What is Precision Medicine?
Precision medicine uses an individual’s genomic information, protein biomarkers, environment, and lifestyle to determine the best course of treatment for their disease. Unlike precision medicine for cancer which primarily relies on DNA mutation testing to make treatment decisions, autoimmune disease looks at RNA, DNA’s dynamic cousin to determine the best treatment.
Everyone is unique. Autoimmune (AI) diseases, in particular, are experienced differently by every single patient. The severity of your symptoms, your flareup triggers, and what treatments are effective will all be unique to you.
Discovering your unique AI fingerprint
The first step to improving life with AI diseases is to understand each person’s unique experience on a molecular level. There are dozens of genes that are known to be associated with autoimmune diseases, and many more that haven’t yet been discovered. The exact DNA sequence of those genes might differ among patients. Even if the gene sequence is identical, the gene activity level (or RNA expression) will differ between people and within an individual over time.
Measuring your Biomarkers
Advances in medicine now make it possible to measure your unique immune system’s gene activity. Molecules called biomarkers create a molecular fingerprint that reflects the activity of your immune genes. Biomarkers can help determine how severe your disease is. In the future, biomarkers could help identify treatments you’re likely to respond to and track changes that are more or less likely to cause flare-ups.
How are biomarkers measured?
When a gene is expressed, it produces a molecular signal called RNA. The RNA encodes instructions for making proteins. Genes have varying levels of activity, and more active genes produce more RNA and more protein. Traditionally, most biomarkers have been proteins, however new technology enables analysis at the DNA and RNA level on samples collected at home. DxTerity is working to bring precision medicine to SLE and other autoimmune diseases by building at-home test kits that measure RNA.
Proof of concept: IFN-1 for Lupus
In a clinical study called LIFT, over a thousand Lupus patients came together to help determine if AI biomarkers could be tested from home. In this study, volunteers used finger stick kits to submit blood samples for testing. It was discovered that a large percentage of SLE patients had high levels of Type 1 Interferon (IFN-1) related RNA, a key immune system pathway responsible for defense against viruses. A follow-up study showed that IFN-1 High SLE patients are 3 times more likely to develop Lupus Nephritis.1 Now, you can learn your IFN-1 status by ordering a DxTerity IFN-1 Test. This information can help your healthcare provider determine if therapies targeting IFN-1, such as newly available Anifrolumab2, could be right for you.
IFN-1 is just the beginning
IFN-1 is a key biomarker for SLE disease prognosis and many new drugs in development look to better control it, but it is just the beginning. Other RNA biomarkers show promise for being a better measure of disease activity than current protein biomarkers, and more indicative of therapy response. Envision a future where genomic monitoring lets you predict disease flares before they happen, so that you and your doctor can adjust your treatment in time.
- Arriens, C. et al. Increased Risk of Progression to Lupus Nephritis for Lupus Patients with Elevated Interferon Signature. Submitted (2019).
- Morand EF, Furie R, Tanaka Y, et al. Trial of Anifrolumab in Active Systemic Lupus Erythematosus. N Engl J Med. 2020;382(3):211-221.
