A new blood test may help identify relatives of people with lupus who have an increased risk of developing the disease.
New research out of the Oklahoma Medical Research Foundation (OMRF) may help clinicians identify which relatives are at the greatest lupus risk. OMRF scientists, Judith James, M.d., Ph.D., and Melissa Munroe, M.D., Ph.D., published their findings in February 2017 in Arthritis & Rheumatology.
Dr. James, an expert in the field of immunology who has contributed over fifty studies to peer-reviewed journals, spoke to the purpose of her research. “We know that family members have some shared genetic risk [of developing lupus],” she said, “but we want to identify who is most at-risk.”
Exploring the research on blood tests
409 relatives of people with lupus were enrolled in the research study. None of the participants had lupus themselves at the time of enrollment. Participants provided:
- family information
- demographic data
- clinical information
- Connective Tissue Disease Screening Questionnaire (SLE-CSQ)
- American College of Rheumatology classification for SLE (participants had to score under 4 to be in the study)
- serum and plasma samples
- Tested for lupus-associated autoantibodies and 52 soluble mediators
Researchers maintained some contact with participants over the next years to measure the number of people that developed lupus. 11% (45/409) of participants developed lupus during follow-up. The average follow-up time was 6.5 years.
Within 6.5 years, 11% of people that have a relative with lupus developed the autoimmune disease
Blood markers for lupus development
While the result above is interesting, the researchers goal is to predict which people are likely to develop lupus. “This research focused on trying to find blood markers that identify people, even seven years beforehand, who are going to become lupus patients,” said Dr. Munroe.
There were statistically significant differences between the people that developed lupus. At a very high level of statistical significance (P < 0.0001), the relatives that developed lupus had higher SLE-CSQ scores and more autoantibody specificities.
At baseline, those that developed lupus had elevated “plasma level of inflammatory mediators, including B lymphocyte stimulator, stem cell factor (SCF), and interferon-associated chemokines (P <= 0.02).” They also had lower levels of regulatory mediators such as transforming growth factor beta and interleukin-10.
The researchers note that these results provide a method for identifying high-risk relatives who may benefit from prevention trials.
With an eye to the future, Dr. James and Dr. Munroe will be working with other researchers on the SMILE project, a clinical trial that will treat people that are at high-risk for lupus with anti-inflammatory medications.
The goal isn’t just to prevent new cases of lupus, though. Dr. James expanded on the vision for their research: “We can learn from the immune systems of family members who don’t get sick. This might tell us how we could retrain the immune system to keep people healthy.”