Does Lupus Discriminate?
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Lupus

Unraveling the Mystery of Autoimmunity

Lupus Deaths on the Rise


By: Christine Haran

Anyone can develop lupus, but people in certain ethnic groups are at much higher risk for this chronic autoimmune disease. This is particularly true for African-American women, who have three times the risk of white women, for example.
To look at how ethnicity influences lupus risk, the Lupus in Minorities: Nature versus Nurture (LUMINA) study was started in 1993 by researchers at the University of Alabama at Birmingham, the University of Texas-Houston Sciences Center and the University of Texas Medical Branch at Galveston. The study involves 300 African American, Hispanic and Caucasian people with lupus between the ages of 20 and 50.

In an autoimmune disease such as lupus, the immune system mistakenly attacks the body's own tissues. In lupus, antibodies can go after many different part of the body, including the muscles and bones, the skin, the nervous system, the kidneys, the heart and the lungs.

The LUMINA researchers have found that lupus behaves differently in African Americans and Hispanics than it in does in Caucasians. LUMINA researchers Graciela Alarcon, MD, MPH, the Jane Knight Lowe Chair of Medicine in Rheumatology at the University of Alabama in Birmingham, discusses some of these differences below, as well as how a combination of genetic and socioeconomic factors affect the course of the disease in these groups of people.


What is lupus?
Lupus is an autoimmune disease that occurs predominantly in women in their reproductive years. When we refer to lupus, for the most part we are referring to systemic lupus erythematosus (SLE).

Lupus is also a multi-system disease, which means it can involve many organ systems, and it may vary significantly from patient to patient. Some patients have a very mild disease in which they only have joint pain, skin rashes and fatigue while others have very serious disease that can involve the brain, kidneys or heart.

Why did you and your colleagues decided to conduct the LUMINA study?
Because this disease affects minority groups more seriously and more frequently, especially African Americans and Hispanics in this country, there was a request by the National Institutes of Health to study lupus in minorities. Most of the studies in the United States, at least, have focused on patients of African-American ethnicity. So we felt that because of the growing number of Hispanics and the fact that we were already experiencing an increased number of patients with lupus among the Hispanic population, we wanted to include the Hispanic group. That's why we got into the LUMINA study, and we are now in our twelfth year of studying these patients. So we have an African-American group, a Hispanic group and a Caucasian group.

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