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Actress with Lupus Spreads Awareness for Autoimmune Disease

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In 2007, Maria Alejandra Hernandez was living her best life in New York City, working her dream job as an actress. However, she started to feel unwell, and generally tired and run down. She had a kidney biopsy done, but it didn’t lead to any answers. She recovered from the mystery illness, and went on to live her life.

Four years later at age 21, her health problems resurged with a vengeance.

“It started with a pain in my finger, I remember,” Hernandez explains. “I thought I probably bumped it or I’m just stressed out. It’s probably going to go away.”

However, the pain didn’t go away, and in fact continued to spread to her shoulders.

“The pain was so excruciating, I couldn’t even lift my hands,” she says. She was hospitalized for a month, while doctors performed a myriad of tests in an effort to diagnose the cause of her sudden pains.

She was eventually diagnosed with systemic lupus erythematosus. The autoimmune disease was causing her body’s own immune system to attack her joints, resulting in the unbearable pain in her fingers and shoulders. Shortly after, she started getting rashes on her face. Butterfly rash, which is a skin rash in the shape of a butterfly that appears across the nose and cheeks of lupus patients, is a hallmark symptom of the disease.

Hernandez admits that she knew nothing about lupus prior to being diagnosed. She explains, “I thought I could tell the doctor, okay, give me the medicine so I can just get better. Well, it doesn’t work that way!”

She recounts with emotion finding out that lupus is a life-long, chronic condition: “I remember one of the doctors telling to me that there was no cure; I felt like my life ended right there.”

While 90% of lupus patients are women, the symptoms can be completely different from person to person. Hernandez says that in addition to joint pain, fatigue, and skin rashes, she also experienced weight gain, hair loss, and kidney problems. At that point, she thought that her career as an actress would have to come to an end.

Lupus put a strain not just on Hernandez’ career, but on her relationship as well. At one point, the young woman told her husband that she likely wouldn’t be able to have children, and that he should find a new relationship to fulfill his dream of having kids.

“He said, ‘No way in hell!'” Hernandez laughs. Her husband stood by her side throughout her aggressive medical treatment. She now manages her symptoms with a combination of daily prescription medications and a healthy diet. Staying positive is also an important part of maintaining her mental health.

Hernandez said that her blood tests have shown promising results that her lupus is under control. As a result, she revealed that her and her husband are looking forward to starting a family of their own.

“For Warriors like myself, [becoming a parent] might take a little longer, but I’m not losing hope,” she declared. “If I hadn’t gone what I went through, I wouldn’t be here now, raising awareness [for lupus],” she said.

“Now, lupus doesn’t control me. But I’m using it to help [others].”

Maria can be found on Instagram at: @mariaalejandrahl. To learn more about Maria’s battle with lupus, visit the Today show YouTube channel.

Is There a Genetic Cause of Lupus?

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Gabriella Piqueras, a 16-year-old Spanish girl living with lupus.
Gabriella Piqueras is a 16-year-old girl living with lupus in Madrid, Spain. Her DNA may be the key to finding a genetic cause for this debilitating autoimmune disease. Image courtesy of El Pais.

Researchers have long pondered whether there is a genetic cause of systemic lupus erythematosus, known as lupus for short. Lupus is a systemic autoimmune disease that occurs when the body’s immune system attacks its own vital organs and tissues, resulting in widespread inflammation and debilitating symptoms. Now, researchers have discovered a genetic mutation in a young patient, whose DNA may be the key to finding a cure for the disease that affects at least 5 million people worldwide.

One Girl’s Case My Help Solve the Mystery

Gabriella Piqueras, a 16-year-old teen from Madrid, is the center of a new research study published in Nature magazine. Ever since Piqueras was five years old, she has suffered from debilitating symptoms, like constant bruising and bleeding beneath her skin. She was admitted to a hospital in Madrid for treatment, where she was diagnosed with lupus as the cause behind her painful symptoms.

Piqueras’ DNA was recently studied by Carola Garcia de Vinuesa, a leading immunologist at the Francis Crick Institute in London. In the study, it was discovered that she had a genetic mutation on her DNA that activates the TLR7 receptor in her cell’s membranes. This receptor activation normally causes immune cells to recognize and attack threatening viruses, but in Piqueras’ case, it causes her immune cells to attack her organs and tissues instead.

Discovering a Genetic Cause for Lupus

After discovering the genetic mutation in the patient’s cells, researchers modified the DNA of mice in a lab at Australian National University in Canberra. As a result, the mice went on to develop lupus. Lead researcher Garcia de Vinuesa commented on the study, saying: “It was already known that this receptor appeared to be activated in lupus patients, but no one knew if it was a cause, a consequence or a side effect of inflammation. Now we can show that it is the cause.”

The discovery of the TLR7 receptor as a genetic cause of lupus is significant. Not only does it show that genetics can lead to development of the disease, it could also explain why 90% of lupus patients are women. Garcia de Vinuesa explains that the instructions for making TLR7 are located on the X chromosome on our DNA. Since women have two X chromosomes on their DNA, and men only have one, women are significantly more likely to develop the disease.

