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T Cells in Systemic Lupus Erythematosus

Mindy S. Lo, MD, PhD, and George C. Tsokos, MD  |  Issue: August 2011  |  

As technology continues to advance, it may soon be possible to measure methylation patterns and other gene expression profiles easily, perhaps even as a bedside point-of-care test. Such a profile could be readily applied in clinical practice as a biomarker to predict disease activity, organ system involvement, and response to targeted therapy. Small-molecule inhibitors that target specific aberrations of gene expression in SLE could then be selectively used depending on a patient’s profile. The few examples discussed here (such as inhibitors of Syk, CaMKIV, and ROCK) have already shown activity in proof-of-principle experiments with immune cells from SLE patients as well as in some animal models. These types of drugs offer additional advantages over the current biologic agents in terms of ease of administration and dosing and will hopefully have fewer side effects than broader immunosuppression. Thus, a gene expression profile could be used to develop an individualized regimen using specific targeted therapies, moving us toward the ultimate goal of personalized medicine for SLE. the rheumatologist

Dr. Lo is a pediatric rheumatology fellow at Children’s Hospital Boston. Dr. Tsokos is chief of the rheumatology division at Beth Israel Deaconess Medical Center and a professor at Harvard Medical School, both in Boston.

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