Although the origin of the blooms is not clear, these findings, nevertheless, indicate that the gut microbiome may be a target of therapy, with the goal of restoring the stability of its composition and reducing the occurrence of more pathogenic species.
Abstract 0872—Lack of association between cognitive test performance and cognitive symptoms in systemic lupus erythematosus (SLE)12
Research by Raghunath S, et al.
Although inflammation (and consequent damage) is the cardinal feature of SLE, patients with SLE experience symptoms whose relationship to inflammation is less clear. These symptoms include pain, fatigue, mood disorders and cognitive dysfunction, all of which can affect patients’ quality of life. In general, these symptoms do not respond to conventional anti-inflammatory treatment and immunosuppressives. The assessment of these symptoms in the study of SLE usually involves instruments or measures imported from other fields, most notably neuropsychology.
As the findings of Raghunath et al. indicate—from the study of 87 patients with SLE—cognitive symptoms were strongly associated with depression, anxiety and fibromyalgia, but were not correlated with results of a battery of neuropsychiatric tests recommended by the ACR for this purpose.
These results are important in highlighting the limitations of current approaches for evaluating certain symptoms and suggest the need for developing tests of cognition specific for the setting of SLE to better assess functional capacity.
David S. Pisetsky, MD, PhD, is a professor of medicine and immunology at Duke University School of Medicine in Durham, N.C., a staff rheumatologist at the Durham VA Medical Center and the first physician editor of The Rheumatologist.
Dr. Pisetsky received his BA from Harvard College, Cambridge, Mass., in 1967 and his PhD and MD from the Albert Einstein College of Medicine, The Bronx, N.Y., in 1972 and 1973. Following house staff training at the Yale-New Haven Hospital, Connecticut, he was a clinical associate at the National Cancer Institute, Bethesda, Md. He joined the faculty of the Duke University Medical Center in 1978, where he has remained since. He served as chief of rheumatology and immunology at Duke from 1996–2007 and chief of the rheumatology section at the Durham VAMC from 1978–2019.
Dr. Pisetsky has conducted basic and translational research on the pathogenesis of systemic lupus erythematosus (SLE) and the immunological properties of nuclear macromolecules. Most recently, he has investigated the immune activities of microparticles, as well as the immunochemical properties of anti-nuclear antibodies. In 2001, he was awarded the Howley Prize from the Arthritis Foundation for his work on the immune properties of DNA. In 2016, he received the Presidential Gold Medal from the ACR.