We have initiated a research focus on patients with incomplete lupus syndromes, or ILE,to develop insightsinto early stages of SLE (1). The ILE subset is relatively understudied and the likely outcomes are notknown. Published studies are small and conflicting in terms of whether this is a stable, relatively benignphenotype or whether a progressive course is likely. The available data suggest that the ILE subset isheterogeneous, and that a subset of these individuals will progress to SLE. We hypothesize that suchpatients include a subset who are in the early stages of a progressive illness that culminates in SLE. Wepropose to determine the clinical and immunologic stability (or instability) of the ILE population and to identifybiomarkers that are predictive of a progressive disease course. We believe that identification of markers ofdisease progression in ILE will lead to approaches to reliable, early diagnosis of SLE. Our long term goal isthe development of strategies for early and reliable identification of individuals who would benefit fromtherapeutic interventions to prevent organ damage.We propose three aims:
Aim 1 : To determine the cellular changes and autoantibody profiles that are best associated with phenotypicprogression in incomplete lupus (ILE)patients.
Aim 2 : To explore the potential of peptoid arrays to identify ILE progressors. The newly available peptoidarray technology will be applied to detect shifts in the antibody repertoire on a scale that is larger than theprotein array and which is not biased for known antigens.
Aim 3 : To determine the SLAM haplotypes and transcriptomic changes that best predict phenotypicprogression in incomplete lupus patients.The long term goals of this project are to develop approaches to the identification of individuals with pre-clinical SLE. This would make feasible the design of studies to test therapeutic approaches with potential forprevention and cure.
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