Published August 18, 2020
Dr. Jessy Alexander, Research Professor with the Department of Medicine, studies the roles of the innate and adaptive immune systems in health and disease. In particular, Dr. Alexander researchers the role of an important arm of the innate immune system, the complement cascade in inflammatory conditions such as glomerulonephritis and lupus. Her recent study seeks to identify proteins that can be targeted for therapeutic treatment of Lupus.
I would like to thank the Community of Excellence for Global Health Equity for their support to carry out the work on lupus patients in India.
Systemic lupus erythematosus is an autoimmune disease that affects 1.5 million people in the USA alone, 90% of which are women of childbearing age. According to the NIH, “1 out of every 250 African American women will develop lupus”, with prevalence of 3 per 1,000 Medicare patients. Lupus is a complex disease affecting many organs in the body with no effective cure. The current therapeutic modality is immunosuppressants and corticosteroids that have toxic side effects.
My research interest is to identify proteins that can be targeted for therapeutic purposes. To achieve that goal we need to understand the disease. There are a number of organisms living in our gut which are classified under the umbrella called Microbiome. The microbiome constituents affect the disease trajectory. Lupus is heterogenous and this study will be the first to characterize the microbiome in lupus patients from India. Important outcomes from this endeavor are that it will allow us to: (1) understand the effects of the microbiome in lupus globally, (2) define mechanistic studies that are clinically translatable, and (3) could form the basis for innovative therapeutic strategies to ameliorate disease pathology in patients with SLE, and define a more targeted cure for lupus patients in India.
CGHE contributed to the collection of samples and processing and storage of samples.
My sponsor was Dr. John Mathew, Chair of Rheumatology in Christian Medical College, Vellore. I worked with a team of rheumatologists. Our target was to collect samples from 40 female lupus patients between 18 and 40 years of age. We collected 22 patient samples by December 2019, processed them and placed them in storage until the collection of samples was complete. I returned to the USA in January and was scheduled to return for completion of the sample collection and sequencing in May/June.
India has restricted travel both within the country and more so from abroad. In addition, there are only COVID19 patients being treated at CMC, Vellore. It will not be possible to collect samples at this juncture.
Once the restrictions are lifted and travel resumed, I plan on returning to CMC, Vellore to complete the sample collection, perform all the necessary sequencing and return with the data. The data will be analyzed and results will be submitted for publication.
While awaiting the pandemic to be controlled and restrictions lifted, I have begun doing work along the same lines that was planned for the patient studies. Once completed this will help compare the results obtained in man and mouse. This will give us a potential tool to study mechanism/s that underlie the changes observed in lupus patients compared to their healthy counterparts.