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Researchers uncover biological rationale for why intensive lupus treatment works
Date:7/26/2010

tion to a high oral dose and gradually reduce the amount of steroids to the lowest level at which the drugs are still effective.

Lupus is a debilitating autoimmune disease in which the immune system attacks the body's own tissue and organs, including the joints, kidneys, heart, lungs, brain, blood and skin. The Lupus Foundation of America estimates that 1.5 million Americans have the disease, which affects all age groups. It is 10 to 15 times more likely in adult women than adult men.

The immune system of lupus patients is dysfunctional, causing inflammation throughout the body. In this study, researchers used the blood cells to investigate why the standard treatment might be less effective in halting the inflammation.

They found that pulse doses of intravenous steroids kill off the cells called plasmacytoid dendritic cells producing interferon alpha, a protein that promotes this inflammation. Oral corticosteroids given at much lower doses did not have this effect.

"Now we have the biological rationale for why pulsing is often more effective than standard therapy," said Dr. Tracey Wright, assistant professor of pediatrics at UT Southwestern and another study co-author.

Dr. Punaro, director of the pediatric rheumatology division at UT Southwestern, said the team hopes that this study will lead to recommendations on ways to treat lupus patients more effectively.

"If the patient receives very high doses of pulse steroids during the induction period, when steroid-sparing long-term drugs which take a while to work are being ramped up to an effective level, then our experience has been that we end up using fewer steroids overall," Dr. Punaro said. "Steroids are probably always going to be a short-term fix because they work quickly and powerfully, but we hope that this information will enable physicians to be smarter about how they use steroids."

The next step, she said, is to use the paper's scientific
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Contact: Kristen Holland Shear
kristen.hollandshear@utsouthwestern.edu
214-648-3404
UT Southwestern Medical Center
Source:Eurekalert

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