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Can identifying a cause for lupus help reverse the disease?

Over 1.5 million people in the U.S. are affected by lupus, and the cause of this autoimmune disease remains unclear. Although there are existing treatments for lupus, they often fail to control the disease and may have unintended side effects. However, the latest discovery of what may be the cause of lupus could potentially lead to new treatments that can reverse the disease.

Scientists from Northwestern Medicine and Brigham and Women's Hospital have noticed that lupus patients exhibit changes in multiple molecules in their blood. These changes, in turn, lead to a lack of activation of a pathway managed by the aryl hydrocarbon receptor (AHR). The AHR regulates the cells' response to environmental agents such as pollutants, bacteria, or metabolites. When the activation of AHR is lacking, T peripheral helper cells—or disease-promoting immune cells—become abundant and promote the production of disease-causing autoantibodies.

Through this discovery, Dr. Jaehyuk Choi and his team hypothesized that activating the AHR pathway with small molecule activators could reduce the number of disease-causing cells. Investigators tested this hypothesis by injecting these AHR small molecule activators into the blood samples of lupus patients. Doing so seemed to reprogram the lupus-causing cells into a cell type called Th22, which may help reverse the damage caused by the disease.

Dr. Choi noted that "if these effects are durable, this may be a potential cure for lupus". Although more research and clinical trials are needed, this finding opens up the possibility of many more treatments that target the AHR pathway and may potentially cure lupus.

The Autoimmune Registry supports various clinical trials, which help bring new treatments to patients. Do you have questions that prevent you from participating in a clinical trial? If so, make a video here to ask those questions (you can also make the video anonymously)!

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