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shown promise in early trials in patients with systemic lupus.

Some other therapies under investigation include molecules designed to block production of anti-DNA autoantibodies or to induce those antibodies to bind to decoy compounds that would trap them and provoke their degradation. An example of such a decoy is a complex consisting of four short DNA strands coupled to an inert backbone. Although the last idea is intriguing, I have to admit that the effects of introducing such decoys are apt to be complex.

Certain cytokines might be useful as therapies, but these and other protein drugs could be hampered by the body's readiness to degrade circulating proteins. To circumvent such problems, researchers are considering gene therapies, which would give cells the ability to produce useful proteins themselves. DNA encoding transforming growth factor beta has already been shown to treat lupus in mice, but too few tests have been done yet in humans to predict how useful the technique will be in people. Also, scientists are still struggling to perfect gene therapy techniques in general.

As treatment-oriented investigators pursue new leads for helping patients, others continue to probe the central enigmas of lupus. What causes the aberrant signaling in immune cells? And precisely how does such deranged signaling lead to autoimmunity? The answers may well be critical to finally disarming the body's mistaken attacks on itself. ®

Dubois' Lupus Erythematosus. Sixth edition. Daniel J. Wallace and Bevra H. Hahn. Lippincott Williams & Wilkins, 2001.

Immunobiology: The Immune System in Health and Disease. Sixth edition. Charles A. Janeway, Paul Travers, Mark Walport and Mark J. Shlomchik. Garland Science, 2004.

B Lymphocyte Signaling Pathways in Systemic Autoimmunity: Implications for Pathogenesis and Treatment. Moncef Zouali and Gabriella Sarmay in Arthritis & Rheumatism, Vol. 50, No. 9, pages 2730-2741; September 2004.

Molecular Autoimmunity. Edited by Moncef Zouali. Springer Science and Business Media (in press).


NIKOLA TESLA sits before his large web coil in 1896. That year he wrote: "I do not think there is any thrill than can go through the human heart like that felt by the inventor as he sees some creation of the brain unfolding to success Such emotions make a man forget food, sleep, friends, love, everything."

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