Research Alliance awards team $3M to study pediatric lupus nephritis

Scientists will look at immune, genetic changes to help personalize treatment

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by Lindsey Shapiro |

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The Lupus Research Alliance (LRA) has awarded a $3-million grant to a multidisciplinary research group working to identify drivers of lupus nephritis, a serious complication of lupus characterized by kidney damage, in children with the autoimmune disease.

Elena Hsieh, MD, an associate professor at the University of Colorado Anschutz School of Medicine, will spearhead the project, backed by a team of experts in immunology, pediatric inflammatory and kidney diseases, genetics, and data analysis.

The grant, called the Global Team Science Award (GTSA), will provide the group with $3 million over three years, which the scientists will use to look for immune and genetic changes that might underlie pediatric lupus nephritis, in an effort to better inform treatment.

“We are delighted to award the 2023 Global Team Science Award as part of our strategic plan for research to scientists who will apply innovative technologies to investigate immune cell abnormalities and changes in the genetic code of patients with pediatric lupus nephritis,” Teodora Staeva, PhD, LRA’s chief scientific officer, said in an alliance press release.

“Selected from many compelling proposals, this project will explore the [variability] of lupus and help inform the acceleration of personalized treatments for lupus nephritis,” Staeva added.

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Lupus nephritis causes inflammation and damage to kidneys

Lupus is characterized by self-reactive immune attacks that affect virtually all of the body’s organs. Lupus nephritis, one of the most severe complications of lupus, causes inflammation and damage to the kidneys that limit their ability to filter waste from the body.

Compared with adult-onset lupus, children with lupus tend to have more active disease and multi-organ involvement from onset, including a higher risk of lupus nephritis.

“The current gold standard for diagnosing and monitoring lupus nephritis, kidney tissue biopsy, is not sensitive enough to characterize structural changes in the kidney or predict how a patient will respond to treatment,” Hsieh said.

With the GTSA funding, Hsieh and colleagues will look for ways to improve the ability of kidney biopsies to predict disease progression in children and their responses to treatment.

“This study could revolutionize the current diagnosis and treatment approach to pediatric lupus nephritis,” Hsieh said.

The team will examine biopsy samples from 300-400 children with lupus nephritis across five countries. This will include high-risk groups known to have an increased frequency of kidney involvement and severe disease, including those of African, Hispanic, Native American, and Asian racial or ethnic backgrounds.

By identifying drivers of lupus nephritis, the study can shift the diagnosis and treatment strategy from a trial-and-error approach to one guided by underlying immune system and genetic characteristics.

Better classification of pediatric lupus nephritis may enable precision medicine

A range of techniques will be used to examine the structural, cellular, and molecular changes in these kidney biopsies, linking them to patients’ overall disease course and treatment responses. The children’s genetic makeup will also be examined.

The data will be used to group children based on their clinical features. The hope is that if childhood-onset lupus nephritis can be better classified, it will allow scientists to identify the best treatments for each group, enabling a precision medicine approach.

“By identifying drivers of lupus nephritis, the study can shift the diagnosis and treatment strategy from a trial-and-error approach to one guided by underlying immune system and genetic characteristics,” Hsieh said.

The project is well-aligned with the GTSA’s goal to fund collaborative research efforts that use cutting-edge technology to better understand how the disease affects patients differently, thereby informing the development of safer and more effective treatments.

Launched in 2020, the GTSA is supported by a grant from Bloomberg Philanthropies.