Researchers combine nanobiotechnology, neutrophils and nucleic acid to combat lupus
“Traditional referrals can delay important treatment for patients with lupus. Because our Lupus Clinic at Ohio State joins multiple specialties in one location, we’re able to institute therapies and establish care plans quickly,” says Wael Jarjour, MD, director of the Division of Rheumatology and Immunology, who co-founded the clinic with Brad Rovin, MD, director of the Division of Nephrology. “This coordinated approach can lead to better physical health, but it also reduces stress and helps patients feel they have more control over such a complex disease.”
“There’s an advantage for clinicians too,” Dr. Rovin says. “We’re able to learn and teach each other about our individual specialties and that makes each of us better lupus experts overall. During any patient appointment, we’re able to just walk down the hall for quick collaboration or to ask a colleague to meet with a patient even if there wasn’t an appointment originally scheduled for that day. Such on-the-spot adjustments to care can make a real difference.”
Both physicians also emphasize the research and novel therapies offered through the Lupus Clinic. “We draw patients from Ohio and the contiguous states, but also from across the nation and world,” Dr. Rovin says. “This significant population of patients with lupus has allowed us to develop a vibrant clinical trials program funded by the NIH and other national organizations. As a result, we can offer cutting-edge treatments that may not be available elsewhere.”
“Our research team is heavily invested in both basic and translational lupus research because we’ve seen how it impacts outcomes,” Dr. Jarjour says. “I would say that our patients are also key to our research success, with the majority providing samples to our biorepository and information to our clinical database. As of November 2022, we have 21 active studies and more than 1,880 participants.
“Traditional lupus therapies often fail to work, so the clinical trials we offer can be life-changing. And because we don’t want to wait for severe disease to establish a foothold, we engage with patients early in their disease process to explain and allow research participation as soon as they’re ready.”
Fostering research
To illustrate the power of clinician collaboration and patient sampling, the Lupus Clinic co-founders cite a recent study they co-authored with other Ohio State and international experts. For their research, A Novel Inflammatory Dendritic Cell That Is Abundant and Contiguous to T Cells in the Kidneys of Patients With Lupus Nephritis, the team analyzed kidney biopsies from patients with proliferative lupus nephritis (LN) and identified a novel inflammatory dendritic cell (infDC) population that’s highly expressed in the LN kidney, but minimally present in healthy human kidneys. These infDCs reside in the PG region and adjacent to infiltrating T cells. Their findings, coupled with recent related literature, suggest infDCs and their T cell partners may be key contributors to driving the local adaptive immune response during active LN.
“While further research is needed to define the T cell subsets residing next to the infDCs and understand the mechanisms by which PG infDCs communicate with T cells to drive local inflammation in LN, this study is an important step forward, and we’ve got the partnerships in place through our clinic to help us do that,” Dr. Jarjour says.
Referrals and research participation for patients with lupus
To illustrate how this type of clinic can advance lupus treatment through clinical research, Dr. Rovin and his colleagues recruited patients with LN from the Ohio State Lupus Clinic to participate in the AURORA 1 trial, which investigated the novel drug voclosporin. This trial showed that the drug significantly increased kidney responses compared to standard treatment, and the resulting data led to FDA approval of voclosporin for LN treatment. Efficacy and safety of voclosporin versus placebo for lupus nephritis (AURORA 1): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial was published in one of the top medical journals in the world, The Lancet, with Dr. Rovin as lead author.
Any physician or patient interested in exploring studies that are actively recruiting can find more detail at Ohio State’s Study Search.
Physicians or other care providers who have questions or would like to refer a patient can call the clinic directly at 614-293-4837 or fax a referral form to 614-293-1456.