Environmental Factors May Also Play a Role

Maria Galindo, a Madrid-based rheumatologist, states that although the study’s findings are important, it’s also important to consider the environmental causes of lupus as well. She explains that there is “a base of genetic susceptibility that, in the presence of external stimuli, triggers an exaggerated autoimmune reaction.” She concludes, “Everything indicates that the TLR7 pathway is very important, but it is not the only one.”

While more research is required to understand both the environmental and genetic factors behind lupus, this Spanish study sheds light on the chronic autoimmune disease that is often referred to as a ‘cruel mystery’. With more scientific research into lupus, more treatments can be developed to help the 5+ million people living with the disease worldwide. And for patients like Gabriella Piqueras, that could make all the difference.

Professional Soccer Player Describes Life with Autoimmune Diseases

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Shannon Boxx, a professional women’s soccer player, secretly battled two autoimmune diseases while winning medals across the globe

Playing Professionally with Invisible Illnesses

In 2012, Shannon Boxx, a professional soccer player on the US national women’s team, was at the top of her career. She had earned medals at three World Cup games and two Olympic gold medals. However, unbeknownst to her teammates and coaches, she had actually been diagnosed with a debilitating autoimmune disease a decade prior, and another autoimmune disease just four years ago.

Boxx, now 42, was first diagnosed with Sjogren’s Syndrome in 2002, which causes widespread dryness, joint pain and fatigue, among other symptoms. She was later diagnosed in 2008 with systemic lupus erythematosus (SLE), or simply, lupus, which also causes a myriad of symptoms, including joint pain, muscle pain, fatigue, skin rashes, brain fog and major organ involvement.

Treatment for Lupus and Sjogren’s Symptoms

When interviewed by the publication The Undefeated, Boxx said that she manages her lupus flares by wearing compression pants, which help with the joint pain that she experiences in her knees. She also takes hydroxychloroquine, also known as Plaquenil, an anti-malarial drug that helps her to manage the joint pain associated with both of her autoimmune conditions. Boxx describes her joint pain as severe; “There were times, even when I was playing on the national team, I was having teammates cut my steak for me because it hurt so much on my wrist to actually hold onto a fork or a knife.”

Fatigue and brain fog are other symptoms that Boxx battles daily. “I used to be able to run forever, and now I can barely walk sometimes for a mile or two. And that’s pretty heartbreaking,” she confessed. Boxx has children, and she wants to be able to run around with her kids for as long as possible. “To know that there’s days that I can’t do it, it puts you in a really bad place, mentally,” she said. When asked about how the fatigue feels, she commented, “It is this feeling of a weight just sitting on you and just even to lift your head off the pillow takes so much effort and your eyes don’t want to open. When I was playing it felt like my feet were in quicksand.”

Autoimmune Disease Triggers

Boxx explained that one of the main triggers for her autoimmune flares is stress. Now that the coronavirus is grappling the world, the global pandemic has added another layer of anxiety to the mix, especially given that she is immunocompromised. As a result, the professional athlete is following local shelter-in-place orders, wearing masks diligently and ensuring to frequently wash her hands and stay six feet apart from others.

Another source of anxiety is the fact that hydroxychloroquine, the medication that she takes, has become more scarce as a result of it being explored for its potential use in treating COVID-19. “It makes me sad that there are a lot of people that are suffering or even worse because they now can’t get the medication that they need,” she said.

Boxx believes another potential source of her flares is over-exposure to the sun, though thankfully, most days are overcast in her home of Portland, Oregon in the Pacific Northwest. She also frequently experiences the so-called ‘butterfly rash‘ that is a hallmark of lupus, and can arise following exposure to sunlight.

Two other factors that must be considered in the pathogenesis of autoimmune disease are sex and race. According to the Sjogren’s Foundation, nine out of 10 Sjogren’s patients are women; similarly, the US National Library of Medicine states that nine out of 10 lupus patients are women. Lupus is also three times more likely to occur in African American women than white women. Boxx, for her part, is a biracial woman, so her gender and ethnic background may have played a part in developing autoimmune diseases.

Moving Forward with Chronic Illness

Shannon Boxx plays in a friendly soccer match against Brazil’s women’s team.

Though living with two different autoimmune conditions is undeniably challenging, Shannon Boxx is determined to live her best life. She retired from playing professional soccer in 2015, and is focusing on taking care of her own health, and spending time with her husband and kids. Though she has retired from professional soccer, she enjoys playing non-competitive games with other international teams and coaching kids’ soccer teams.

Boxx is also an advocate for those living with chronic illnesses, and actively participates in awareness campaigns for the Lupus Foundation of America. Commenting on her conditions, she said, “I’ve been able to deal with it, and still do something that I love…[lupus] has shown me that I can’t take [soccer] for granted, because that’s something that I love to do. If anything it’s given me perspective.”