Leading the way to a cure

Lupus Research Update: 2006 Volume 3

Volume 3, 2006 - Online Edition | In This Issue

Meet the Investigator >
Pilot Grant Program >
Research Results - Using Cholesterol Levels to Screen for Worsening Lupus-Related Kidney Disease >
Research Results - New Genetic Findings Linked to Lupus in Mouse Models >
Research Results - Rituximab for Lupus Shows Promise >
Research Results - New Target for Treatment Identified >
Advocacy Update - Senator Charles Schumer Champions Lupus Research >
Beyond the Research - The ALR Walks Nationwide >
Drug Research and Development News >

Research Results - Using Cholesterol Levels to Screen for Worsening Lupus-Related Kidney Disease

How are cholesterol levels and lupus nephritis, or inflammation of the kidney, connected? That’s just the question Annaliese Tisseverasinghe, a young medical student at the University Health Networks Research Institute -Toronto Western Hospital, wanted to answer. She’d read that high blood levels of cholesterol, or hyperlipidemia, can make kidney disease worse in animal models and in humans without lupus nephritis and thought it would make a great project.

Although a published study had already connected hyperlipidemia with the development of renal failure in lupus patients, Ms. Tisseverasinghe and her colleagues designed their study to identify any association between high total cholesterol level taken the first time a patient was seen in a lupus clinic and kidney problems years later.

The researchers evaluated data prospectively collected on 1,060 patients seen in the University of Toronto lupus clinic since 1973, with an average follow-up period of 8.8 years. They found 9 percent of patients had experienced kidney deterioration and 4 percent were in end stage renal disease. Overall, nearly one-third of the 161 deaths that occurred were related to kidney disease. The bottom line: a high total cholesterol level obtained during a first visit to a lupus clinic is significantly associated with renal deterioration and death, suggesting that high cholesterol levels contribute in some way to a worse renal outcome in lupus. The results were published in the July 2006 issue of the journal Arthritis and Rheumatism.

“The immediate implications for lupus patients with renal disease is that there is now an additional reason to aggressively treat dyslipidemia in the hope that it will not only decrease their risk of cardiovascular disease, but may also delay progression towards renal damage,” said Paul Fortin, MD, senior scientist at the University Health Network Research Institute and Director of Clinical Research at the Arthritis Centre of Excellence. He is Ms. Tisseverasinghe’s mentor and oversaw this study.

What’s next? Dr. Fortin and his team are now trying to see if a specific lipid abnormality, such as high LDL cholesterol or triglycerides, is associated with the finding. They are also interested in studying whether certain autoantibody profiles, especially those related to oxidized LDL cholesterol, might be a possible “lupus factor,” associated with worse renal outcome. Meanwhile, Dr. Tisseverasinghe is completing her residency in internal medicine and hopes to begin a fellowship in rheumatology in three years.

Tisseverasinghe A, Lim S, Greenwood C, Urowitz M, Gladman D, Fortin PR. Association between serum total cholesterol level and renal outcome in systemic lupus erythematosus. Arthritis Rheum. 2006 Jun 26;54(7):2211-2219

Just the Facts

What the study showed:
High cholesterol levels early in lupus may predict a worse outcome in later renal disease

What it means:
Lupus patients have another reason to try and reduce serum cholesterol levels

What's next:
Zeroing in on the type of cholesterol that may be related to the kidney damage

ALR-related research:
ALR-funded researcher Michelle A. Petri, MD of Johns Hopkins University is currently testing the effectiveness of the statin drug atorvastatin (Lipitor) in slowing the development and progression of atherosclerosis and overall disease activity in lupus patients. Additionally, ALR-funded researcher Bevra Hahn, MD of the University of California, Los Angeles is investigating whether potential lipid markers are associated with atherosclerosis in lupus patients and developing a lupus-specific risk prediction model for atherosclerosis.

ALR funding:
$1.3 million to date

1.5 million

people in the U.S. have Lupus.

172 million

dollars committed to lupus research by the Lupus Research Alliance.

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