Courtesy : AchieveClinical

New research suggests that the key to curing the chronic autoimmune disease known as lupus may come from combining two drugs that have already been successfully created. It’s an incredibly significant claim and one that could change the lives of millions around the world.

Lupus is a mysterious and terrible illness indeed. It’s extremely difficult to diagnose and treat, often mimics the effects of other diseases along the way. Due to it’s very nature, the disease can inflict damage on any part of the human body, from the skin to the nervous system. Lupus remains one of the more widely misunderstood illnesses in the country.

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However, the news of this research is certainly intriguing.

Anyone who has followed our blog may have read our earlier post about a significant grant that the Lupus Research Institute (LRI) awarded to researchers at the University of Florida in Gainesville. It looks like this grant has been put to great use as they have discovered that lupus can be combated in mice when certain metabolic pathways in immune cells are artificially inhibited.

Some fast facts on lupus here in the United States:

  • An estimated 1.5 million Americans are living with lupus
  • 90 percent of diagnosed lupus patients are women
  • Lupus can be triggered by a viral infection
  • About 16,000 people are diagnosed annually
  • Researchers believe that some people are genetically predisposed to this illness

One genetic marker for lupus is the presence of defective helper T cells. These are white blood cells which are responsible for activating other immune cells. Remember that an autoimmune disease is one in which the patient’s immune system has malfunctioned and begun attacking its own healthy tissues. These defective T cells have a hyperactive metabolism which causes additional inflammation and more damage to the body.

Surprising Revelations from this Study

The research team at UF decided to test these two drugs because both had proven abilities to block these metabolic pathways. The key to success in this clinical trial seems to lie in their combined abilities.

“The most surprising result from this study was that the combination of the two metabolic inhibitors was necessary to reverse disease, when it could have been predicted based on models published by others that either one alone would work,” explained Dr. Laurence Morel, co-author of the study and director of experimental pathology at UF’s College of Medicine.

The turning point in this lupus clinical study was analyzing the effects of glycolysis (the breakdown of glucose for energy) and mitochondrial metabolism (describes how energy is produced within a cell) as they relate to T cell metabolism.

“The two processes regulate the energy states of immune cells, which are hyper-activated in lupus and responsible for initiating and sustaining the disease,” said Dr. Morel. “Our study is the first to report a detailed analysis of these cellular metabolic pathways in lupus.”

2DG and metformin were selected because of their abilities to block glycolysis and mitochondrial metabolism respectfully. Metformin has been approved to treat people living with type 2 diabetes and other medical conditions, while 2DG is still classified as under development.

A New Class of Drugs for Lupus

The combination proved quite successful, as it reversed the symptoms of lupus in mice. The drugs didn’t affect the T cells in healthy mice either. So the research team has concluded that they can be used safely and at a fairly modest cost.

“This study may also open the door to targeting other metabolic pathways,” suggested Dr. Morel. “In addition, such a new class of drugs may potentially benefit patients with lupus, as opposed to the more classic approach that typically relies upon immunosuppressive drugs.”

The plan is to approve this promising combination for human clinical trials in the near future. However, there are a few more items that the UF team needs to address. Probably one of the more important questions is whether this combination can be used alongside more conventional lupus medications.


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