Lupus discovery could help manage disease in African patients

September 17, 2018, University of Edinburgh

Two variants of an autoimmune disease that affects thousands but is hard to diagnose are relatively common among black Africans, research shows.

The findings, relating to , or SLE, could improve diagnosis and treatment of the condition.

They could enable better management of the disease in of African descent, particularly in southern Africa, where incidence and mortality rates are relatively high.

Blood tests in black African patients pinpointed a high prevalence of two types of the disease, one of which was previously unacknowledged.

SLE—the most common form of lupus—can affect many parts of the body including the kidneys, heart, lungs, blood, brain and skin.

The new variants were identified by analysing that attack proteins in .

Some of the patients—almost half of those tested—carried an antibody already linked with lupus and used in its diagnosis. Patients with this antibody are more likely to have classic symptoms, including diseased organs and joints.

A second, larger group of patients—many of whom had skin-related symptoms—carried an antibody targeting a different protein in healthy cells. This antibody was not previously known to be important for SLE and is not currently used in diagnosis.

The study, carried out by the University of Edinburgh and partners in Zimbabwe, suggests that diagnostic tests for lupus should be broadened to include the second antibody.

The current recommended diagnosis method tests for the first antibody only. Incorporating the second antibody in tests would allow earlier diagnosis of the more predominant variant of the disease, and improved outcomes for patients, researchers say.

The disease occurs more frequently in people of African descent, with worse symptoms and higher mortality. If diagnosed and managed early, it is usually not life-threatening, but poor and late in the developing world leads to high .

The study, published in BMJ Global Health, was funded by the OAK Foundation and the UK National Institutes of Health Research.

Professor Francisca Mutapi, of the University of Edinburgh's School of Biological Sciences, who led the study, said: "For the first time, we have highlighted the importance of two variants of systemic lupus that affect black Africans, including one which was previously not defined in detail. Thanks to our research, we also have the means to diagnose and distinguish them."

Professor Elopy Sibanda, of the Asthma, Allergy and Immunology Clinic in Harare, Zimbabwe, who led the clinical aspects of the study, said: "These findings will be valuable in diagnosing SLE in affected patients. It is currently difficult to diagnose lupus erythematosus, as many symptoms overlap with those of other locally prevalent conditions, including HIV."

Explore further: Study reveals early warning signs of heart problems in patients with newly diagnosed lupus

More information: Elopy N Sibanda et al, Evidence of a distinct group of Black African patients with systemic lupus erythematosus, BMJ Global Health (2018). DOI: 10.1136/bmjgh-2017-000697

Related Stories

Study reveals early warning signs of heart problems in patients with newly diagnosed lupus

August 2, 2018
Cardiovascular disease is a leading cause of death in patients with lupus, a systemic autoimmune disease. In a new study in Arthritis & Rheumatology—a journal published by Wiley on behalf of the American College of Rheumatology—imaging ...

Sirtuin-1 levels linked to lupus

May 9, 2018
The Cardiometabolic and Kidney Risk Research Group, in collaboration with the Genomic and Genetic Diagnosis Unit of the Health Research Institute of Valencia's Hospital Clínico, INCLIVA, the Department of Biochemistry and ...

Patient-friendly and accurate cardiac damage diagnosis

September 7, 2018
Systemic inflammatory diseases, such as lupus, often cause cardiac damage that goes undetected. An international research team headed by the Institute for Experimental and Translational Cardiovascular Imaging at the University ...

Deconstructing lupus—could some of its makeup be part of its cure?

February 20, 2018
Chandra Mohan, Hugh Roy and Lillie Cranz Cullen Endowed Professor of biomedical engineering, has received a $600,000 Target Identification in Lupus grant from the Lupus Research Alliance to address fundamental questions in ...

New guidelines published to improve diagnosis and treatment of lupus

October 9, 2017
A University of Birmingham academic has led the authorship of the UK's first guideline on the care of adults with systemic lupus erythematosus (lupus).

Study points to potential personalized approach to treating lupus

March 29, 2018
In individuals with lupus, immune cells attack the body's own tissue and organs as if they are enemy invaders. A new Yale-led study describes how a protein found in common bacteria triggers that auto-immune response. The ...

Recommended for you

HIV vaccine protects non-human primates from infection

December 14, 2018
For more than 20 years, scientists at Scripps Research have chipped away at the challenges of designing an HIV vaccine. Now new research, published in Immunity, shows that their experimental vaccine strategy works in non-human ...

RNA processing and antiviral immunity

December 14, 2018
The RIG-I like receptors (RLRs) are intracellular enzyme sentries that detect viral infection and initiate a first line of antiviral defense. The cellular molecules that activate RLRs in vivo are not clear.

The 'greying' of T cells: Scientists pinpoint metabolic pathway behind age-related immunity loss

December 13, 2018
The elderly suffer more serious complications from infections and benefit less from vaccination than the general population. Scientists have long known that a weakened immune system is to blame but the exact mechanisms behind ...

Scientists create most accurate tool yet developed to predict asthma in young children

December 13, 2018
Scientists at Cincinnati Children's Hospital Medical Center have created and tested a decision tool that appears to be the most accurate, non-invasive method yet developed to predict asthma in young children.

New genetic study could lead to better treatment of severe asthma

December 12, 2018
The largest-ever genetic study of people with moderate-to-severe asthma has revealed new insights into the underlying causes of the disease which could help improve its diagnosis and treatment.

Researchers discover unique immune cell likely drives chronic inflammation

December 11, 2018
For the first time, researchers have identified that an immune cell subset called gamma delta T cells that may be causing and/or perpetuating the systemic inflammation found in normal aging in the general geriatric population ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.