Understanding the immune pathology of SLE membranous nephritis

Systemic lupus erythematosus or lupus is a disease that causes persistent inflammation in several different organs in the body. SLE affects about 500 in 1 Million people in the UK and millions of people worldwide. Lupus nephritis or kidney disease in lupus is a serious manifestation of lupus that can range in severity from mild blood and protein leak in the urine to persistent inflammation with worsening kidney function or even kidney failure. Kidney biopsy findings help to predict severity of the disease and the way disease will progress. Treatment strategies are also directed by kidney biopsy findings. There are 5 different classes of lupus nephritis based on these biopsy findings ranging from Class 1 to Class 5. Class 5 lupus nephritis also called membranous lupus nephritis is similar to the way membranous nephropathy (MN) presents in patients. The latter condition is found in patients that do not have lupus.

It is known that lupus is an autoimmune disease which means that immune system produces antibodies against self, attacking different organs in the body. High antibody level shows that disease is severe and decreasing antibody levels will be seen when treatment is given.  In this study we hope to find other, more specific antibodies in the blood of patients with Class 5 lupus nephritis.

Previous research has shown that besides this autoimmune process, there are genetic and epigenetic (meaning environmental factors causing heritable change without affecting genetic sequence) mechanisms causing lupus. This will result in identifying which patients with lupus will get lupus nephritis, picking up disease early and developing drug therapy to reduce or stop antibodies causing inflammation. This will therefore improve lives of lupus patients affected worldwide.