Emerging Thoughts on Lupus: From Causes to Diagnostics to Treatments

Living with Lupus can be stressful and frightening.  We at LupaVita know that our patients are often left wondering why they acquired Lupus in the first place and what they can do to achieve their highest quality of life.  You are not alone – an estimated 5 million people worldwide are living with Lupus.

In this blog post, we hope to offer you some comfort by discussing some of the amazing research into causes, diagnosis, and treatment of Lupus with the goal of helping Lupus patients.

Causes:

After receiving a Lupus diagnosis, many wonder “why did I get this?”  Current thinking suggests a combination of genetic and environmental factors leads to Lupus, though we often cannot point to a single cause.  Recent research by Melissa Wilson PhD, an evolutionary biologist at Arizona State University, attempts to explain an interesting characteristic of many autoimmune diseases such as Lupus – women are about four times as likely to be diagnosed than are men.

Through her theory termed the “pregnancy-compensation hypothesis”, Wilson suggests that a woman’s immune system evolved to engage in a complicated interplay with a potential placenta.  According to her theory, a woman’s immune system needs to tamp down its activity so as not to reject a potential placenta and developing baby.  Yet to compensate for the immune system’s decreased activity in relation to a potential placenta, other aspects of the immune system must ramp up to defend against potential infections.  According to Wilson, the female immune system was designed in this way with the expectation that women of child-bearing age would be almost constantly pregnant.

However, in modern society, this is often not the case.  Without a placenta and developing baby, the female immune system can get confused.  It’s as if the immune system were expecting to engage in a tug of war with the placenta, and in the placenta’s absence, the immune system might turn its pent-up strength onto itself, leading to autoimmune disease.

Wilson’s theory helps us to understand why women of child-bearing age are much more likely to acquire an autoimmune disease such as Lupus.  Excitingly, her thinking might lead to therapeutic interventions helping to prevent such autoimmune diseases.  For example, it’s plausible we could find a medical intervention that mimics aspects of the placenta to give the non-pregnant female immune system an adversary in its “tug-of-war”, such that it does not turn against itself.

For more information on Wilson’s “pregnancy-compensation hypothesis,” consult this recent article in The Atlantic.

https://www.theatlantic.com/health/archive/2019/06/women-autoimmune-diseases-pregnancy/591901/

Diagnostics:

Diagnosing Lupus is not straight-forward.  Many of our patients can likely relate to the tiring, nerve-racking process of receiving their diagnosis, where they may have seen multiple doctors over the course of months or years and been subjected to numerous diagnostic tests without clear answers.  The truth is that Lupus is a complex disease that manifests in various ways, and there is currently no one diagnostic test that pinpoints a Lupus diagnosis.

Progentec, a company out of Oklahoma City, is hoping to change this.  Progentec was recently awarded a Small Business Innovation Research (SBIR) grant from the National Institute of Allergy and Infectious Disease to further study their blood test for Lupus biomarkers.  Their blood test aims to help in the initial diagnosis of Lupus, monitor a Lupus patient’s response to medical therapy, and help predict how a Lupus patient might respond to a certain therapy.

Progentec’s biomarker test has great potential to increase efficiency and effectiveness in Lupus care.  For more information about Progentec’s work, visit their company’s website:

https://www.progentec.com

Treatment:

Many of the treatments for autoimmune diseases such as Lupus are a bit non-specific and have actually been repurposed for use in autoimmune diseases from their original indications to treat other diseases.  For example, Plaquenil was originally developed to treat Malaria; Methotrexate is a chemotherapeutic used in some cancer treatment protocols; and prednisone is a steroid with broad and systemic anti-inflammatory effects.

Given the lack of precision with current autoimmune drugs, patients are justified in hoping for more intelligently designed drugs with specificity for their unique condition and with the potential to offer fewer side effects.  Resolve Therapeutics is on a mission to provide such a solution for patients battling Lupus.

Resolve Therapeutics has recently announced that it has completed enrollment in a phase 2A clinical trial testing safety and efficacy of its potential Lupus drug RSLV-132.

RSLV-132 works by attacking the very molecules that lead to inflammation and symptoms in Lupus.  In short, one of the molecular causes of Lupus includes genetic material such as DNA and RNA existing where it should not – outside of the cell for example.  The presence of this DNA and RNA can trick the immune system into fighting these molecules as if they were a foreign infection.  RSLV-132 specifically aims to destroy the misplaced RNA, in the hopes of decreasing some of the inflammatory symptoms of Lupus.

News of Resolve Therapeutics’ progress in their clinical trial should be hopeful for Lupus patients, as it represents a step towards improved treatments.  For more information on RSLV-132 and its clinical trial, consult a recent article from Business Wire:

https://www.businesswire.com/news/home/20190722005093/en/Resolve-Therapeutics-Announces-Completion-Enrollment-Phase-2a

Conclusion:

Living with Lupus can be difficult.  We still have an abundance of questions about various aspects of this disease that has the potential to affect many different body parts and organ systems.  However, there is much cutting-edge research looking into how we can improve the lives of those battling Lupus.  Through this blog post exploring some of this exciting work, we aspire to give you hope for a future where we are better able to care for patients with Lupus.