Access: Lupus Research -- Blood Components
Research Summaries from 2012
Lupus-Related Changes in Energy Metabolism
People with lupus may experience chronic fatigue, the exact causes of which are yet to be fully understood. There are a number of different energy-producing metabolic processes that may be affected in people with lupus, but not much research has been done in this area. The results indicate lupus-related reductions in levels of metabolic markers crucial for energy production, as well as significant reductions in specific antioxidants. The relationship between these changes and some specific lupus drug therapies is discussed, as is possible dietary supplementation.
Short-Term Use of Hydroxychloroquine Reduces Cholesterol in Lupus
People with lupus are at increased risk of cardiovascular disease, especially when taking steroids. The use of anti-malarial drugs, such as hydroxychloroquine, significantly reduces this risk. Few studies have prospectively examined the effects of anti-malarial drugs on cholesterol levels (a cardiovascular disease risk factor, if elevated), especially with short-term use. The results of this study highlight the beneficial effects of short-term hydroxychloroquine treatment in people with lupus.
Seasonal Influences on Lupus Flares
Low levels of vitamin D in the blood are associated with increased lupus disease activity. The degree to which levels of vitamin D fluctuate during lupus flares, especially in different racial/ethnic groups, is not well-known. This study examined the relationship between fluctuating levels of vitamin D during different seasons, characterized by differing amounts of light exposure, while patients experienced lupus flares. The results of this study illustrate seasonal influences on lupus flares, which fluctuated with vitamin D levels uniquely in non-African-American but not in African-American lupus patients.
Interferon-Associated Risk for Premature Heart Disease Among People with Lupus
People with lupus are at increased risk for premature heart disease. Among lupus patients, lupus disease activity is even more important than traditional risk factors for heart disease. Type I interferon, a protein which plays a major role in the etiology of lupus, may have a significant role in the development of premature heart disease in people with lupus. The researchers examined the relationship between type I interferon and premature heart disease among people with lupus and also among women who do not have lupus or other related diseases. Three specific indicators of premature heart disease was studied in these populations. The researchers identify specific heart-related factors that lupus patients should work with their doctors to monitor over time.
Autoantibody Profiling in People with Lupus
Measurement and monitoring of autoantibody levels in people with lupus can be useful in diagnosis and disease monitoring and also have the potential to illustrate the efficacy of drug therapies being taken for lupus over time. There are a number of autoantibodies that are important in lupus, including antibodies to double-stranded DNA (anti-ds-DNA), anti-Smith antibodies, and others, which may have to be tested or measured separately (which can be time-consuming and/or costly). The development of a single test that can simultaneously measure several different autoantibodies important in lupus could be important and useful. The results indicate that a single test can indeed accomplish this and suggest that most lupus patients can be categorized into at least one of two groups that have distinct kinds of autoantibody profiles with unique susceptibilities to specific kinds of lupus manifestations.
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Lupus Anticoagulant Affects Pregnancy Outcomes
Having antibodies typical of anti-phospholipid syndrome (APS) can increase the risk of pregnancy complications. However, whether or not specific women with APS, such as women who also have lupus, may be at even greater risk of pregnancy complications has not been fully established or agreed upon. Identification of specific women with APS or specific characteristics, such as the presence of specific APS antibodies, which can predict increased risk of adverse pregnancy outcomes, could be very useful. The results of this study highlight the important role of lupus anticoagulant, as well as that of a previous blood clot, in adverse pregnancy outcomes.
Men Require More Lupus Genes to Develop Lupus
Lupus is thought to develop due to a combination of both genetic and environmental factors and is more common in women. Numerous studies have identified genes that increase the likelihood of developing lupus. The disparate incidence of lupus in women over men may be related to sex-specific genetic or hormonal factors. However, the degree to which these sex-specific factors favor the development of lupus in women over men has not been well established. The results of this study indicate that men require more lupus genes than women in order to develop lupus. The implications of these results are discussed in the context of possible sex- and hormone-related differences between men and women with lupus.
Vitamin D Indicates Lupus Disease Activity But Not Organ Damage
Vitamin D promotes calcium absorption from the gut and also helps to maintain appropriate levels of calcium in the blood. It is essential for maintaining bone health, but also regulates immune functions. Vitamin D is normally produced in the body upon exposure to sunlight. However, since many people with lupus avoid sun exposure, they may be at risk for having less than optimal levels of vitamin D. This study examined the relationship between levels of vitamin D and autoantibodies in people with lupus. The results highlight the importance of physician-guided maintenance of appropriate levels of vitamin D in people with lupus.
