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Study on Lupus and Autoantibodies as an Early Disease Marker
From the New England Journal of Medicine
From the New England Journal of Medicine
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October, 2003 -- A new study published in the New England Journal of Medicine offers a glimmer of hope to the millions of Americans who suffer from systemic lupus erythematosus (lupus), as well as many other autoimmune diseases. In a study published in The New England Journal of Medicine, scientists report that in patients suffering from systemic lupus erythematosus (commonly known as lupus), autoantibodies--proteins that the body mistakenly unleashes against its own tissue--are typically present years before patients are diagnosed with the disease. This research by scientists at the Oklahoma Medical Research Foundation (OMRF) and the University of Oklahoma Health Sciences Center (OUHSC) may help identify what causes lupus and ultimately to develop a way to prevent the chronic autoimmune disease. The study found that in patients suffering from lupus, autoantibodies (proteins that the body mistakenly unleashes against its own tissue) are typically present years before patients are diagnosed with the disease. Ultimately, the study's findings may help identify what causes lupus and lead to the development of a way to prevent the chronic autoimmune disease. "This groundbreaking research will have broad implications for the medical community when it comes to identifying and tracking patients who are at risk for developing lupus and many of the other autoimmune diseases," said Dr. Noel Rose, chair of the American Autoimmune Related Diseases Association Scientific Advisory Board and professor of Pathology, Molecular Microbiology and Immunology, The Johns Hopkins University. "And, more importantly for patients, this could mean that diagnosis is made earlier on, before major damage to the body occurs." There are more than 80 and another 40 suspected autoimmune diseases. They all share the same underlying cause -- autoimmunity, the process by which the body's immune system turns on itself, attacking healthy organs, tissues and cells. Approximately 50 million Americans suffer from one or more autoimmune diseases. Of those, nearly 75 percent -- or roughly 30 million -- are women. Autoimmune diseases include lupus, multiple sclerosis, juvenile diabetes, rheumatoid arthritis, scleroderma, Sjogren's disease and Graves' disease. "For a decade, we have been attempting to pinpoint the first thing that goes awry in the body of a lupus patient," said John Harley, M.D., Ph.D., head of the arthritis and immunology research program at OMRF and senior author of the study. Harley also serves as chief of rheumatology at OUHSC and staff physician with the Veterans Affairs Medical Center in Oklahoma City. In lupus and other autoimmune diseases, the immune system loses its ability to differentiate between foreign substances and its own cells and tissues, causing the body to attack itself. Lupus can affect any part of the body--most commonly the skin, joints, blood and kidneys--and can be life-threatening. The disease primarily strikes women and has no known cure. In conducting this new study, the researchers used the Department of Defense Serum Repository in Washington, D.C., which contains approximately 30 million blood samples collected from more than five million U.S. Armed Forces personnel. From the military's medical records, the scientists were able to identify 130 servicemen and women who were initially healthy but later developed lupus. The scientists then analyzed blood samples collected from the lupus patients prior to their diagnosis and compared them with samples from matched service personnel without the disease. "In patients with lupus, we found that their natural defense system just continued to produce more and more abnormal responses--autoantibodies--up until the time they were diagnosed with the disease," said Judith James, M.D., Ph.D., of OMRF and OUHSC, one of the study's co-authors. "Unaffected military personnel might occasionally make an abnormal immune response, but those normally resolve spontaneously, and no additional antibodies develop." The study, noted Harley, holds important clinical value. "We hope that the new findings will lead to studies that will help identify those who would benefit from prophylactic therapy," he said. "This would give us a chance to intervene and keep those people from developing some of the most serious manifestations of the disease." In the long term, Harley hopes this study will lead to new and safer therapies. "We are now looking at potential environmental causes for this abnormal immune response," he said. "If we are able to identify a pathogen that triggers this process, then we could set to work on developing new strategies to stop that pathogen. Some think that a vaccine might be a successful approach." 
Note From Mary Shomon: Get the first and most comprehensive book to address autoimmune diseases as an overall category of conditions: Living Well With Autoimmune Disease: What Your Doctor Doesn't Tell You...That You Need to Know. This patient-oriented manual focuses on the issue of autoimmunity, and conventional and alternative prevention and treatment for patients.
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