Dysfunctional Red Blood Cells in Childhood Could Predict Lupus

Many doctors want to know more about lupus. However, this disease – like all autoimmune diseases – is complex. Questions remain about why and in what ways the immune system of someone with lupus attacks their own body.

Research is leading to some answers that could help the roughly 5 million people in the world who have lupus. This disease affects mostly women, usually between 15 to 44 years of age. But people even younger than that can get lupus too. In fact, 1 out of every 5 people with lupus develops it as a child.^1,2

Mitochondria in the red blood cells of children with lupus

In 2021, doctors at Weill Cornell Medicine published new findings on how problems with parts of red blood cells (RBCs) might lead to lupus. Their research showed something amiss in the mature RBCs of children with active lupus. The RBCs contained mitochondria.^3,4

Fully grown RBCs that function in the right way do not have mitochondria. Mitochondria most often appear in other cells where it works to turn food into energy for the body’s use. RBCs transport oxygen in the body and do not need mitochondria to do this. Mitochondria in RBCs are usually broken down and discarded when the cells are forming.³

How mitochondria in RBCs are linked to lupus

The study noted above showed that dysfunctional RBCs can play a role in how lupus develops and progresses. Red blood cells that had mitochondria appeared more often in children with active lupus. The doctors leading the study found that a defect kept the mitochondria from being cleared out of the RBCs as they grew.^3,4

The connection to lupus has to do with how the body’s immune system tries to cleanse the blood of these cells. Various pathways exist. One is the use of certain white blood cells (WBCs) called macrophages. When this takes place, proteins known as type I interferons are released in the body.^3,4

Other research has shown that type I interferons cause inflammation found in autoimmune diseases like lupus. Children and adults with lupus tend to have large amounts of type I interferons. A connection also exists between the number of interferons and flare-ups of symptoms.^3,4

The 2021 study revealed that the children with lupus had lots of type I interferons. Those with the greatest number of type I interferons had both RBCs with mitochondria, as well as the antibodies that mark these cells for removal.^3,4

How this finding could lead to new lupus treatments

This finding of RBCs in children with lupus might impact new treatments. Past research showed lupus could stem from mitochondrial dysfunction in other cells. Now doctors know to also look at RBCs as a source of dysfunction and a factor in the development of lupus.^3,4

Insight into how lupus works helps doctors as they look to expand and improve treatments. Pinpointing specific pathways that lead to disease provides focus areas. Doctors can pursue other studies to better understand what prevents the removal of some cells in the body. What doctors learn may help develop treatments that address these problems or their effects.^3,4

What this means

If you have lupus or think you might have lupus, talk to your doctor. They can help you understand how the disease works. Your doctor can run tests to check for certain markers linked to lupus, such as antibodies and inflammation.

Your doctor may be able to tell you about clinical trials underway for people with lupus. These trials assess the safety and success of potential new treatments. There may be one that targets factors that play a role in the lupus that affects you.