Optimizing Assessment of Heart Disease Risk in People with Lupus
Lupus is associated with an increased risk for developing cardiovascular disease. Previous studies indicate that this increased risk cannot be fully accounted for by traditional risk factors, such as high cholesterol or blood pressure. Heart disease risk is typically assessed based on, at least in part, measurement of blood pressure and cholesterol levels at a certain point in time for a person of a given sex and age. However, recent studies suggest that cholesterol and blood pressure can vary considerably over time in people with lupus. This study examined whether heart disease risk could be better predicted in people with lupus when multiple measures of cholesterol and blood pressure were taken over time. The results suggest that traditional methods of blood pressure assessment (such as single-point-in-time measures) tend to underestimate its potential role in the development of heart disease and do not predict heart disease-related outcomes in people with lupus. Potential strategies to better assess heart disease risk in people with lupus are discussed.
Research Summaries from 2011
Blood Test May Indicate Lupus Nephritis Activity
Inflammation of the kidneys, or lupus nephritis, is a relatively common and potentially severe manifestation of lupus. It can be difficult to accurately identify, however, without a kidney biopsy. The development of new kinds of tests that could help identify lupus nephritis disease and activity without the need for such an invasive procedure could be very useful. The researchers developed a new kind of blood test to help identify lupus nephritis disease and activity among a variety of patients with kidney disease (some with lupus and some without).
Genetic Profiling Can Predict Some Lupus Manifestations
People with lupus can experience a wide variety of disease-related manifestations, including nephritis (kidney inflammation) and skin rashes. The variability of these symptoms likely results from underlying genetic factors. While most studies have focused on identifying the presence of specific genes that increase the risk of developing lupus, few studies have focused on which genes may give rise to which manifestations of lupus. Identification of which genes may be associated with which lupus manifestations could help facilitate the future development of personalized medicine for people with lupus.
Variable Effects of Two Influenza A (H1N1) Vaccinations in People with Lupus
Most of the world’s population had little or no pre-existing immunological protection against the 2009 influenza A (H1N1) pandemic. People with lupus were considered to be at especially high risk and were recommended for vaccination. Relatively little is known, however, about the effects of influenza vaccinations in people with lupus. This vaccination had variable effects in people with lupus and depended on their white blood cell count and on whether they were taking immune-suppressing drugs. The results highlight the importance of acquiring increased knowledge about and perhaps developing additional strategies for vaccinating people with lupus against influenza A (H1N1).
Are MicroRNAs Novel Biomarkers for Lupus Nephritis?
People inherit DNA from their parents and it contains the blueprints for making all of the proteins in the body. RNA is the translating material which helps in the conversion of these blueprints into functioning proteins. MicroRNAs are small pieces of RNA that help to regulate the extent to which instructions for making specific proteins can be used for that purpose. Specific blueprints can be “turned off” by microRNAs so that some proteins won’t be made. The role of microRNAs in lupus has recently been studied. Specific microRNAs have been identified in lupus patients and in some patients who have kidney involvement (lupus nephritis). In this study, the researchers hoped to learn whether people with lupus kidney involvement from different races shared the same set of microRNAs.
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New Combination of Antibodies May Better Predict Childhood Neuropsychiatric Lupus
Neuropsychiatric lupus (NPSLE) is difficult to diagnose and can be present when disease activity in other organs cannot be identified. The researchers hoped to learn whether antibodies to ganglioside M1, a fat found throughout the brain, could predict childhood NPSLE any better than standard laboratory measures currently in use. At the time of initial evaluation (and before NPSLE developed), 83% and 50% of children who later developed NPSLE had anti-ganglioside M1 and anti-ribosomal P antibodies, respectively. None of the 18 patients who did not develop NPSLE had either one of these antibodies. This study suggests that anti-ganglioside M1 antibodies might help to predict NPSLE in children with lupus, especially when paired with anti-ribosomal P antibodies.
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Research Summaries from 2010
Use of Hydroxychloroquine Benefits Sugar Metabolism in Women With Lupus
Hydroxychloroquine (Plaquenil) is in a class of drugs that was originally developed to treat malaria and has been considered to be a safe and effective treatment for mild lupus and rheumatoid arthritis (RA) since 1957. Low blood sugar is an occasional side effect of taking these anti-malarial drugs, but how this happens is not well understood. The researchers hoped to learn whether there are any tests that could predict low blood sugar in women with lupus taking hydroxychloroquine.
