A new biology of clinical outcome in immune-mediated disease

The long-term outcome of inflammatory diseases, including systemic lupus erythematosus (SLE), rheumatoid arthritis, Crohn’s disease, asthma and multiple sclerosis, varies greatly between people even if they have the same diagnosis. For instance, a patient with SLE might respond to therapy never to relapse, while another with what appears to be an identical disease might suffer relapses, renal failure and death. This illustrates why long-term disease course is a far more important to people than the specific diagnosis they are given.

Medical science has largely neglected the factors that determine patient outcome in these diseases. We will redress that by investigating a ‘marker’ we have discovered by measuring gene expression in white blood cells of patients with various inflammatory diseases. This marker allows us to confidently predict long-term disease outcome, and has led to a test that can help doctors and patients decide on optimal treatment. We will use studies in human volunteers to understand the mechanism underlying this gene expression change.

Our study will provide information we believe will lead to better tests to predict outcome and the development of new drugs that can alter it.