Risk Factors of Lupus

According to a recent edition of the New York Times Health Guide,2 the number of people diagnosed with Lupus has more than tripled over the past four decades. This may simply indicate a greater degree of physicians trained in recognizing the syndrome. Several of the national Lupus organizations estimate that the total number of persons living with the disease exceeds 1.5 million people.  The following are among the major risk factors for Lupus:

Gender Risks:  As previously stated, Lupus appears more frequently in women as well as in African-Americans, Asians, Hispanic and Native Americans. It also can happen more often in some families, indicating that it is a genetic disease. (More information below on women of color.)

Genetic Risk Factors for Lupus:  Your genes are the components of your DNA that tell every cell in your body what to do.  In people with Lupus, the genes combine and react to various factors in their surroundings to which they are exposed by attacking parts of their body. Until recently it has only been a scientific theory that when this reaction occurs, the body reacts with a response from the autoimmune system. However, new research done in Canada 3now proves that various genes interact with each other and the environment, under the right conditions and circumstances, to make it easier for some people to develop Lupus.In addition, new research also indicates that a person whose sibling has been diagnosed with Lupus (a brother or sister born to your mother or father) has a greater risk to contract the disease.

Environmental Risk Factors for Lupus:  Some things that are part of our everyday environment can also be a risk for Lupus for persons who may be vulnerable. These include:

  • Ultraviolet Light:  Research on Lupus has indicated that exposure to sunlight (which contains ultraviolet rays) can not only expose a person to the dangers of sunburn and skin cancer but can also increase the risk for Lupus. Sunlight can cause damage to skin cells that may stimulate an autoimmune response in persons with Lupus.
  • Smoking:  Some controversial research studies have found that persons who smoke increase their risk for Lupus. Other research indicates that  while past smoking is not a risk, current smoking does increase a smoker’s risk for Lupus.
  • Infections: Research studies have also indicated that some types of viral infections can trigger Lupus in susceptible persons. These include the more common ones like colds, and less common infections such as cytomegalovirus (CMV) a type of herpes virus which causes chicken pox, and shingles. Another harmless virus common to young children is the Parvovirus B-19 which usually has no ill effects except to pregnant women and persons with compromised immune systems like Lupus. A more serious risk factor for Lupus is another member of the herpes family, the Epstein-Barr Virus (EBV). EBV, which causes a mild illness in most people, can create a Lupus response in some susceptible people.

Hormonal Risk Factors for Lupus: One of the highest risks for Lupus is being a woman. Lupus prevalence data indicates that Ninety percent of people with Lupus are young women of childbearing age, mostly likely since they have higher estrogen levels. Women increase their risk of SLE by taking oral birth control or hormone replacement therapy since it may trigger an immune response. Not all researchers agree that a woman’s chances of contracting Lupus are increased if she is taking estrogen based birth control pills or post-menopausal hormone replacement therapy. However, it is important to note that women are only 2.5 times as likely as men to contract SLE or have flare-ups of SLE after menopause if they have chronic SLE.

Race as a Risk Factor for Lupus: Research indicates that not only do African American women seem to be at least four times more genetically sensitive to contracting Lupus, they also appear to be at risk for getting more severe Lupus symptoms at a much younger age. Other women of color such as Latino, Asian, and Native American women also appear to be at higher risk than white women. While there may be some underlying criteria for this group of women to be more sensitive to Lupus, such as environmental exposure, researchers believe that there may a genetic predisposition for Lupus in some racial groups. Current research is targeting more studies in this important area.

Lifestyle Factors: Unfortunately, there are many activities which most people get involved with in their daily lives which can cause an initial outbreak or flare-up of Lupus. These include:

  • Exposure to the Sun:  One of the major activities which sets off SLE is exposure to the sun’s Ultraviolet (UV) rays which are a major trigger for SLE. When a susceptible person’s skin is exposed to the sun the UV rays can change the DNA structure in their skin cells. The body’s protective system (the immune system) sees these changed cells as invaders and mounts an autoimmune attack on them.
  • Exposure to Chemicals:  SLE symptoms have appeared in persons exposed to certain chemicals. Several chemicals are thought to be dangerous and are being currently tested as factors in Lupus. However, it is it is extremely difficult to prove that any specific chemical may be the cause of Lupus, since our bodies are exposed to a large variety of chemicals during our lifetime and many traces of these chemicals do not remain in the body over time. A temporary type of early onset Lupus has been linked to some types of over the counter (OTC) medicines and prescription drugs. This condition ends when these drugs are stopped.
  • Hormones:  While hormone replacement therapy, (HRT) was the treatment of choice for women experiencing hot flashes and menopause, it is no longer utilized. HRT clinical trails discovered that the therapy created health risks to those on the hormone therapy. The trials did not indicate whether HRT triggers SLE flare-ups. Women’s health guidelines suggest that they should discuss with their physician whether taking hormones is a safe choice for them and suggest that women who utilize hormone therapy use the lowest possible dose.
  • Oral Contraceptives. Recent data indicates taking oral contraceptives (OCs) is safe for females with inactive or stable Lupus. Taking OCs was previously discouraged since it was mistakenly believed that the estrogen in the OCs increased the risk for blood clots; women at high risk for blood clots or who already have been diagnosed with blood clots should not use OCs. Women who have been newly diagnosed with Lupus should wait until the disease has stabilized and avoid OCs since Lupus can cause complications in the early stages of the disease.