Researchers have devised a blood test that predicts which blood relatives of patients with systemic lupus erythematosus (SLE) — people who are at high risk of developing the disease — will actually develop it, even seven years before the disease declares itself. The blood test can be used to provide preventive care to those testing positive.
Researchers at the Oklahoma Medical Research Foundation (OMRF) published their findings in a study titled “Discerning Risk of Disease Transition in Relatives of Systemic Lupus Erythematosus Patients Utilizing Soluble Mediators and Clinical Features” in the journal Arthritis & Rheumatology.
SLE is an autoimmune disease in which the body’s own immune system causes ongoing inflammation and blood vessel abnormalities. Antibodies, which normally fight infection, injure the body’s tissues and organs. They are known as autoantibodies.
Blood relatives of patients with SLE were tested for the presence of cytokines — naturally occurring proteins of the body’s immune system that cause inflammation — known as pro-inflammatory cytokines.
After an average of 6.5 years from their last evaluation for SLE, 45 (11%) of the 409 lupus relatives who agreed to participate in the follow-up study had developed SLE.
The individuals who had high levels of pro-inflammatory cytokines in their blood at the start of the study developed SLE years later, making it possible to predict which high-risk individuals will develop SLE.
“Although many relatives transitioned into lupus patients, we had far more, 89 percent, who stayed healthy,” Melissa Munroe, co-author of the study, said in a press release. “This research focused on trying to find blood markers that identify people, even seven years beforehand, who are going to become lupus patients.”
Based on the results, the researchers recommend physicians test relatives of SLE patients for specific inflammatory proteins in their blood. They suggest referring those who test positive to a rheumatologist and for possible enrollment in clinical trials on the prevention of the disease.
A prevention trial is being launched at OMRF known as SMILE. Its objective is to identify individuals at high risk for SLE and treat them with anti-inflammatory medication. It is expected that this will delay the onset of lupus, lessen the symptoms of the disease, or potentially prevent it altogether.
“This kind of work is really expansive and new,” said Judith James, holder of the Lou C. Kerr Chair in Biomedical Research at OMRF, and co-author of the study. “It gives us hope that we can better identify early markers for the development of lupus, but maybe even more importantly, that 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.”