On Oct. 16, 2003, scientists from the Oklahoma Medical Research Foundation (OMRF) and the University of Oklahoma Health Sciences Center (OUHSC) reported that in patients suffering from systemic lupus erythematosus (commonly known as lupus), autoantibodies – proteins that the body mistakenly unleashes against its own tissue – are typically present years before patients are diagnosed with the disease.

In lupus and other autoimmune diseases, the immune system loses its ability to differentiate between foreign substances and its own cells and tissues, causing the body to attack itself. Lupus can affect any part of the body – most commonly the skin, joints, blood and kidneys – and can be life-threatening. The disease primarily strikes women and has no known cure.

Researchers had long known that these abnormal proteins could be found in people suffering from lupus and other autoimmune illnesses. Indeed, Dr. Morris Reichlin, James’ rheumatology mentor and colleague at OMRF, had done pioneering work in demonstrating how and why certain people’s bodies produce autoantibodies. But, James asked, when do they first show up? Is it possible they actually appear in the body before the first symptoms of disease?

The notion was striking. But there was one big hurdle: You can’t reverse time to test the blood of lupus patients before their first symptoms arose. James decided, she says, “to find a way to work backward.” She knew that the U.S. military collected biological samples from enlisted personnel and kept those samples, along with the individuals’ medical records, for many years. If she and her research team could comb through tens of thousands of medical records and identify soldiers and sailors who eventually developed the disease, they could then request blood samples, taken before the onset of symptoms, and test them for autoantibodies.

Working with the then-chief of rheumatology at the Walter Reed Medical Center in Washington, D.C., James and the OMRF team—which also consisted of Harley and Dr. Hal Scofield—gained access to the U.S. Department of Defense serum repository. When they conducted their own testing on blood samples gathered from military personnel, the results were definitive: Of 130 servicemen and women who developed lupus, 88 percent had telltale autoantibodies before they showed clinical symptoms. Some of these markers appeared up to a decade before people became ill.

When James and her colleagues published the results of their research in the prestigious New England Journal of Medicine, “It made a very big splash in the lupus world,” says Dr. Jill Buyon, director of the division of rheumatology at New York University. “The idea that you could identify people who might later develop clinical autoimmunity was quite powerful.”

Indeed, the work held exciting potential for helping patients. Tests to detect these abnormal proteins could become a part of routine checkups for high-risk individuals, and a positive test could signal the need to take preventive action. The New York Times ran a story about the research, and Scientific American also featured it in a cover story entitled “New Predictors of Disease.”