Lupus therapy: one size does not fit all

Lupus is not a simple disease. This disease can be categorised into different clinical subtypes according to the major organ involved, such as brain or kidney. Monash Immunology researchers have shown that two clinical subtypes of lupus defined by major organ involvement, one affecting the central nervous system (CNS) and the other affecting the kidneys, have associated, distinctive patterns of immune response.
Dr Fabien Vincent et al found that the immune system proteins known as BAFF and APRIL increase in CNS lupus, and decrease in renal lupus. Their serum levels do not correlate to overall disease activity, only the specific disease expression. These results highlight that some immunological pathways may be associated with lupus disease expression, while not associated with disease activity assessed with current composite scores. Serum cytokines levels assessment may help differentiate specific clinical phenotypic subsets of lupus patients who may benefit from therapies which are tailored to regulate the BAFF/APRIL pathway. See article. Image: www.neurology.org.