About 1.5 million people in the United States have systemic lupus erythematosus, and most are women. It is three times more common in Asians, African-Americans and Hispanics than in Caucasians. It is an autoimmune disease and the symptoms are diverse and widespread. The body’s immune system wages an attack against its own tissues, and the symptoms are driven by where in the body the inflammatory immune response hit. It is the inflammatory response in the organs that leads to tissue damage. Patients are at risk for damage to the heart, lung, brain and blood vessels. Kidney damage, common among lupus patients, can be life-threatening.

Unraveling how the immune system wages an attack on the body it protects may lead to treatments not only for lupus but for other immune-mediated conditions. Betty Diamond, MD, is head of the Feinstein’s Center for Autoimmune Diseases and she is spearheading studies to unravel the molecular pathways that trigger lupus, and develop ways to target treatment. She and her colleagues collect blood from patients to test for genes and also to figure out the immune system markers that are specific to the disease process. Patients can also volunteer to take a battery of cognitive tests and undergo brain scans that will ultimately help them identify biochemical clues to the disorder. There are also more than a dozen clinical drug trials for lupus patients at all stages of the disease process.

When the body's immune system senses a threat, it normally goes into action against a real enemy. B-cell lymphocytes respond to foreign invaders by making antibodies. Sometimes, the immune system creates antibodies against its own tissue. And that is what happens in lupus. The B-cell lymphocytes target DNA released from dying cells and produce anti-DNA antibody. This antibody is known to damage tissue in the kidneys, but Dr. Diamond and her colleagues say that there is growing evidence that the brain is affected as well. Some people with lupus have memory problems and others are beset with mental fog and fatigue, Diamond said. Neuropsychiatric symptoms are common in lupus and can include headache, difficulty expressing thoughts, occasional seizures or strokes. They are trying to figure out how and why the anti-DNA antibodies trigger this damage.