Lupus nephritis: A 'difficult and challenging disease'

Lupus nephritis, which affects about half of lupus patients, causes severe inflammation of the kidneys, potentially requiring dialysis or organ transplant.

Chris Arnold 3 minute read January 17, 2022
Vector illustration of human kidneys.

Lupus nephritis causes severe inflammation of the kidneys and can potentially result in irreparable damage. GETTY

Scientists have developed a therapy for lupus nephritis that targets specific immune cells and could be an alternative to current treatments. 

Researchers from the Azrieli Faculty of Medicine of Bar-Ilan University, the Albert Einstein College of Medicine, the University of Houston, and the pharmaceutical company Equillium produced the treatment. The discovery was published in the Journal of Clinical Investigation. 

Lupus is an autoimmune disease that causes the body to attack itself. Lupus nephritis, which affects about half of lupus patients, causes severe inflammation of the kidneys and can potentially result in irreparable damage. 

The new treatment uses genes that produce proteins on the outer membrane of T cells, or white blood cells, which are essential for immune responses. Dr. Chaim Putterman, of the Azrieli Faculty of Medicine of Bar-Ilan University, says up until now, these genes were not considered relevant to lupus nephritis. 

“The intervention we describe, which targets T cells rather than multiple immune cell types, can potentially provide physicians with another effective tool for treatment of a difficult and challenging disease,” Putterman said in a statement.

Researchers were able to develop an antibody that can disrupt the interaction between the potentially harmful immune cells, halting T cells from ever activating and resulting in a crucial decrease in kidney inflammation. 

More than 1,000 people participated in the study, in which researchers monitored their urine for creatinine, a chemical compound that is left over when the body produces energy and is evacuated through urination. There are normal levels of creatinine a healthy person would produce, while lupus patients are found to have significantly higher levels.

Medication options for lupus nephritis

There are several medication options available for lupus nephritis patients, but there is potential that a person’s body does not respond to the treatments, the disease continues to break down their body, and the need arises for dialysis or an organ transplant. Many medications can also actually increase the patient’s susceptibility to other infections. Lupus patients are already at an increased risk to get sick as well. Infections are the second most common major cause of illness and death for people with lupus, according to the Lupus Foundation of America. 

Different types of lupus can also have different impacts on the body. There are three types of cutaneous lupus, which primarily affects the skin. People with this condition can develop sores on their head, a severe rash on body parts that primarily get hit with sunlight, such as the arms, or develop a butterfly-shaped rash that is similar to a sunburn, reads. 

Since the variety of symptoms and severity from person to person, and symptoms can develop and change over time, or be mistaken for other conditions, diagnosing and treating the disease is difficult, according to the Mayo ClinicMedications that are primarily used to treat malaria, such as hydroxychloroquine, can be used to control flare ups in lupus patients, though they come with side effects including stomach pain, and potential retina damage.

More than one out of every 1,000 people in Canada has lupus, which equates to approximately 38,000 people, out of a population of about 38 million, Lupus Canada writes on its website.

Women between 15 and 45 years old are the most likely demographic to be diagnosed with lupus, and it is between eight and 13 times more likely to occur in women than men. 

Chris Arnold is a Toronto-based freelance writer . He can be reached here.
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