What Causes Lupus?

Lupus is a chronic (long-lasting) autoimmune disease that causes inflammation. When a person develops an autoimmune disease like lupus, their immune system attacks healthy cells or tissues by mistake. Lupus affects several organs and parts of the body, including the skin, lungs, kidneys, joints, muscles, and heart.

Similar to other autoimmune conditions, the cause of lupus is currently unknown. However, research shows that a combination of hormonal, genetic, environmental, and immunologic factors can increase your risk of developing the condition.

Risk Factors

While researchers are still studying the exact underlying cause of lupus, they have identified some risk factors that can increase your chances of developing the condition. Here’s what they suspect: your hormones, genes, environment, and immune system functioning—or a combination of these factors—can all influence your likelihood of developing lupus.

Hormonal

Lupus is almost 10 times more common in women than in men. Researchers believe that hormones may contribute to why more women than men are living with the condition. These hormones include, but are not limited to:

• Estrogen
• Estradiol
• Testosterone
• Prolactin
• Progesterone
• Dehydroepiandrosterone (DHEA)

Many research studies have attempted to understand the role of hormones in the development of lupus. The Nurses’ Health study researched if the change in estrogen levels during a woman’s menstrual cycle would increase a woman’s chance of getting the conditions. The results of the study found that the following factors put a women at an increased risk for lupus:

• Early age of first period 
• Use of oral contraceptives (e.g., birth control) that contain estrogen
• Hormone replacement therapies after menopause

Genetic

Certain genes may play a role in the development of lupus. Researchers believe some genes carry instructions for proteins that can affect how the immune system works and make you vulnerable to inflammation in your immune system.  

While more research is needed, some studies have shown that genetic variations can increase the risk of lupus. In most cases, mutations in multiple genes can give you a higher chance of developing the condition.

Immunologic and Inflammatory

Because lupus is an autoimmune condition, most people living with lupus experience changes in the way their immune system works. 

Researchers have learned that when cells are damaged or no longer needed in your immune system, they go through apoptosis—a process that causes the self-destruction or death of the cells. In most cases, these cells exit the body when they are no longer in use. 

However, for people living with lupus, researchers believe that the dead cells remain in the body and release substances or toxins that can trigger inflammation in the immune system. As a result, the immune system begins to attack healthy tissues within different organs of the body, eventually manifesting the physical symptoms of lupus.  For people living with lupus, these dead cells are not cleared away properly from the body.

Environmental

Studies have found that certain environmental factors can influence your likelihood of developing lupus. These factors include: have been associated with an increased risk of developing lupus. Research has linked lupus to:

• Having a current or past history of smoking cigarettes
• Exposure to silica dust—commonly in cleaning powders, soil, pottery materials, and cement
• Getting certain infections, such as the Epstein-Barr virus (EBV) or other bacterial infections, which can cause inflammation in your immune system  
• Using or being exposed to ultraviolet (UV) light 
• Being allergic to certain medications such as antibiotics

Is Lupus Hereditary?

Like many autoimmune diseases, lupus tends to run in families. However, having a family history of lupus doesn’t guarantee that you will develop the disease. 

It is important to note that in most cases, people do not inherit the condition itself. Instead, people inherit the genetic mutations that increase or decrease their risk of developing lupus.

But, keep in mind:

• Not all people have lupus developed the condition because of a genetic mutation
• Having a genetic mutation does not guarantee that you will develop the condition

Lupus affects each person differently—which is why getting a diagnosis for the condition can be so tricky sometimes. 

Who Gets Lupus?

Anyone can get lupus. But, some people are more likely to develop lupus than others. The following risk factors may increase your likelihood of developing the condition:

• Sex: Lupus is more common in women than in men.
• Age: Lupus is most common in women ages 15 to 44 years old.
• Ethnicity: Black women are more likely to develop lupus compared to white women. Lupus is also more common in women who are Hispanic, Asian, Native American, and Alaska Native. 
• Geography: Over the past 50 years, lupus has become more common in industrialized Western countries. Researchers believe that people living in Africa and Asia have lower rates of lupus compared to Western countries. But, women of African or Asian ancestry who live in Western countries are more likely to develop lupus than women of European ancestry. 

A Quick Review

Lupus is a complex autoimmune condition that causes your immune system to attack healthy tissue in organs like the skin, kidneys, heart, and lungs. The exact cause of lupus is currently unknown. 

Researchers hypothesize that a combination of hormones, genes, immune system functioning, and environmental factors can increase your risk of developing lupus. Other factors, such as being a woman, also raise your chances of developing the condition.