Dr. Joan Wither
The Independence at Home Community Outreach team meets once per week to discuss patients, and which specialists are best suited to visit them based on the patients’ needs.(Photo: The Globe and Mail)

Finding the clues to diseases such as lupus and kidney disease is one of the most complicated research puzzles for modern medicine. But Dr. Joan Wither and her research team intend to meet that challenge head-on.

It can be a mouthful simply to explain the groundbreaking research that Dr. Wither, a Senior Scientist at the Krembil Research Institute, and a rheumatologist in the Arthritis Program at Toronto Western Hospital, is conducting.

Her research program focuses on identifying the genetic and immune system abnormalities that lead to systemic autoimmune rheumatic diseases (SARD), including systemic lupus erythematosus (SLE), Sjögren's syndrome and scleroderma.

Dr. Wither is hunting for biomarkers for these diseases, which are related. A biomarker is exactly what it sounds like – a measurable substance in a person, or any organism, that indicates some sort of change such as an infection or a disease.

Her SARD research has four goals, the first of which is to identify biomarkers for the early identification of patients at risk of developing SARD. Dr. Wither is also looking to evaluate therapies for prevention and to map and understand the immune mechanisms that lead to "flares" in autoimmune diseases and their progression, so there can be better diagnosis and treatment for every patient's disease.

Finally, she says, it's important to develop diagnostic tests using biomarkers to monitor how SARD progresses and anticipate when it leads to more severe problems, such as renal (kidney) disease.

Dr. Wither is looking at people with antinuclear antibodies, antibodies that bind to the nucleus of cells.

We all have antibodies in our blood, preventing us from getting sick or minimizing illness. Sometimes antibodies develop that work against our own bodies to trigger an autoimmune reaction that can damage our organs, such as the antinuclear antibodies that are found in SARD. The amount and pattern of these antibodies can be tested through an antinuclear antibody (ANA) test.

Some people have abnormal levels of these antibodies.

"We focus on the patients who have positive ANA tests," Dr. Wither explains.

Krembil Arthritis Magazine 

The Krembil Research Institute and the Globe and Mail have teamed up for a special project designed to highlight the tremendous achievements of the science and research programs at Krembil. The first of three magazines in this series looks at the brain and spine program, a second highlights the vision program and a final edition, which is also now available on line, explores the arthritis program.

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