Heart & blood vessels

People with lupus are more likely to develop heart and blood vessel disease, and the risk starts early. A young person with lupus can have changes in their arteries that you would normally only expect in someone much older.

Two things seem to drive this: ongoing inflammation, and changes in the fats carried in the blood, such as cholesterol. The usual tools doctors use to estimate heart risk were designed for older adults, and they miss many young people with lupus.

We look for early warning signs in blood samples so that the young people most at risk can be spotted and helped, for example with cholesterol-lowering medicines, long before any problems start.

Cardiovascular disease is a leading cause of morbidity in SLE, and accelerated atherosclerosis begins in adolescence. Conventional risk scores perform poorly in this population. We study the immunometabolic links between inflammation, lipoprotein metabolism and vascular disease to build better tools for risk prediction.

Key questions

• Which serum metabolomic and proteomic signatures predict atherosclerosis progression in young people with cSLE?
• Can these signatures identify who is most likely to benefit from statins?
• How do lipids shape immune cell function, and how does inflammation remodel lipid metabolism?
• How does cardiometabolic risk change across the lifespan in SLE?

Approach

Serum metabolomics and proteomics in UK and US cohorts, including samples from the APPLE trial, combined with vascular imaging outcomes and machine learning.

Key papers