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Researchers use blood serum markers to develop lupus risk index

Researchers at the Feinstein Institute for Medical Research, USA have developed an index that identifies the risk for lupus based on the presence and amount of Immunoglobin G (IgG) and Immunoglobin M (IgM) antibodies and levels of C1q, a protein complex associated with protection from lupus, in blood serum. The findings are published in the open access journal Molecular Medicine. 

The risk index, which needs to be validated in further studies, could be useful in following at risk individuals over time to identify those that may benefit from early interventions, and to identify diagnosed lupus patients who might be at risk of an impending flare. 

Dr Betty Diamond, the corresponding author said: “Lupus – or systematic lupus erythematosus (SLE) – is a multi-organ autoimmune disorder with disproportionally higher prevalence in individuals of West African descent. Understanding risk and why it differs between populations may enable prevention studies. Here we analyzed serum from unique populations with varying degrees of risk in order to identify serologic factors that might correlate with risk of or protection against SLE.”

To compare potential biomarkers of SLE among women with different SLE risks, the authors analyzed blood serum samples from five cohorts: 40 Malian women with a history of malaria infection (MAL), 51 African American lupus patients (SLE), 80 healthy African American women (AAHC), 98 unaffected sisters of lupus patients (SIS), and 16 Caucasian healthy controls (CHC). 

The authors found that titers of IgM antibodies – which are known to protect against lupus onset – were lowest in the SLE, SIS and AAHC cohorts and higher in the MAL and CCH cohorts. Levels of IgG antibodies – the presence of which precedes lupus onset – were highest in the SLE and MAL cohorts and similar in the CHC, AAHC and SIS cohorts. The SLE cohort was also found to have the lowest C1q levels. C1q promotes immune tolerance, which includes stopping immune cells from attacking the body’s own cells as is the case in autoimmune diseases such as lupus. Ninety percent of individuals with hereditary C1q deficiency also have lupus. 

Dr Diamond said: “The possibility that a risk index could help identify populations as risk for development of clinical lupus is novel and exciting. The risk index we developed was highest in SLE patients; second highest in unaffected sisters of SLE patients; third highest in healthy African-American women and lowest in healthy Caucasian women and malaria-exposed West African women. Thus, it confirms known lupus risk, as well as our hypothesis that high levels of IgG, low levels of IgM (and the resulting high IgG to IgM ratio) and low levels of C1q predispose to lupus. Our results also confirm the hypothesis that exposure to malaria results in increased levels of protective IgM antibodies and C1q which may delay onset of lupus in genetically predisposed individuals.”

The authors caution that their risk index needs to be validated in future longitudinal studies which also need to determine the actual risk of developing SLE for each risk score. However, the observations made in this study may suggest new therapeutic approaches for SLE treatment and could eventually be used in early diagnosis, according to the authors.

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Notes to editor:

1.    Research article:
Serologic features of cohorts with variable genetic risk for Systemic Lupus Erythematosus 
Molecular Medicine 2018
DOI: 10.1186/s10020-018-0019-4 
The article will as available at the journal website.

Please name the journal in any story you write. If you are writing for the web, please link to the article. All articles are available free of charge, according to BMC's open access policy.

2.    Molecular Medicine is an open access journal publishing recent findings that elucidate disease pathogenesis at the molecular or physiological level, which may lead to the design of specific tools for disease diagnosis, treatment, or prevention. Manuscripts containing material relevant to the genetic, molecular, or cellular basis of key physiologic or disease processes are considered for publication. Manuscripts submitted to Molecular Medicine should describe the implications of the results for human disease and medicine, at a level approachable by our broad audience.

3.    A pioneer of open access publishing, BMC has an evolving portfolio of high quality peer-reviewed journals including broad interest titles such as BMC Biology and BMC Medicine, specialist journals such as Malaria Journal and Microbiome, and the BMC series. At BMC, research is always in progress. We are committed to continual innovation to better support the needs of our communities, ensuring the integrity of the research we publish, and championing the benefits of open research. BMC is part of Springer Nature, giving us greater opportunities to help authors connect and advance discoveries across the world.

4.    About the Feinstein Institute  

The Feinstein Institute for Medical Research is the research arm of Northwell Health, the largest healthcare provider in New York. Home to 50 research laboratories and to clinical research throughout dozens of hospitals and outpatient facilities, the Feinstein Institute includes 4,000  researchers and staff who are making breakthroughs in molecular medicine, genetics, oncology, brain research, mental health, autoimmunity, and bioelectronic medicine – a new field of science that has the potential to revolutionize medicine. For more information about how we empower imagination and pioneer discovery, visit FeinsteinInstitute.org