Pain Lupus

Does Lupus Discriminate?

Anyone can develop lupus, but people in certain ethnic groups are at much higher risk for this chronic autoimmune disease. This is particularly true for African-American women, who have three times the risk of white women. In an autoimmune disease such as lupus, the immune system mistakenly attacks the body's own tissues. Antibodies can go after many different part of the body, including the muscles and bones, the skin, the nervous system, the kidneys, the heart and the lungs.

To look at how ethnicity influences lupus risk, the Lupus in Minorities: Nature versus Nurture (LUMINA) study was started in 1993 by researchers at the University of Alabama at Birmingham, the University of Texas-Houston Sciences Center and the University of Texas Medical Branch at Galveston. The study involves 300 African-American, Hispanic and Caucasian people with lupus between 20 and 50 years old.

The LUMINA researchers have found that lupus behaves differently in African-Americans and Hispanics than it in does in Caucasians. One of the researchers, Dr. Graciela Alarcon, of University of Alabama in Birmingham, discusses some of these differences below, as well as how a combination of genetic and socioeconomic factors affect the course of the disease.

What is lupus?
Lupus is an autoimmune disease that occurs predominantly in women in their reproductive years. Lupus is also a multi-system disease, which means it can involve many organ systems, and it may vary significantly from patient to patient. Some patients have a very mild disease in which they only have joint pain, skin rashes and fatigue while others have a very serious form of the disease that can involve the brain, kidneys or heart.

Why was the LUMINA study conducted?
This disease affects minority groups more seriously and more frequently in this country, especially African-Americans and Hispanics. Plus there was a request by the National Institutes of Health to study lupus in minorities. Most of the studies in the United States have focused on patients of African-American ethnicity. Yet there is a growing number of Hispanics that are being diagnosed with the disease.

What are the differences seen between ethnic groups?
There are several differences. The disease starts at a younger age and more abruptly in the African-Americans and the Hispanics. Also African-American and Hispanic patients have more kidney disease, and therefore, there is a higher mortality rate. Researchers are studying another Hispanic subgroup in Puerto Rico, but they tend to be more like the Caucasians.

So in African-Americans and Hispanics, the whole disease just comes on with full force within two or three weeks, whereas Caucasians and the Hispanics from Puerto Rico may develop the disease in a more insidious manner, so the disease starts smoldering until somebody really notices it.

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