Systemic Lupus Erythematosus
Current Research continued...
Recent large studies of families with lupus have identified a number of
genetic regions that appear to be associated with risk of SLE. Although the
specific genes and their function remain unknown, intensive work in mapping the
entire human genome offers promise that these genes will be identified in the
near future. This should provide knowledge of the complex factors that
contribute to lupus susceptibility.
NIAMS-funded researchers are uncovering the impact of genetic,
socioeconomic, and cultural factors on the course and outcome of lupus in
Hispanics, African Americans, and Caucasians. Preliminary data show that
African American and Hispanic lupus patients typically have more kidney damage
compared with Caucasians. In addition, NIAMS-funded researchers found that
African American lupus patients have more skin damage compared with Hispanics
and Caucasians, and that the death rate from lupus is higher in African
Americans and Hispanics compared with Caucasians.
It is thought that autoimmune diseases, such as lupus, occur when a
genetically susceptible individual encounters an unknown environmental agent or
trigger. In this circumstance, an abnormal immune response can be initiated
that leads to the signs and symptoms of lupus. Research has focused on both the
genetic susceptibility and the environmental trigger. Although the
environmental trigger remains unknown, microbial agents such as Epstein-Barr
virus and others have been considered. Researchers also are studying other
factors that may affect a person's susceptibility to lupus. For example,
because lupus is more common in women than in men, some researchers are
investigating the role of hormones and other male-female differences in the
development and course of the disease. A current study funded by the NIH is
focusing on the safety and effectiveness of oral contraceptives (birth-control
pills) and hormone replacement therapy in women with lupus. Doctors have
worried about the wisdom of prescribing oral contraceptives or estrogen
replacement therapy for women with lupus because of a widely held view that
estrogens can make the disease worse. Oral contraceptives and estrogen
replacement therapy do not, as once feared, appear to intensify lupus symptoms.
Scientists do not know the effects of oral contraceptives on women with
antiphospholipid antibody syndrome.
Patients with lupus are at risk of developing atherosclerotic vascular
disease (hardening of the blood vessels that can cause heart attack, angina, or
stroke). The increased risk is due partly to having lupus and partly to steroid
therapy. Preventing atherosclerotic vascular disease in lupus patients is a new
area of study. NIAMS-funded researchers are studying the most effective ways to
manage cardiovascular risk factors and prevent cardiovascular disease in adult
In childhood lupus, researchers are evaluating the safety and effectiveness
of drugs called statins that lower LDL (or bad) cholesterol levels as a method
of preventing fat buildup in the blood vessels.
Research has focused on both the genetic susceptibility and the
One out of five lupus patients experiences symptoms such as headaches,
dizziness, memory disturbances, stroke, or changes in behavior that result from
changes in the brain or other parts of the central nervous system. Such lupus
patients have what is called "neuropsychiatric" lupus. NIAMS-funded
scientists are applying new tools such as brain imaging techniques to discover
cellular activity and specific genes that may cause neuropsychiatric lupus. By
uncovering the mechanisms responsible for central nervous system damage in
lupus patients, researchers hope to move closer to improved diagnosis and
treatment for patients with neuropsychiatric lupus.