Robert Winchester, MD
Columbia University College of Physicians and Surgeons, New York, NY
2011 Lupus Pregnancy
In approximately 1 in 10 pregnancies among women with lupus, a condition called “preeclampsia” arises, in which very high blood pressure develops and protein spills out into the urine. This is much more frequent than in pregnancies of healthy women. Preeclampsia is a mysterious and dangerous complication for both mother and unborn child.
With LRI funding, Dr. Winchester, in collaboration with lupus pregnancy experts and rheumatologists Jane E. Salmon, MD, and Jill P. Buyon, MD, will pursue a highly innovative concept that preeclampsia in lupus is caused by a dramatically reduced number of an unusual lymphocyte-like cell termed a “natural killer cell” that normally encourages growth of the placenta by recognizing the foreign antigens of the fetus.
Drawing on data on more than 550 lupus pregnancies, the team will examine whether cases in which mothers with low numbers of lymphocyte-like natural killer cells who also share a certain genetic mix with their fetuses are more likely to develop the potentially fatal complication.
Findings could lead to powerful new ways to give women with lupus key information about their risk for developing preeclampsia and perhaps identify ways of modifying this untoward response.
With the LRI grant he received in 2004, Dr. Winchester set out to determine if a particular pattern of gene activity in immune system cells he had identified as indicators of injury in kidney tissue also appear in the blood.
Hopes are high that he is on track, so that a blood test for these biomarkers can be developed to watch for kidney problems, rather than subjecting people with lupus to repeated biopsies.
“If there are different predominant pathogenetic mechanisms of renal injury in lupus, then we can identify them molecularly and treat the patients differently and more appropriately.” – Dr. Winchester
Based on findings from his 2004 grant on kidney and biomarkers, Dr. Winchester was awarded a $40,000 New York Arthritis Foundation grant with Columbia University colleague Anne Davidson, MD, to look at TCR repertoires and kidney microarray data in the mouse.
Rev. March 2011
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- B Cells
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- Human Lupus Biology
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- Why the Lupus Immune System Reacts to Its Own DNA