Re: Mysterious disease that causes the body's immune system to turnagainst itself

[Guest guest]

This is a very important development regarding lupus. Thanks for sending

the info, a.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Mysterious disease that causes the body's immune

system to turnagainst itself

Mysterious disease that causes the body¹s immune system to turn against

itself

Published: Friday, 25-Jun-2004

A mysterious disease that causes the body¹s immune system to turn

against

itself also sends a warning signal to alert doctors of the onset of its

worst symptoms, University of Florida physicians have found.

To date, doctors have had no way of knowing which patients with the

unpredictable autoimmune disorder lupus were likely to develop one of

its

most dangerous and life-threatening aspects: kidney disease, which

afflicts

as many as half of the 1.5 million Americans who have lupus, according

to

the Lupus Foundation of America.

Now doctors with the Center for Autoimmune Diseases at the UF Health

Science

Center have identified a protein that shows up in markedly increased

levels

in the urine of lupus patients with kidney disease, and have located the

variant of the gene that overproduces the protein. The researchers say

this

will eventually enable doctors to use a simple urine test to look for

the

presence of the protein as an early indicator of the development of

kidney

disease. And in article published this month in Arthritis and

Rheumatism,

the scientists say the findings also could open a door to the

development of

preventive treatments, or less toxic treatments that could be given

early in

the course of the disease.

³All we can do now is quote newly diagnosed lupus patients the

statistics

for the chance of kidney disease,² said article co-author Dr. Hanno B.

s, co-director of UF¹s Lupus Clinic. ³We can offer detailed

genetic

testing and assess what the likelihood of the disease might be. But with

MCP1 (protein), we can screen for the levels in the urine and base our

need

for treatment on that.²

s, an assistant professor in the College of Medicine, said the

study

results showed kidney disease was about two to three times more likely

to

develop in lupus patients with certain genetic variants that produce a

protein called monocyte chemoattractant protein 1, or MCP1, which acts

as a

traffic cop that directs immune system cells toward sites of

inflammation.

The researchers also have been able to detect large amounts of MCP1 in

the

urine of lupus patients with kidney disease, or lupus nephritis, at

levels

that are highest in cases of more severe kidney inflammation.

s said MCP1 may provide a ³window² into the kidneys and eliminate

the

need for invasive biopsies to confirm whether a particular treatment is

working. If MCP1 levels in the urine climb, the treatment is not

working; if

they fall, it is, he said.

Lupus, or systemic lupus erythematosus, is an autoimmune disease that

may

affect the skin, kidney, heart, muscles, brain and circulatory system.

The

disease¹s intermittent symptoms vary among patients. It is difficult to

diagnosis and its cause is unknown. Black and Hispanic women of

childbearing

age acquire the condition more frequently than do whites, and women are

10

times more likely to have it than are men.

The study evaluated 134 participants who were patients at UF¹s Center

for

Autoimmune Diseases, 90 percent of whom were female. s worked

closely

with UF colleagues Dr. Marco Tucci, the paper¹s lead author, Dr. Mark

Segal,

an assistant professor in nephrology, and Dr. Westley Reeves, the

division

chief of rheumatology and clinical immunology.

³We found that MCP1 was markedly higher in patients with kidney disease

and

lupus than it was in those without,² s said. ³And we found that

the

genetic subtype that allows people to secrete much more of this protein

is

more common in patients who have lupus nephritis compared with those

lupus

patients who don¹t develop lupus nephritis in the course of their

disease.²

Because lupus is caused by overactivity of the body¹s immune system,

doctors

prescribe immunosuppressant drugs for kidney disease treatment,

including

steroids. The drugs have many adverse effects, including an increased

risk

for infection. Kidney disease causes water to build up in the body and

can

lead to swelling in the ankles, the hands or around the eyes. Because

water

retention is most commonly caused by heart disease, the first thing a

doctor

will check is the heart, sometimes delaying the diagnosis of a kidney

condition. Before immunosuppressants were available, many people with

lupus

and kidney disease died.

http://www.ufl.edu/