March 8, 2023
As part of our researcher interview series, we are featuring 3 Questions with Ashira Blazer, MD, at Hospital for Special Surgery — one of our Diversity in Lupus Research Award recipients. Below Dr. Blazer explains why she focused her career on lupus, and explains how the project LRA is funding will help people with lupus nephritis.
1. Why did you choose to focus on lupus research in particular? Do you have a personal connection to lupus?
In many ways, lupus chose me. As a medical student, I was interested in immunology, but I wasn’t sure where my focus would land. One late November, I got a call from my first cousin while I was studying for my musculoskeletal block exam. With my textbook in my lap open to the chapter on lupus, I asked why she had missed our usual holiday celebration. She told me that she had been feeling sick and started to describe her symptoms. As she spoke, I realized I was reading each symptom from the pages of my textbook. I told her I thought she could have lupus, and the next week we spoke with my then professor. We quickly got her to care, and over the next weeks and months, made the diagnosis and devised a treatment plan. I also learned of other family members who carried the diagnosis. I’ve always been extremely family-oriented, and studying lupus was a way to marry my scientific interests with my sense of caring for my community.
2. Why is diversity important in the lupus research field? Why would you encourage other researchers of diverse backgrounds to consider focusing their career on lupus research?
While science enjoys an impartial reputation, the truth is all scientific questions are asked by people. People carry their own experiences, world views, and biases. When scientific questions are asked from one or two cultural perspectives, the body of work produced can also carry those world views and biases. This can perpetuate disparities or even structural racism in science and medicine. Breaking down these barriers requires scientists of all racial, ethnic, socioeconomic, and gender diverse backgrounds. This is especially true in SLE research because most of the affected patients are women of color
3. What do you hope your Career Development Award project will achieve for people with lupus?
More often than not, when a lupus patient develops kidney disease we assume that lupus nephritis is the primary cause. About 13% of the African American population carries a genetic risk factor that causes kidney disease and protein in the urine. This risk is caused by common mutations in the Apolipoprotein L1, or APOL1, gene. In my prior work, lupus nephritis patients with APOL1 gene mutations were more than twice as likely to need dialysis compared to those without the mutations. Currently the kidney biopsies we use to diagnose cannot differentiate lupus nephritis from APOL1-associated kidney disease. My Career Development Award will be a step forward in developing a non-invasive urine test for APOL1 associated kidney disease in lupus nephritis. This is especially important because African-ancestry lupus patients are at highest risk for kidney disease and dialysis.