Researcher Looks for Clues to Help Treat Pediatric Lupus

Dr. Rullo

With the support of the ACR Research and Education Foundation (REF) Awards and Grants program, Ornella Rullo, MD, has developed research that may help rheumatologists better treat pediatric patients.

“Kids and adolescents who are diagnosed with lupus tend to develop more complications than adults,” she says. “So, it’s important for pediatric rheumatologists to know which patients need earlier or more intensive treatments, or need to be followed more closely, in order to help prevent worse outcomes later on.”

Dr. Rullo, a clinical instructor in the Division of Pediatric Rheumatology at Mattel Children’s Hospital UCLA in Los Angeles, recently completed a study that identifies a key marker that could be used by rheumatologists to provide better care for patients who have been diagnosed with pediatric lupus.

Her team enrolled patients in a longitudinal study to determine whether osteopontin levels can help recognize lupus patients who are likely to have serious complications, such as organ damage. The study found that six of the 17 subjects accumulated damage, indicated by an increase in SLICC/ACR Damage Index (SDI) scores. Five of the six patients who accumulated damage had high circulating plasma osteopontin (cOPN) levels in at least one of the two visits prior to the increase on SDI. Eighty percent of the subjects with a high cOPN had an increase in SDI, whereas only 11% of subjects with a cOPN in the bottom three quartiles had an increase in SDI, indicating an increase in SDI was more likely in those patients with a preceding high cOPN. “It looks like it may be a factor,” Dr. Rullo says. She presented the abstract at the ACR’s Pediatric Rheumatology Symposium in Miami in June 2011.

Dr. Rullo credits the leadership of the REF with having the vision to understand the need for supporting physician scientists as their careers develop. “They help support huge transitions in a career. I would not have been able to take the steps to continue on my path without the ACR REF,” she says.

After completing her residency in the Department of Pediatrics at Cedars Sinai Medical Center in Los Angeles, Dr. Rullo began her fellowship in pediatric rheumatology at Mattel Children’s Hospital UCLA in 2006. She was the first fellow in this program to develop a longitudinal research project. “We saw a need to focus on aspects of pediatric lupus that lead to bigger problems,” she says. As a result, she received her first award from the REF—the ACR REF/Amgen Pediatric Rheumatology Research Award, which recognizes and promotes scholarship in the field.