Lupus Breakthrough: Advanced Treatments in the Works

The discovery of a fundamental imbalance in the immune response of patients who have lupus could lead to improved targeted treatments, giving hope to millions of people living with the chronic autoimmune condition.

“We’ve identified a fundamental imbalance in the immune responses that patients with lupus make, and we’ve defined specific mediators that can correct this imbalance to dampen the pathologic autoimmune response,” explains co-corresponding author Dr Deepak Rao.

The chronic autoimmune condition called systemic lupus erythematosus – referred to as SLE or simply lupus – affects millions of people worldwide, mainly women and people assigned female at birth. The symptoms include joint and muscle pain, extreme fatigue, a characteristic rash across the face, headaches, fevers, hair loss, and swollen glands. The disease appears to emerge from problematic interactions between T and B cells, two types of immune cells. High levels of T follicular helper and T peripheral helper cells lead to the production of the CXCL13 pro-inflammatory molecule that attracts B cells. When the aryl hydrocarbon receptor (AHR) pathway is insufficiently activated, T peripheral helper cells are overpopulated, increasing problem-causing autoantibodies in people with lupus. However, when the AHR pathway is activated with small molecule activators, the T cells seem to reprogram themselves to the Th22 subtype, meaning that instead of causing inflammation and disease, it promotes healing. Should the effects be durable, it could become a potential cure.