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Low Levels of Vitamin D Are Seen With Increased Lupus Disease Activity
Low levels of vitamin D are associated with autoimmune illnesses, especially lupus. Vitamin D is activated by a chemical reaction made possible by exposure to the sun’s ultraviolet B rays. Since people with lupus may need to avoid sun exposure, this can increase the risk for vitamin D insufficiency. The researchers hoped to learn about the relationship between levels of vitamin D in the blood and lupus disease activity.
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Lupus Antibodies Related to Persistent Disease Activity and Heart Disease
People with lupus are at increased risk for developing heart disease. It is known that lupus patients make antibodies that could interfere with some of the proteins that control cholesterol. Since unregulated cholesterol is a risk factor for heart disease, it is possible that these particular antibodies might increase the risk for this in lupus patients. The researchers hoped to learn whether antibodies to cholesterol regulators are associated with disease activity or heart disease in people with lupus.
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Proteins on Blood Cells More Accurately Predict Lupus Disease Activity
There are a number of ways that a doctor can monitor people to try to predict lupus flares. The measurement of complement proteins, C4 and C3, in blood samples is widely used in this way. Measurement of two proteins that split off from C4 and C3 (C4d and C3d) and may be increased in the blood during inflammation has also been found useful, although these tests are not widely available at this time. The researchers hoped to learn whether measurement of C3d and C4d would be a more accurate way to test for lupus disease activity when measured while attached to a red blood cell than when they are freely circulating in the blood.
An Exploration Study of Umbilical Cord Stem Cell Treatment in Lupus
In animal studies, stem cells taken from the umbilical cord (which connects the mother to the baby during pregnancy) have been found to help treat a variety of diseases, including lupus. However, umbilical cord stem cells have not been given to humans before. The researchers hoped to determine whether umbilical cord stem cells could be given safely to people with severe and treatment-resistant lupus, and whether this might help to treat lupus.
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Blood Components Help Differentiate Lupus and Antiphospholipid Syndrome
Cytokines are proteins of the immune system that work to communicate between different cells. Tumor necrosis factor- α (TNF-α) is a cytokine that helps to control both blood clotting and inflammation and soluble interleukin-2 receptor (sIL-2R) helps to regulate inflammation. Results from this study suggest that both proteins may be important clues to figuring out how lupus develops and that TNF-α, especially, may play a role in risk for blood clotting.
Low Level of Vitamin D Does Not Necessarily Result in Bone Disease in People With Lupus
People with lupus are advised to avoid the sun because the ultraviolet rays can trigger rashes. Some patients experience more widespread flares after sun exposure. However, sun avoidance leads to low levels of vitamin D in the body. Low levels of vitamin D are associated with thinning of the bones, or "osteoporosis." The researchers wanted to know about possible relationships between vitamin D levels in the blood, lupus treatments, and bone mineral density (BMD), a measurement of how thick bones are. The results of this study showed that people with lupus who are treated with steroids are at increased risk of having low levels of vitamin D. Although reduced levels of vitamin D are known to be directly linked to osteoporosis, this study did not show that connection.
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Can Blood Tests Help Us Learn about CNS Lupus (Lupus and the Brain)?
Some people with lupus can develop mild or, more rarely, severe inflammation of the brain, also called Central Nervous System lupus (CNS lupus). Very rarely, people can develop serious problems from CNS lupus such as seizures or strokes. Sometimes it is hard to know the difference between CNS lupus and problems that might be due to fatigue, depression, or migraine headaches. Therefore, it would be helpful to have blood tests that could tell the difference, so appropriate treatments could be given.
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Research Summaries from 2007
When Platelet Counts are High
The spleen is an important organ in both the body’s immune system and its blood circulation. The spleen makes antibodies that protect against infections. The researchers wanted to see if there were specific lupus symptoms that showed up more often in patients whose spleens weren’t functioning well. The findings of this study suggested that when lupus patients have high platelet counts, the damage to the spleen could be caused by blood clots related to antiphospholipid antibodies.
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Study Identifies Possible Cause of Low Platelet Count in Lupus
Having a reduced number of platelets is a serious complication of lupus. A large percentage of cases are due to antibodies that bind to at least one of two proteins on the surface of blood platelets. A group of researchers in Tokyo have studies these two types of antibodies and suggest that antibodies to each of the proteins operate in distinctly different ways.
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