September 24, 2019

The Accelerating Medicines Partnership (AMP) RA/Lupus Program, a joint effort involving the National Institutes of Health (NIH), the Foundation for NIH, pharmaceutical companies, and non-profit organizations such as the Lupus Research Alliance, has reached a milestone, finishing an important phase of its studies. Researchers with the AMP RA/Lupus Program have published a summary report on their findings from this stage, which include identifying kidney cells that may predict if patients will respond to treatment and discovering immune cells that may promote the disease. These results pave the way for the next stage of the research that will search for new drug targets.

The goals of the AMP RA/Lupus Program are to use new technologies to understand how lupus nephritis—the kidney inflammation that affects about half of patients with the disease-develops, to uncover targets for new drug development, and to find better, less-invasive ways to diagnose patients. As we previously reported, for the recently completed phase of the project, researchers fine-tuned their procedures for analyzing kidney and skin samples, blood, and urine. They also performed studies to find ways to predict which patients will benefit from therapy. For example, the researchers measured which genes were switched on in samples of kidney tissue removed with a biopsy. They found that patients who didn’t respond to therapy within six months of the biopsy often had a distinctive pattern in cells known as tubular cells. However, these findings are preliminary and based on a small number of patients with lupus nephritis. It remains to be determined whether these observations will hold up in a larger patient group.

AMP RA/Lupus Program scientists are also looking at what can be learned about the disease from samples that are easier to obtain than kidney tissue, such as urine, skin, and blood. The new studies tested large numbers of proteins in urine and found that the levels of some were higher in patients with lupus than in people who don’t have the disease. The researchers suggest that this approach may provide important data about how the disease affects the kidneys. The gene changes the researchers observed in the tubule cells also occurred in skin cells of people who did not respond to treatment. This raises the possibility of developing  ess-invasive ways to monitor disease progression and response to therapy that could substitute for a kidney biopsy.

For the next phase of the partnership, researchers will analyze samples from about 200 patients with lupus nephritis. They will try to answer whether testing urine for proteins and identifying immune cells in the blood can be used to diagnose the disease or to predict how a patient’s condition will change. Such information could also reveal if patients will respond to certain therapies.