Busted: Lupus Culprit Uncovered

Dendritic cells appear to play localized role in lupus-related tissue damage

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) By eliminating a key immune system cell in mice with lupus, researchers were able to reduce symptoms of the disease. In the process, they discovered a possible new therapeutic target for lupus and other autoimmune diseases.

The findings focus on the role of the dendritic cell in systemic lupus erythematosus (SLE), a chronic inflammatory disease that affects the skin, joints, blood and kidneys.

Led by Mark Shlomchik, professor of Laboratory Medicine and Immunobiology at Yale University and senior author of the paper, the study found that knocking out dendritic cells in mice with lupus did not make pathogenic T cells, a major component of the immune system, disappear as expected. Instead the pathogenic T cells disappeared from inflamed tissue in the kidneys and other areas in the mice that lacked dendritic cells to begin with.

That means dendritic cells appear to play a localized role in lupus tissue damage, possibly making them a prime target for therapy in lupus patients and others with different autoimmune diseases.

“Dendritic cells could be having the same effects in a variety of other autoimmune diseases, but we will not know until we do similar experiments in other disease models,” Shlomchik said.

Close to 200,000 people in the U.S. have Lupus, with women being affected nine times more than men. Women of Afro/Caribbean descent are affected three times more often than other ethnic groups. Lupus is an autoimmune disease that attacks multiple organ systems and connective tissues in the body, is incurable, but treatable, and most people with it will live a normal lifespan. The initial symptoms of Lupus are fever, joint pain and fatigue. About 30 percent of lupus patients have dermatologic symptoms, with 30 percent to 50 percent getting the characteristic butterfly shaped rash on the face. Another very serious complication is end stage renal disease (ESRD), and kidney transplants are common. Lupus can also be drug induced by quinidine, phenytoin (Dilantin), hydralazine (Apresoline), and procainamide (Pronestyl), but is fortunately reversible. Drugs used to treat lupus are frequently DMARDS (disease modifying anti-rheumatic drugs) such as Humira, Rituxan, Remicade, Methotrexate, and Enbrel; Steroids and other immunosuppressants help reduce symptoms as well, with examples being Belimumab and Atacicept. Painkillers are common and often necessary. An ANA (anti-nuclear antibody) blood test is frequently used to diagnosis lupus.

Reviewed by: 
Review Date: 
December 21, 2010
Last Updated:
March 8, 2011