Is lupus genetic?
No single gene or group of genes has been proven to cause lupus, although certain gene variations have been linked to lupus. Lupus does, however, appear in certain families. For example, if an identical twin develops lupus, there is a higher chance that the other twin (who has the exact same genes) will develop it, while there is a smaller chance for fraternal twins according to a study published in 2012. Studies suggest that there is an increased risk of developing lupus if a family member has been diagnosed.
The majority of lupus cases that develop are referred to as sporadic, which means no known relative has the disease. Although lupus can develop in people with no family history of lupus, there are often other autoimmune diseases in some family members.
People of African, Asian, Pacific Island, Hispanic/Latino, Native American or Native Hawaiian descent have a greater risk of developing lupus, which may be related to genes. In the U.S., communities of color have higher and more severe disease activity, which may also be linked to social determinants of health like poverty or lack of access to health care.
There is no known cause for lupus, but it’s likely that lupus results from several factors interacting with each other. For example, we know that genetics, environmental exposures (such as certain medications or severe exposure to ultraviolet rays) and hormones all likely contribute to the development of lupus. The microbiome, or the collection of bacteria and other microorganisms that live in a person’s intestinal tract, may also be important. While the disease mostly affects women, at least 10% of men live with lupus.
People are more susceptible to developing lupus if they have immediate relatives with the disease, but that doesn’t mean they will. In fact, most don’t, says Lindsey Criswell, MD, MPH, director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Even if a person with lupus has an identical twin, there’s less than a 50% chance the undiagnosed twin will develop it.
Probably not, says Courtney Montgomery, PhD, member of Oklahoma Medical Research Foundation in Oklahoma City. The goal of genetic research is to improve outcomes for people with lupus, not change their DNA. “Besides, we fear that if we alter the DNA code to fix one thing, there may well be unexpected, negative consequences elsewhere,” she says.
Currently, no screening or genetic tests are available. We encourage family members to lead active, healthy lives. Sunscreen protection is always a good idea. If symptoms develop (e.g., joint swelling and pain, unexplained rashes, atypical chest pain), we encourage family members to seek evaluation from their regular doctors, and to be sure to mention the family history of lupus.
If your children show no symptoms of lupus, checking for autoantibodies in the blood (ANA, double-stranded DNA, and others) will not be an effective screen for the presence or absence of lupus. ANA testing is not advisable in individuals who do not have symptoms, and we highly discourage testing children for lupus since doing so in the absence of lupus signs or symptoms usually causes undue concern or alarm.
While there is a likelihood that a mother with a positive ANA test will predispose a child to have a positive ANA, the ANA test alone is not helpful without other signs or symptoms of lupus.
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