Systemic lupus erythematosus (SLE) is an autoimmune disease that can severely damage the kidneys, joints, and other tissues. The Carolina Lupus (CLU) Study focuses on measures of endogenous hormone exposure (menstrual and reproductive history), exogenous sources of estrogen (including estrogen replacement therapy and fertility drugs), occupational exposures that have been linked to the development of SLE or other autoimmune diseases (e.g., silica dust), and medical history- related factors including infectious diseases, allergies, and transfusions. The CLU Study is a population-based case-control study of recently diagnosed patients living in eastern North Carolina and South Carolina. Participants include 255 cases and 355 controls frequency matched by age, gender, and state; 90% of the cases are female and 61% are African-American. Cases are identified through 30 community-based rheumatology and 4 university-based rheumatology practices. Population- based controls are identified through drivers license records. Almost half (45%) of the patients have been referred by community-based rheumatologists. Data is collected using a standardized interview and one blood sample. . Serum is collected to measure specific autoantibodies. White blood cells will be stored for additional studies of gene-environment interactions relating to metabolism, immune function, and hormones. Preliminary analysis of medical-related risk factors has been conducted on 159 cases and 201 controls. This analysis was limited to conditions that occurred before the age at diagnosis (or reference age for controls) and were adjusted for age, sex, and race. The risk of developing SLE increased with a history of hives (odds ratio, OR,1.8, 95% CI, 1.0- 3.3) and was somewhat increased with herpes zoster (OR 2.5, 95% CI 0.7-8.5). (None of the subjects were taking immunosuppressant drugs at the time herpes zoster was diagnosed). Also SLE patients were more frequently allergic to sulfa drugs (OR 7.8, 95% CI 2.8-21.6) and to codeine (OR 2.5, 95% CI 0.9 6.8), but not to penicillin (OR 1.1, 95% CI 0.6 -2.1). There was no association between SLE risk and history of eczema, asthma, hay fever, urinary tract infection, or allergy to foods or insect stings. Patients were somewhat more likely than controls to report they had received a transfusion (OR 1.7, 95% CI 0.8-3.5); transfusions relating to anemia or platelet disorders were excluded from this analysis. A history of stroke, blood clot, or pulmonary embolism was also more common in SLE patients (OR 9.9, 95% CI 2.0- 48). These results raise questions about the role of specific inflammatory, infectious, and allergic conditions, and possibly to transfusion-related microchimerism or infections, in the development of SLE. - autoimmune diseases, systemic lupus eryhtematosus, estrogen, menarche, hormone replacement therapy, silica, solvents - Human Subjects & Human Subjects: Interview, Questionaires, or Surveys Only

Agency
National Institute of Health (NIH)
Institute
National Institute of Environmental Health Sciences (NIEHS)
Type
Intramural Research (Z01)
Project #
1Z01ES049023-03
Application #
6289988
Study Section
Epidemiology and Biometry Training Committee (EB)
Project Start
Project End
Budget Start
Budget End
Support Year
3
Fiscal Year
1999
Total Cost
Indirect Cost
City
State
Country
United States
Zip Code
Cooper, Glinda S; Bynum, Milele L K; Somers, Emily C (2009) Recent insights in the epidemiology of autoimmune diseases: improved prevalence estimates and understanding of clustering of diseases. J Autoimmun 33:197-207
Cooper, Glinda S; Treadwell, Edward L; St Clair, E William et al. (2007) Sociodemographic associations with early disease damage in patients with systemic lupus erythematosus. Arthritis Rheum 57:993-9
Calvo-Alen, J; Alarcon, G S; Campbell Jr, R et al. (2005) Lack of recording of systemic lupus erythematosus in the death certificates of lupus patients. Rheumatology (Oxford) 44:1186-9
De Roos, Anneclaire J; Cooper, Glinda S; Alavanja, Michael C et al. (2005) Rheumatoid arthritis among women in the Agricultural Health Study: risk associated with farming activities and exposures. Ann Epidemiol 15:762-70
Szalai, A J; Wu, J; Lange, E M et al. (2005) Single-nucleotide polymorphisms in the C-reactive protein (CRP) gene promoter that affect transcription factor binding, alter transcriptional activity, and associate with differences in baseline serum CRP level. J Mol Med 83:440-7
Parks, Christine G; Cooper, Glinda S; Hudson, Lori L et al. (2005) Association of Epstein-Barr virus with systemic lupus erythematosus: effect modification by race, age, and cytotoxic T lymphocyte-associated antigen 4 genotype. Arthritis Rheum 52:1148-59
Cooper, Glinda S; Martin, Stephen A; Longnecker, Matthew P et al. (2004) Associations between plasma DDE levels and immunologic measures in African-American farmers in North Carolina. Environ Health Perspect 112:1080-4
Lambe, Mats; Bjornadal, Lena; Neregard, Petra et al. (2004) Childbearing and the risk of scleroderma: a population-based study in Sweden. Am J Epidemiol 159:162-6
Cooper, Glinda S; Treadwell, Edward L; Dooley, Mary Anne et al. (2004) N-acetyl transferase genotypes in relation to risk of developing systemic lupus erythematosus. J Rheumatol 31:76-80
Parks, Christine G; Pandey, Janardan P; Dooley, Mary Anne et al. (2004) Genetic polymorphisms in tumor necrosis factor (TNF)-alpha and TNF-beta in a population-based study of systemic lupus erythematosus: associations and interaction with the interleukin-1alpha-889 C/T polymorphism. Hum Immunol 65:622-31

Showing the most recent 10 out of 30 publications