This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Systemic Lupus Erythematosus (SLE) is an autoimmune disease of uncertain etiology that affects predominantly women with a predilection for the African-American race. Development of nephritis is a prominent feature in SLE, contributing to morbidity and mortality. Although most patients with lupus have some renal involvement, only 15-30% have overt nephritis at the time of initial diagnosis. A further 15-30% of patients with SLE develop nephritis later in the course of their disease. The methods presently employed to screen for nephritis fail to detect early-silent-disease. Renal biopsy is the gold standard for the diagnosis of lupus nephritis. However, it is not suitable as a screening tool due to its invasive nature and the impracticability of repeated measures. Treatment options for nephritis are limited and associated with significant toxicity. Therapies are complicated by considerable life threatening adverse effects. If patients at risk of developing lupus nephritis could be identified early, this may allow for less toxic therapies to be employed which could potentially avert the development of overt renal disease. There is a need for the development of markers to screen for the presence of silent-lupus nephritis.
Our aim i s to identify useful markers of early sub-clinical disease. Such markers will also be helpful for the assessment of the efficacy of ongoing treatment. We will initially establish how selected biological markers and sensitive measurements of renal function relate to activity of nephritis as defined by renal biopsy in patients with SLE at the time of biopsy.
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