PROJECT SUMMARY/ABSTRACT This proposal is to continue longitudinal follow-up of the population-based Michigan Lupus Epidemiology & Surveillance (MILES) Program Cohort and Biobank. The overarching goal is to prospectively collect data and biospecimens that will allow for comprehensive investigations related to risk factors for lupus onset, progression, and comorbidities. To date, the baseline round of Cohort visits has been completed, and the first follow-up round of visits is ongoing. Detailed data collection encompasses measures related to sociodemographics, health/wellness, reproductive health, physical function, environmental exposures, lifestyle factors, and genetics. Lupus-specific measures, including disease activity indices, are measured for the SLE cases. The state-of-the-art biobank includes serum, plasma, DNA/RNA (from lymphocyte subsets), urine, hair, and toenail clippings. Biobank specimens are processed and stored in appropriate conditions to provide the capacity to perform assays including contemporary immunoassays, biomarkers of disease and exposure, and DNA methylation of relevant lymphocyte subsets. Major thematic areas that the MILES Cohort & Biobank is designed to support include epigenetics, environmental epidemiology, and renal lupus. The MILES Cohort will thus serve as a robust platform for ongoing and future research investigations that are relevant to the full spectrum of lupus and its complications.