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NEJM editorial on significance and limitations of new lupus gene expression research
Date:1/20/2008

ystem. The new research on ITGAM, I think, will help redirect the attention of the scientific community back to this aspect of the disease. While the immune system, as the attacker, is of central importance in disease pathogenesis, it is also necessary to look at the response of the tissues they are attacking, Dr. Crow explains.

Dr. Crow also praised the impressive collaborative effort that was required to complete the reported studies. For one of the studies, the International Consortium for Systemic Lupus Erythematosus Genetics (SLEGEN) coordinated the planning and organization of a large genotyping and data analysis effort that involved contributions from more than 150 participants. While some investigator groups have the patient numbers and financial support to provide important new genetics data independently, the success of the SLEGEN study supports broad collaboration, with credit shared among the many essential contributors, as a model that could be followed in investigation of the genetic factors in other complex diseases.

However, three of the four studies, including both large genomewide association studies, are also missing a critical component they dont take into account the populations of people that have the highest morbidity and mortality from the disease. In the major studies, all of the subjects were of European descent, says Dr. Crow, but lupus is most severe in people with African, Asian and Hispanic backgrounds. We need to confirm that these same genes are involved in all of our patient populations and identify any distinct genes that might be involved in those populations at greatest risk for poor outcomes.

Hospital for Special Surgery has been a leader for more than forty years in research into the underlying mechanisms of lupus and was the nations first National Institutes of Health-sponsored Specialized Center of Research in lupus. The Mary Kirkland Center for Lupus Research at HSS combines novel research with pat
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Contact: Phyllis Fisher
fisherp@hss.edu
212-606-1197
Hospital for Special Surgery
Source:Eurekalert

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