Hopkins Lupus Cohort

描述（由申请人提供）：传统的心血管危险因素不能完全解释系统性红斑狼疮（SLE）中动脉粥样硬化风险的增加，动脉粥样硬化是死亡的主要原因。在这个项目中，我们希望通过评估新发现的潜在危险因素与亚临床动脉粥样硬化（软（非钙化）冠状动脉斑块）之间的关系，确定SLE患者动脉粥样硬化的新致病途径。同样，超过50%的SLE患者发生狼疮肾炎，其中75%的非裔美国SLE患者。肾活检是确定肾脏活动性的金标准，但它是昂贵的，侵入性的，并且对患者有真正的风险。我们假设肾脏活动的尿液标记物将在人类狼疮肾炎中具有临床用途，就像它们在肾移植患者和SLE小鼠模型中一样。此外，我们希望开发和研究三种评估高凝性风险的新方法（内源性血栓形成潜力、补体激活和血小板微粒），以确定这些标志物是否可以预测未来的血栓形成事件或与抗磷脂抗体相关。公共卫生相关性：尽管SLE患者的生存率大大提高，但永久性器官损害仍在公众中发生。该项目与其他风湿病学家和放射科医生合作，解决了三个挑战：动脉硬化、血凝块和狼疮肾病。

DESCRIPTION (provided by applicant): Traditional cardiovascular risk factors do not entirely account for the increased risk of atherosclerosis, the major cause of death, in systemic lupus erythematosus (SLE). In this project we want to identify new pathogenic pathways of atherosclerosis in SLE patients, by assessing the association between newly identified potential risk factors and a refined measure of subclinical atherosclerosis, soft (noncalcified) coronary plaque. Similarly over 50% of SLE patients develop lupus nephritis, including 75% of African-American SLE patients. Renal biopsy is the gold standard to determine renal activity, but is expensive, invasive, and has real risk to the patient. We hypothesize that urinary markers of renal activity will have clinical utility in human lupus nephritis, as they have in renal transplant patients and murine models of SLE. In addition we want to develop and study three new approaches to assess hypercoagulability risk (endogenous thrombogenic potential, complement activation, and platelet microparticles) to determine if these markers can predict future thrombotic events or associated with antiphospholipid antibodies. PUBLIC HEALTH RELEVANCE: Although the survival of SLE patients has greatly improved, permanent organ damage continues to occur in the general public. This project addresses three challenges: hardening of the arteries, blood clots, and lupus kidney disease in collaboration with other rheumatologists and radiologists.