Leading the way to a cure


New Predictors of SLE Disease Activity

Pascual, Virginia, MD

Baylor Institute for Immunology Research

SLE is characterized by flares that cannot be predicted with current laboratory tests. Assessment of disease activity is time-consuming, as it requires the clinical evaluation of the patient together with different laboratory tests. The ALR funded an initial project by Dr. Pascual and her colleagues that successfully developed a new test to monitor the severity of the disease and the response to treatment. They worked with “global leukocyte gene analysis” — a technique using the equivalent of a teaspoon of blood to analyze the expression of all genes within white blood cells. They studied the blood of children and adults with SLE suffering from a wide array of clinical manifestations. By combining the results of these tests with novel statistical analyses, they identified a series of markers that were used to calculate “activity scores” and rank patients according to the severity of their disease. These scores were compared with the standard measurements of disease activity, which rely on physical examinations by the physician at each visit and the results of several different blood and urine analyses. The results of this comparison support the validity of the test that Dr. Pascual’s team developed. Further, some of the markers that they identified can predict the development of kidney disease in children with SLE months before any clinical or laboratory evidence appears. The goals for the next two years of the research are to validate these tests in a large scale study using samples from pediatric patients across the country. They also plan to design a simple, affordable version of the test that could be applied to any SLE patient to assess the severity of the disease and predict the development of serious complications like kidney inflammation.  

What this study means for people with lupus: Ultimately, this test would allow doctors to better treat patients. It would enable them to monitor disease activity and spot oncoming flares so that they could intervene with more aggressive therapy early and, thus, perhaps prevent irreversible complications. Further, doctors could monitor your response to therapy and be able to lower the dose of potent drugs sooner when your flare is coming under control.  

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