The accumulated experience from this and other studies suggests that telemedicine can be useful even as the virus recedes. A hybrid system incorporating telemedicine may have value, however, because some patients may need in-person visits so rheumatologists can monitor their disease more closely; a higher physician global assessment score may identify such patients.
Abstract 0326—Apolipoprotein L1 (APOL1) in African-American SLE: Frequency and clinical associations3
Research by Petri M, et al.
Patients of African ancestry have worse outcomes from renal disease than patients of European ancestry, resulting in part from the influence of apolipoprotein L1 (APOL1) gene variants. These variants have presumably arisen as part of the host defense against trypanasomiasis in Africa. As now shown, two gene variants, called G1 and G2, increase the risk for a number of forms of renal disease, including lupus nephritis, as well as a greater likelihood of progression to chronic kidney disease (CKD) and end-stage renal disease (ESRD). In addition to the effects of the gene variants on the kidney, some studies have suggested an increase in the risk of cardiovascular disease.
This study by Petri et al. confirmed the high risk of renal disease in patients with at least one risk allele, but it did not find an association with avascular necrosis, cardiovascular disease or pulmonary fibrosis. A larger study may be needed to evaluate the risks for these complications more fully, but these findings are nevertheless important in indicating the vulnerability of the kidney to the presence of risk variants in patients with SLE.
In the future, more basic studies should clarify the intracellular role of APOL1; important issues to be elucidated concern its regulation by toll-like receptors and interferon and its role in processes such as autophagy.
Given the high burden of CKD among African Americans, these investigations are very important, with lupus providing a unique setting to delineate structure-function relationships of the gene variants and their role in pathophysiology.
Abstract 0323—Ro positivity is an under‐recognised poor prognostic marker in systemic lupus erythematosus patients4
Research by Liao K, et al.
Anti-nuclear antibodies (ANAs) in SLE come in two main types: those specific for SLE (i.e., anti-DNA antibody and anti-Sm antibody), and those that are not specific for SLE and have a wider expression in other rheumatic diseases (e.g., anti-Ro antibody, anti-RNP antibody). In general, studies on the pathogenesis of SLE have tended to focus on disease-specific ANAs rather than non-disease-specific ANAs.
