NutritiOnal statUs of individuals with RheumatoId arthritis and SLE
Research type
Research Study
Full title
NutritiOnal statUs of individuals with RheumatoId arthritis and Systemic lupus erytHematosus. NOURISH Study
IRAS ID
145696
Contact name
Christopher Edwards
Contact email
Sponsor organisation
R&D Department, University Hospital Southampton NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
RA and SLE are autoimmune, systemic inflammatory conditions and patients with RA and SLE can develop cachexia, which is weight loss and deterioration in physical condition.
Clinically patients with rheumatoid cachexia lose lean body mass in preference to fat. The condition is under-recognised as patients typically increase their fat mass and so their weight remains stable, but this can lead to an increased cardiovascular and infection risk and a reduced muscle bulk.
The pathology of rheumatoid cachexia is not understood. It is likely to be mediated by chemical messages called cytokines, which are cell signalling molecules. There is some evidence that the cytokines TNFa and IL6 are involved in rheumatoid cachexia. Biologic therapies are used to treat synovial disease in RA and SLE, they target these cytokines and may be of use in treating cachexia.
Multiple specific nutrient deficiencies have been seen in patients with RA. Research groups have shown that patients with RA are deficient in folic acid, vitamin D and E, zinc, calcium and selenium.
In caring for malnourished individuals, especially those with more severe degrees of malnutrition it is important to understand that if a single nutrient is replaced without an appreciation of the more extensive nutritional imbalances then there is a significant risk of metabolic imbalance and adverse outcome. Current approaches to dietary care and nutritional support fail to take adequate account of the variability in patient nutritional status at presentation, the impact of medications and their potential for additive and sequential effects.
We hope that by looking at micro-nutritional status of patients with RA and SLE we can identify patients at risk of developing cachexia, which factors might be implicated and help to target therapies to treat cachexia.
REC name
London - South East Research Ethics Committee
REC reference
15/LO/0401
Date of REC Opinion
18 Mar 2015
REC opinion
Further Information Favourable Opinion