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Discoveries Show Promise In Preventing Premature Artherosclerosis and Skin Disease While Reducing Brain And Kidney Damage In Lupus Patients

Lupus is a debilitating, frustrating disease for the patients who live with it and the physicians who treat it. Lupus is particularly exasperating as there have been no medical breakthroughs in thirty years for this sometimes fatal disease. Now there is new hope.  Research done by Nilamadhab Mishra, M.D., of the Section on Rhematology and Immunology at Wake Forest University Baptist Medical Center, is the first to demonstrate histone deacetylase inhibitors such as valporic acid and vorniostat could be beneficial in preventing premature artherosclerosis, brain and kidney disease brought on by lupus. Clinical trials in humans are the next step.

It seems incomprehensible that for thirty years no new drugs have been developed to treat the multiple symptoms of systemic lupus erythematosus (SLE). For Nilamadhab Mishra, M.D., an assistant professor of Internal Medicine who came to the United States in 1996 to find a cure for lupus, this has meant fertile ground for research. His Rheumatology Section colleagues have identified epigenetic alterations linked with a lupus-like disease in mice and their research was the first to demonstrate histone deacetylase inhibitors could be beneficial in treating lupus. Dr. Mishra is planning phase one clinical trials for two promising drugs: valproic acid, a histone deacetylase inhibitor, that is already approved by the U.S. Food and Drug Administration for the treatment of seizures, and vorniostat, recently approved for treating cancer.

Atherosclerosis

Atherosclerosis is a common disorder of the arteries. It occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard substances called plaque.

Eventually, the plaque deposits can make the artery narrow and less flexible. This makes it harder for blood to flow. If the coronary arteries become narrow, blood flow to the heart can slow down or stop, causing chest pain (stable angina), shortness of breath, heart attack, and other symptoms.

Pieces of plaque can break apart and move through the bloodstream. This is a common cause of heart attack and stroke. Blood clots can also form around the plaque deposits. Clots block blood flow. If the clot moves into the heart, lungs, or brain, it can cause a stroke, heart attack, or pulmonary embolism.

More on atherosclerosis

Dr. Mishra and his colleagues also were the first to demonstrate that not only will these drugs help lessen the severity of lupus-related kidney and brain disease, they also will prevent premature atherosclerosis, a common complication of lupus. Finally, the investigators found new biomarkers that can help in diagnosis, treatment, and prognosis. There also is hope that Dr. Mishra’s findings might answer other mysteries such as why women are disproportionately affected by lupus.

In an article published in JAMA, Dr. Mishra hypothesizes that a region of the active X chromosome containing genes that protect against lupus may be silenced, leaving women vulnerable. It seems, at long last, answers may be within reach.

 

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The information on this Website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified healthcare provider. If you have a medical problem or a health-related question, consult your physician or call Health On-Call at 336-716-2255 or 1-800-446-2255.

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Last Modified: 8/26/2008