The cause of lupus has long escaped doctors trying to treat the autoimmune disease.
However, a study published this week identified a cause of lupus based on molecular defects in patients’ blood. Lupus overproduces specific cells that attack the body’s organs and tissues. The incurable disease affects hundreds of thousands of people in the U.S.
Researchers are trying to strike a balance with the cells to help regulate lupus. Treatment currently relies on immunosuppressants to reduce inflammation and pain, however, the drugs often don’t effectively treat the disease and their side effects hinder the body’s ability to stave off infections, researchers said.
“Up until this point, all therapy for lupus is a blunt instrument. It’s broad immunosuppression,” said study co-author Dr. Jaehyuk Choi, an associate professor of dermatology and a Northwestern Medicine dermatologist, in a statement. “By identifying a cause for this disease, we have found a potential cure that will not have the side effects of current therapies.”
Choi’s colleagues at Northwestern and researchers at Brigham and Women’s Hospital in Boston took part in the study published this week in the journal Nature. They compared blood samples of 19 patients with systemic lupus erythematosus, the most common form of lupus, and 19 patients without the autoimmune disease.
More than 200,000 people in the U.S. have lupus, according to the Centers for Disease Control and Prevention, but the nonprofit Lupus Foundation of America estimates the number is closer to 1.5 million people. Most people with lupus are women and people of color. The disease is more common among Black women and they tend to suffer from more severe forms of disease and die at a higher death rate from it than others, the CDC said. Most people survive with lupus, but the Lupus Foundation said around 10 to 15% of people with lupus die prematurely due to complications of the disease.
Before the study was published this week, scientists had not identified a cause for lupus. Experts theorized that genetics, environmental factors including chemicals or viral infections, or immune and inflammatory influences were possible causes, the National Institutes of Health said.
People with lupus typically experience extreme fatigue, pain or swelling of muscles and joints, skin rashes such as butterfly-shaped rash on their cheeks or nose, fever and hair loss. It causes problems across the body, including kidney failure, seizures and memory problems. It attacks the brain and central nervous system and causes heart problems, the NIH said.
The findings by Northwestern and Brigham and Women’s researchers may give some semblance of hope, although the results are early and based on a small sample of blood tests.
Researchers identified a new cause for lupus. The patients in the study had a chemical imbalance that controlled how their T cells, a type of white blood cell that’s part of the immune system, reacted to infection.
In an email, Choi said lupus patients had too much of a protein called interferon, which helps fight infection, and not enough aryl hydrocarbon receptor (AHR) proteins, which regulate the body’s response to infection. This resulted in an overabundance of disease-promoting cells attacking the body. Replacing deficient AHR molecules with active ones could heal wounds instead of further injuring them, researchers say.
The researchers put AHR-activating molecules into lupus patients’ blood samples, which appeared to reprogram lupus-causing cells that could promote healing, a news release said.
Choi said the study offers the potential for new therapeutic strategies in lupus treatment. The goal is to target the disease-causing cells to better protect patients from the disease.
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