Women with lupus have chance for safer pregnancies, Oklahoma City expert says

For decades, women with lupus were discouraged from having children. Now, a doctor at the Oklahoma Medical Research Foundation says, if they're willing to plan, most women with lupus can safely have a baby. Read more: http://newsok.com/women-with-lupus-have-chance-for-safer-pregnancies-oklahoma-city-expert-says/article/3657713#ixzz1tIsA0dMx

Epstein Barr Virus Protects Against Autoimmunity

To the surprise of investigating researchers, an animal model of Epstein Barr virus protected lupus-prone mice against development of the autoimmune disease. Earlier work had suggested that EBV might promote the development of autoimmunity. More...

Early Treatment With Rituximab in Newly Diagnosed Systemic Lupus Erythematosus Patients

Abstract

Objectives. To assess the effectiveness of B-cell depletion therapy (BCDT) as a steroid-sparing treatment in newly diagnosed SLE patients.
Methods. Eight female SLE patients were treated with BCDT using a rituximab/CYC-based regimen aiming to avoid the routine use of oral steroids. Post-treatment, patients were given AZA. The BILAG disease activity index was used for clinical assessment. Serum anti-dsDNA, complement (C3), ESR, circulating B lymphocytes (CD19⁺) and protein : creatinine ratio were tested at 0, 1, 3, 6 and 12 months post-treatment. Disease activity and steroid requirement over the first 6 months of treatment were compared with three SLE patients treated conventionally, each carefully matched for ethnicity, sex, age at disease onset and disease duration at diagnosis.
Results. All patients achieved B-cell depletion (CD19 count <0.005 × 10⁹/l). The mean decrease in global BILAG at 6 months for the BCDT patients was −12.0 vs 13.22 for the controls. Post-BCDT, no patient developed any significant deterioration, mean ESR fell from 70.12 to 17.14 mm/h at 6 months, mean serum anti-dsDNA antibody levels fell by >70% at 1 month and serum C3 level normalized in two patients by 6 months. There were no adverse events. The mean cumulative prednisolone dose at 6 months for the BCDT patients was 1287.3 mg (range 250–4501.8 mg) vs 2834.6 mg (range 0–6802.5 mg) for the controls.
Conclusion. Early treatment of SLE patients with BCDT is safe and effective and enables a reduction in the overall steroid burden.

Introduction

Rituximab (RTX) has been widely used in the treatment of patients with SLE who have failed to respond to conventional immunosuppression. Even though two double-blind controlled trials, Explorer^[1] and Lunar,^[2] failed to meet their endpoints, increasingly large studies continue to indicate the utility of this approach.^[3,4] In an interesting extension of the use of B-cell depletion therapy (BCDT), Pepper et al.^[5] reported the use of RTX in newly diagnosed biopsy-proven patients with LN. We have sought to extend their work by using RTX accompanied by AZA for patients with SLE whose principle clinical features have been non-renal. Our aims are similar to those of Pepper et al., namely to determine the effectiveness of a B-cell depletion regimen at diagnosis and to avoid the use of oral steroids, especially given their propensity for inducing damage in patients with SLE.^[6] Damage is associated with an increased mortality in patients with SLE.^[6] We now report on the first 6–12 months following treatment of eight newly diagnosed patients, describing their clinical features and response to treatment. We compared their disease activity and steroid requirement over the first 6 months of treatment with three carefully matched SLE patients treated conventionally. More...

EMD Serono Collaborates with Lupus Research Institute to Sponsor Research with Promise for Developing New Treatments

The Lupus Research Institute (LRI) is very pleased to announce a new joint initiative to support innovative research in lupus with EMD Serono, the biopharmaceutical division of global pharmaceutical giant Merck KGaA Darmstadt, Germany   more...

Systemic Lupus and Malignancies

Abstract

Purpose of review Individuals with systemic lupus erythematosus (SLE) have an increased susceptibility to certain types of cancer. Given concerns focused on this issue, we present a review of this important topic.
Recent findings In non-Hodgkin lymphoma (NHL), a several-fold increased risk is seen in SLE versus the general population. It has long been suspected that immunosuppressive drugs play a role in this risk, but there may be other important driving factors as well. Lupus disease activity may itself heighten the risk of lymphoma in diseases like SLE. Lung cancer risk also is increased in SLE; smoking appears to drive this risk. Additionally, cervical dysplasia risk is increased in SLE, particularly with immunosuppressive drug exposure. An altered clearance of cancer-related viral agents in SLE (due to the disease and/or immunosuppression) may contribute to this risk and may also drive the risk for other cancers (such as vulvovaginal and hepatic carcinomas) in SLE. On the positive side, one new and significant finding is that SLE patients seem to have a decreased risk of certain nonhematologic cancers (breast, ovarian, endometrial, and prostate).
Summary Though much has been learnt so far regarding the risk in SLE, much yet remains unknown.

Introduction

Cancer is increasingly common in the developed world; agencies like the American Society of Clinical Oncology, the Union for International Cancer Control and the American Cancer Society call the current climate a 'cancer epidemic'. Links between chronic disease and cancer risk have been emphasized at various levels, including the World Health Organization.^[1] In terms of susceptibility to cancer, individuals with systemic lupus erythematosus (SLE) have been shown to have distinct cancer risk profiles. Compared with the general population, current data indicate a slight (10–15%) increase in cancer in SLE overall.^[2] Within these data, the most evident increased risk is of hematologic cancers, specifically non-Hodgkin lymphoma (NHL), which has seen a heightened risk of about three times in relation to the general population.^[2–5] In contrast, certain cancers, such as breast, endometrial, and ovarian cancers, may have a decreased risk in personswith SLE, according to recent data,^[6] and meta-analyses, which also suggest a decreased risk of prostate cancer in men with SLE.^{[7•,8•] More: http://www.medscape.com/viewarticle/758478?src=mp&spon=38}

OMRF researchers identify three lupus genes

Three newly confirmed lupus genes are opening new avenues of research at the Oklahoma Medical Research Foundation.

A paper published in the April 6 issue of the American Journal of Human Genetics describes three lupus genes discovered by OMRF researchers as part of a massive international collaboration.

With help from partners around the world, including universities and research facilities in Granada, Spain, Taipei, Taiwan, Seoul, Korea, Bogota, Colombia, and across the U.S., OMRF scientists gathered more than 17,000 samples for large-scale genetic testing.

The project, which began in 2009, took a year to gather the samples and another year to run the genetic tests. Since then, the researchers have pored over the data, said lead author and OMRF scientist Christopher Lessard, Ph.D.

“We have pinned down three new genes that show statistical significance for lupus risk,” he said. “We’ve also turned up another 11 regions we think might be related to lupus, but those need more study.”

The study is notable for its inclusion of several ethnic groups and results that show that the genes that cause lupus aren’t always universal, said OMRF researcher Patrick Gaffney, M.D.

Using samples from a wide range of ethnic backgrounds, scientists found the genes IRF8 and TMEM39a were associated with lupus in European-American, African-American, Gullah and Asian patients. A third gene named IKZF3 was only significant in African-American and European-American samples.

Lupus is a chronic autoimmune disease, caused by a combination of environmental and multiple genetic factors. The disease causes the immune system to become overactive, mistaking the body’s own cells like they were bacteria or viruses and attacking them. Symptoms include fatigue, fever, rashes and joint pain. The Lupus Foundation of America estimates 1.5 million Americans have lupus. About 9 of every 10 lupus patients are women.

Article source: http://www.news-medical.net/news/20120330/OMRF-researchers-identify-three-lupus-genes.aspx

March 2012 Lupus Newsletter

March 2012 Lupus Newsletter