ISSUE #6 SEPTEMBER 2006
Lupus Now® Research Update is an electronic publication of the Lupus Foundation of America, the nations leading nonprofit voluntary health organization dedicated to lupus. This e-newsletter provides reviews of recently published papers from significant medical journals translated into understandable language, information about advances in lupus research and clinical studies, and other relevant news for individuals with an interest in lupus. The commentary aims to put research findings into perspective, explain the limits to the conclusions that can be drawn, and examine the possibilities for future research directions. This is an exciting time in lupus research, so it is important for everyone in the lupus community to be fully informed about ongoing studies and developments and what they might mean.
Joan T. Merrill, M. D., Editor Head, Clinical Pharmacology, Oklahoma Medical Research Foundation Medical Director, Lupus Foundation of America, Inc.
Freemer, M. ; King Jr., T. ; Criswell, L., Annals of the Rheumatic Diseases 2006; 65: 581-584
Researchers looked at the medical records of 410 lupus patients which included a self-report of each persons smoking history and the antibodies that had been detected in these patients. Since the current smokers in this study appeared to have more double-stranded DNA (dsDNA) antibody than former smokers, the researchers suggested that the mechanism by which tobacco smoke alters DNA could be an important factor in what causes these antibodies to be made. The findings of this study, though dealing with the relation between smoking and dsDNA autoantibodies, may therefore have implications for understanding what causes lupus in general.
Rider, V. ; Li, X. ; Peterson, G. ; Dawson, J. ; Kimler, B. ; Abdou, N., Journal of Rheumatology 2006; 33: 1093-1101
Lupus is nine times more frequent among women of childbearing ages than men. This overwhelming difference, coupled with the way that flares seem to occur with certain phases of the menstrual cycle, has spurred research into the role of sex hormones in the development of lupus and disease activity. In particular, the interactions of immune cells (B and T cells) and estrogen has been the subject of growing attention. In this study, researchers compared the effects of one type of estrogen, estradiol 17-ß (beta) on the T cells of women with lupus and healthy women.
Espinosa, A. ; Zhou, W. ; Ek, M. ; Hedlund, M. ; Brauner, S. ; Popovic, K. ; Horvath, L. ; Wallerskog, T. ; Oukka, M. ; Nyberg, F. ; Kuchroo, V. K. ; and Wahren-Herlenius, M., Journal of Immunology 2006; 176: 6277-6285
Individuals affected by Sjögrens syndrome and lupus have immune system proteins (autoantibodies) that target a protein called Ro52, and this protein itself may be increased in the patients. The findings suggest the possibility that increased manufacture of Ro52 by patients with Sjögrens and lupus could be part of the reason why they have unbalanced immune cell activation and problems with regulated immune cell disposal (programmed cell death or apoptosis).
Leung, Y. Y. ; Lo, K. M. ; Tam, L. S. ; Szeto, C. C. ; Li, E. K. ; Kun, E. W., Lupus Vol. 15, No. 5, May 2006, pp. 276-281
In order to measure how well the kidneys are functioning, doctors frequently use a measurement called the creatinine clearance (CrCl) which requires patients to save all of their urine over a 24-hour period. Researchers wanted to know whether creatinine clearance (CrCl) that is estimated by different, easier methods agreed with the CrCl measured, using a 24-hour collection. The researchers found that easier methods for measuring kidney function, although not perfect, are reasonably reliable. This could be of significant benefit in treating patients and also in running clinical trials of new medications.
Allen, E. ; Farewell, V. ; Isenberg, D. ; Gordon, C., Rheumatology 2006; 45(3): 308-313
Researchers have long attempted to develop some framework to sort patients into subgroups so predictions could be made about who might do better with one treatment approach versus another. In this study, researchers studied the symptoms and test results of 440 lupus patients over 10 years and found that patients who had previous history of active disease in a given part of the body were at greater risk for having future disease activity of the same type. A patient's chance of developing active kidney (renal) disease was increased if there was evidence of past damage in the kidneys.
Zampieri, S. ; Alaibac, M. ; Laccarino, L. ; Rondinone, R. ; Ghirardello, A. ; Sarzi-Puttini, P. ; Doria, A. ; Peserico, A., Annals of Rheumatic Diseases 2006; 65: 545-548
Tumor necrosis factor alpha (TNF-alpha) is an immune-regulating protein (cytokine) that is released by cells into the bloodstream. In this study researchers examined biopsy samples taken from patients with lupus skin rashes. The skin rash samples showed a strong presence of TNF-alpha particularly in the skins outer layer (the epidermis). These findings suggest that TNF-alpha is produced by the surface region of the skin, and might have a role in causing of this kind of rash.
Wozniacka, A. ; Lesiak, A. ; Narbutt, J. ; McCauliffe, D. P. ; Sysa-Jedrzejowska, A., Lupus Vol. 15, No. 5, May 2006, p. 268-275
In this study, chloroquine phosphate (brand name: Aralen®) was tested to see if it could affect cytokines in lupus patients, including two interleukins (IL-6 and IL-18) and a special inflammatory protein called tumor necrosis factor alpha (TNF-alpha). After three months of chloroquine therapy, at a dose of 125 mg twice daily, the levels of IL-6, IL-18 and TNF-alpha decreased significantly in the lupus patients The results indicate that chloroquine treatment lowers some inflammatory proteins.
More than 60 percent of women 50 years of age and older who have participated in a medical research study would definitely or probably participate again if given the opportunity, according to a recent survey conducted by a Washington, D. C. advocacy organization.
The LFA continues its series of public and professional education programs “State of the Art Approaches from Lupus Experts” for people with lupus, their families, and health professionals. Scientific thought leaders provide updates on new basic and clinical research developments, including skin disease, renal disease, and pregnancy, and the latest information on investigational therapies and clinical trials of potential new medicines to treat lupus.
The Eighth International Congress on SLE and Related Conditions will be held in Shanghai, China on May 23-27, 2007. The scientific program covers cutting-edge development in basic research, the latest advances in clinical management, and rapid progress in translational medicine. The Lupus Foundation of America will lead a parallel conference for individuals with lupus and their families. A highlight of the Congress will be the fourth observance of World Lupus Day on May 25.
The LFA, through its Five-Year Research Program, Bringing Down the Barriers, has this year awarded research grants to 23 investigators at 22 institutions in the United States, adding nearly $1 million to LFAs on-going commitment to lupus research. Since its inception, the LFA and its chapters have provided more than $16 million to support lupus research.
Public awareness of lupus received a giant boost on August 31 when representatives of the LFA appeared on ABC's Good Morning America. Dr. Susan Manzi, a member of the LFA Medical-Scientific Advisory Council, presented an overview of the medical aspects of lupus. Kelly Drury, an LFA national spokesperson, discussed her personal case of lupus and explained to GMA's nearly six million viewers the serious impact lupus can have on individuals and families. This was an excellent opportunity to bring urgently needed national attention to lupus.
Walk for Lupus Now® is the official lupus walk-a-thon to raise funds for lupus research and education programs. This fall, LFA chapters throughout the nation will conduct walking events. Walk with us to support the LFA and help raise urgently needed funds to help individuals in your community who need our help TODAY.