OUTCOME OF SYSTEMIC LUPUS ERYTHEMATOSUS IN MINORITIES--NATURE VS NURTURE

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The LUMINA Study is a longitudinal, non-intervention follow-up study of the outcome of patients with systemic lupus erythematosus. The goals of this study are: 1) To select a well-defined cohort of Caucasians (C), Hispanics (H) and African Americans (A-A) (80 in each group) with SLE of 5 years or less in duration from all SLE patients seen either as outpatients or inpatients at UAB and UTHSC at Houston in order to ascertain their initial status and follow their course and early outcomes at 6 months intervals thereafter for a period of 3 years. UAB center will enroll 120 patients (60 Caucasians and 60 African-Americans). UTHSC at Houston will enroll 120 patients (80 Hispanics, 20 Caucasians, and 20 African-Americans), for a total of 240 lupus patients in both centers. 2) To determine the HLA class II genotypes (HLA,DRB1, DRB3, DRB5, DQA1, DQB1 and DPB1 alleles) by oligotyping, the gene dosage thereof, and Class III C4 and C2 protein allotypes in these patients. 3) To determine the demographic, socioeconomic and cultural features of these patients. (4) To determine pertinent clinical parameters, disease manifestations (e.g., extent of organ system involvement and co-morbidities), laboratory features (e.g. CBC, urinalysis, serum creatinine, lupus anticoagulant) and selected autoantibodies (e.g. ANA, anti-DNA, etc.) whose expression we feel may be genetically mediated; 5) To follow disease outcome as manifested by a) the number and severity of flares, b) disease activity as measured by the SLAM, c) disease severity as measured by the SLICC scale, d) overall functional status, e) renal survival, and f) survival, biannually over a 3 year period. (6) To examine the relative contributions/interactions of genetic, demographic, socioeconomic, cultural, and initial clinical and laboratory features on the course and outcome of early SLE through time dependent statistical analytic approaches including proportional hazard, Cox regression, and General E equations.