Page 9 - N&V Winter 2019

We found that patients with thickened cancer are over-active and actually cause that change the fats in the body.
arteries had changes in the types of fat in disease. From our previous research we Following on from this discovery, we
their blood and increased numbers of iNKT know that an important factor that controls thought that diet could be an important
cells compared to patients with normal immune cell behaviour is the amount of fat therapeutic option for patients in order to
arteries. Our results suggested that very they have on their surface (the cell control their risk of heart disease. We
detailed analysis of blood fats and iNKT membrane). We also know that the therefore asked 300 patients about their
cells could be used to predict the early pathways controlling how much fat is opinions on diet using an online survey
signs of heart disease in lupus patients. This produced by immune cells are disrupted in promoted through social media. This data is
work has been published in scientific people with lupus. In this project we wanted now published in Lupus (Robinson et al
journals (Smith et al, Science Immunology, to find out whether the defects identified in 2019) and the results highlighted a huge
2016) and presented at scientific meetings adult patients were also seen in patients gap in dietary education for patients.
as talks (5 national/international meetings) with JSLE. Patients feel it is important to know how
and as posters (4 national/international In the last 3 to 4 years we have been diet can help their disease symptoms
meetings).
investigating a group of 65 young patients however few patients receive clinical
We are now continuing this work in a with JSLE compared to age and sex counselling regarding diet.
number of ways: we are working to try to matched teenage healthy controls. We
identify a blood fat profile (unique to lupus have performed a very thorough investi- We now want to identify potential drugs or
patients) that can be used in the clinic to gation of over 44 different types of dietary/life-style interventions for future
predict increased risk of heart disease in immune cells in the blood of patients and clinical studies - tailored for patients
adult patients. This will allow us to identify controls. In particular, because JSLE is often stratified for their cardiovascular disease
patients that need specific advice and diagnosed during puberty, we have been risk that have different fat profiles. We will
treatment in order to reduce their risk of investigating the differences between involve young people with JSLE with the
heart disease. We are also investigating immune cells from males versus females. design of such studies and are already
the causes of altered blood fats and how We have identified several important doing so through collection of food
this can influence defects in the immune differences and are still working to frequency questionnaires in lupus clinics
system in lupus patients. To carry out this pinpoint the relationship between sex and engagement events, including the
work we have obtained grants from other hormones, immune cells defects and fat involvement of professional nutritionists.
charities; including the University College defects in JSLE patients. In particular we Once we can understand the link between
London Hospital Biomedical Research are developing complex ways to analyse fat levels in the blood and different
Centre and from the pharmaceutical the data in order to combine all the disease features we can identify and
company UCB Pharma. We now have a detailed information that we have to propose potential new treatments for JSLE
research assistant and a new PhD student improve our understanding of what goes patients. This includes using drugs that
working on this project. wrong in patients and in the long term help reduce fat levels such as statins, dietary
supplements or life-style counselling. We
In the second project, ‘Understanding to improve treatments. plan to use blood fat levels to match
Immunopathogenesis of Juvenile onset SLE: We know that heart disease is also a major patients with the most appropriate therapy.
could targeting lipids control disease serious complication for patients with JSLE We are already discussing ways to set up
progression’ we collaborated with Dr John (more so than in patients with adult onset a clinical study to do this.
Ioannou and Dr Coziana Ciurtin – Principal disease). Therefore we have also Understanding these differences could help
Investigators in the Adolescent Centre for performed a very detailed investigation of develop more appropriate treatment
Rheumatology Versus Arthritis at UCL. over 200 different types of blood fat (as options for JSLE patients, such as using
This project was focused on investigating described above for adult patients). We drugs or diet to change the type of
the immune cells and blood fats in lupus identified that JSLE patients can be divided particular fats that are contributing to
patients diagnosed when they were into three groups: immune cell defects in patients. We have
children or adolescents (juvenile-onset SLE Group 1: High bad fat; presented this work as talks at a number of
or JSLE). In young people the immune Group 2: High good fat and national and international scientific
system is still developing; very little is Group 3: low good and bad fat. meetings, including the British Society for
known about what goes wrong in patients JSLE patients in each group had different Rheumatology, the American College for
that develop JSLE, whether the defects are clinical and immune cell features. In Rheumatology annual meetings and the
the same as seen in adult disease and particular, JSLE patients in Group 1 had forthcoming EULAR 2019 meeting. Further
whether the same treatments are relevant markers associated with increased risk of funding has been obtained from The
for this group of young patients. Rosetrees Trust and LUPUS UK to support
cardiovascular disease (heart disease). Our
In adult patients with SLE we know that results suggest that we can use detailed George Robinson to continue this work.
many of the immune cells involved in blood fat measurements to pinpoint JSLE Dr Liz Jury
protecting the body from infections or patients that would benefit from therapies
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luPus uK NEWS & VIEWS SUMMER 2019