Systemic Lupus Erythematosus
Current Research continued...
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 lupus patients.
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 environmental trigger.
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.
Promising Areas of Research
- Identifying lupus susceptibility genes
- Searching for environmental agents that cause lupus
- Developing drugs or biologic agents to treat lupus
Researchers are focusing on finding better treatments for lupus. A primary goal of this research is to develop treatments that can effectively minimize the use of corticosteroids. Scientists are trying to identify combination therapies that may be more effective than single treatment approaches. Another goal is to improve the treatment and management of lupus in the kidneys and central nervous system. For example, a 20- year study supported by the NIAMS and the NIH found that combining cyclophosphamide with prednisone helped delay or prevent kidney failure, a serious complication of lupus.
Scientists are using novel "biologic agents" to selectively block parts of the immune system.
On the basis of new information about the disease process, scientists are using novel "biologic agents" to selectively block parts of the immune system. Development and testing of these new drugs, which are based on compounds that occur naturally in the body, comprise an exciting and promising new area of lupus research. The hope is that these treatments not only will be effective, but also will have fewer side effects. Preliminary research suggests that white blood cells known as B cells may play a key role in the development of lupus. Biologics that interfere with B cell function or block the interactions of immune cells are active areas of research. These targeted treatments hold promise because they have the advantage of reduced side effects and adverse reactions compared with conventional therapies. Clinical trials are testing the safety and effectiveness of rituximab (also called anti-CD20) in treating people with lupus. Rituximab is a genetically engineered antibody that blocks the production of B cells. Other treatment options currently being explored include reconstructing the immune system by bone marrow transplantation. In the future, gene therapy also may play an important role in lupus treatment.