Researchers at Yale School of Medicine have introduced a drug that can be used as an effective medicine in reversing the kidney damage caused by a specific condition called lupus nephritis. The study was published on 8 April 2020 in the journal of Science Translational Medicine.
Chronic kidney disease (CKD) occurs when the kidney cannot filter the blood and results in malfunctioning of kidneys over time whereas kidney damage, also known as an end-stage renal disease (ESRD), occurs when the kidney stops working in a way that survival without dialysis or a kidney transplant becomes impossible. Common signs for kidney damage include swelling in legs, ankles and feet, shortness of breathing and decreased urination. It can lead to heart diseases like stroke or attack.
Joseph Craft, the Paul B. Beeson professor of medicine (rheumatology) and professor of immunobiology, says:
Kidney damage affects about half of the patients with lupus, sometimes leading to renal failure with a requirement for dialysis or transplantation. Finding what causes that damage is extremely important.
National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) has specified that the overall occurrence of the CKD has reached approximately 14% from 1988 to 2004. According to NIDDK, more than 661,000 Americans are suffering from kidney failure, of these 468,000 people are on dialysis and nearly 193,000 are living with a kidney transplant.
The Centers for Disease Control and Prevention (CDC) has specified that CKD is more common in older people and women. An average of 38% and 13% of older adults (65 and above) and adults (45-64 years), of which 15% are women and 12% are men, are diagnosed with CKD.
Now, Yale researchers have found a drug that was earlier used to treat cancer but now it is showing an effective response in reversing kidney failure caused by a condition known as systemic lupus erythematosus (SLE, or lupus), or a platelet disorder.
Lupus is an autoimmune disease that occurs when the body’s immune system becomes hyperactive and produces an excessive amount of antibodies that further act abnormally by attacking healthy tissues and other organs such as heart, brain, liver and skin. The condition can be triggered by viral infections, traumatic events, strong medication and other environmental factors. Lupus nephritis is the damage specifically to the kidneys caused by systemic lupus erythematosus (SLE). Some common signs of lupus nephritis are swelling of face, legs and ankles.
According to Lupus Foundation of America (LFA), lupus is nine times more common in women than in men and affects disproportionately women aged between 15-55 years. The condition is often caused by a change in hormonal activity and sex chromosomes at the time of puberty or menopause. Uncontrolled symptoms of lupus can lead to kidney failure.
In lupus nephritis, one of the white blood cells, known as T cells, gain access to kidney tissue which results in depletion of oxygen. T-cell, a type of lymphocyte, plays an essential role in the immune system by attacking the pathogens such as virus infected cells, foreign cells and cancer cells. The team found that depletion of oxygen further causes tissue damage, resulting in ESRD.
Joseph Craft and lead author of the study, Ping-Min Chen, a graduate student of Yale and a postdoctoral researcher at Harvard Medical School, have investigated the role of T cell. They have found that hypoxia-inducible factor-1 (HIF-1), an oxygen-sensitive transcriptional activator, regulates oxygen consumption and changes in response to varying oxygen concentrations in the kidney. The activation of HIF-1 leads the T cells to attack tissue that lower the oxygen levels in healthy tissues and results in kidney damage.
Prof. Chen’s Idea of Blocking HIF-1
Professor Ping-Min Chen had proposed an idea that blocking the effect of HIF-1 can help in averting the oxygen consumption and damage to kidney tissue. For this purpose, the team used a drug that is currently being used as a cancer therapy. In the present study, the drug is used in holding back the effects of HIF-1 to treat lupus in mice. Surprisingly, the drug slowed down the penetration of T-cells into kidney tissue and proved to be effective in reversing kidney damage. The team also found that the same damage caused by HIF-1 was present in those SLE patients that had a biopsy of lupus nephritis.
Prof. Craft says:
The findings suggest this therapy might be beneficial in lupus nephritis. Since this drug and others that block HIF-1 function have been used in humans with cancer, they could be used for the treatment of patients with lupus.
First Line Treatment for Lupus
Glucocorticoids are being used in the first place to treat lupus along with some immunosuppressive drugs, including cyclophosphamide, azathioprine, mycophenolic acid, and methotrexate as well as antimalarials, steroidal and non-steroidal anti-inflammatory agents.
Many drugs that are being used to treat cancer are also being prescribed to treat lupus. A chemotherapy agent known as cytoxan is used to treat different kinds of cancers, including lymphomas, myeloma and leukemia. This agent is also prescribed for severe complications of lupus. Another chemotherapy agent called methotrexate, originally introduced for cancer, is also used to treat lupus and rheumatoid arthritis.
Famous Celebrities with Lupus
If you have been diagnosed with lupus, you are not alone. Some celebrities have also suffered from lupus. They include:
Selena Gomez: She had a kidney transplant due to lupus.
Shannon Box: She announced her lupus with the symptoms of fatigue, joint pain and muscle soreness.
Micheal Jackson: He suffered from lupus of the skin
Nick Cannon: He had experienced lupus with kidney failure and blood clots in his lungs.