New discoveries in lupus research: Expert identifies biomarkers for heart disease and for children with lupus nephritis

Two separate findings by a University of Houston nationally recognized expert in systemic lupus erythematosus (SLE or lupus), a chronic autoimmune disease that affects multiple organs including the kidneys, skin, joints and heart, are being reported in scientific and medical journals.

Chandra Mohan, M.D., Ph.D., Hugh Roy and Lillie Cranz Cullen Endowed Professor of biomedical engineering in the UH Cullen College of Engineering, has identified blood biomarkers that predict which lupus patients will develop heart disease in the future and found new urine biomarkers for diagnosing lupus nephritis (LN) in children with lupus.

Lupus and Cardiovascular Disease

Lupus is associated with an increased incidence of acute and chronic cardiovascular disease as compared to the general population.

Mohan’s team, in collaboration with Dr. Maureen McMahon at UCLA, used a comprehensive metabolomic screen of baseline sera from lupus patients to identify metabolites that predict future carotid plaque progression, following eight to nine years of follow-up. Nine patients had SLE without plaque progression, eight had SLE and went on to develop atherosclerotic plaques, and eight patients were controls who did not have SLE.

“The arachidonic acid pathway metabolites, leukotriene B4 (LTB4) and 5-hydroxyeicosatetraenoic acid (5-HETE), and the oxidized lipids 9/13-hydroxyoctodecadienoic acid (HODE) were found to be significantly altered (p < 0.05 and fold-change >2) in SLE patients compared to SLE patients without plaque progression,” reports Mohan in Frontiers in Cardiovascular Medicine. “SLE patients also exhibited significantly altered levels of branched chain amino acid (BCAA) metabolites and plasmalogens compared to the non-SLE controls.”

Taken together with the rich literature on these metabolites, the findings suggest that the identified metabolites may not only be prognostic of cardiovascular disease development in SLE patients, but they may also be active drivers of atheroma formation. Early identification of these high risk SLE patients may help institute preventive measures early in the disease course.

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