on helping the patients lower their anxiety because of various side effects of the disease.