The Interferon Pathway
The researchers focused on variants in the type-1 interferon (IFN-1) pathway because of their prominent (if still unclear) role in patients’ genetic susceptibility to AI-CTDs. In an earlier study, these researchers described a novel system using two interferon-stimulated gene (ISG) expression scores, ISG-Score-A and ISG-Score-B, which in combination identify clinically meaningful differences in interferon status between and within autoimmune diseases.2 In the current study, they set out to apply the scoring system to predict progression from at-risk status to AI-CTD.
AI-CTDs most often affect the joints and the skin, the researchers write. Although musculoskeletal ultrasound can detect subclinical synovitis in lupus, and skin biopsies can show differences in interferon gene expression in cutaneous lupus, neither test has been assessed in at-risk individuals.3,4
The Study Details
The prospective, observational study defined at risk as being ANA positive, having no more than one clinical lupus criterion (based on the 2012 Systemic Lupus International Collaborating Clinics [SLICC] classification criteria), symptom duration of less than 12 months and being treatment-naive.