Lupus band test for diagnostic evaluation in systemic lupus erythematosus

Lupus ◽  
2022 ◽  
pp. 096120332110664
Author(s):  
Chanidapa Wongtada ◽  
Stephen J Kerr ◽  
Pawinee Rerknimitr
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Sensitivity And Specificity ◽  
Lupus Erythematosus ◽  
Normal Skin ◽  
Characteristic Curve ◽  
Systemic Lupus ◽  
Clinically Normal ◽  
Activity Types ◽  
Lesion Skin

Background The lupus band test (LBT) using a sample of clinically normal skin was proposed as a useful diagnostic test for systemic lupus erythematosus (SLE). It is mostly performed to help diagnosing SLE in patients with insufficient clinical and serological profiles. However, most published studies on its utility are outdated and the results remain controversial. Objectives To determine the diagnostic performance of LBT on non-lesion sun-protected (NLSP) and sun-exposed (NLSE) skin for SLE. Methods Consecutively presenting patients with clinical and serological suspicion of SLE who had LBT performed on non-lesion skin during January 2012 to August 2021 were retrospectively studied. LBT performed on either NLSE or NLSP skin biopsies were all included. Laboratory characteristics, number, types and patterns of deposited immunoreactants and disease activity were also assessed. Results LBT was performed in 57 patients with suspected SLE. LBT was positive in 18/57, 9/28 and 6/21 patients in overall non-lesion, NLSE and NLSP, respectively. Of all patients, 23 patients were diagnosed with SLE and 34 patients with other diseases. Overall, the sensitivity and specificity of LBT on non-lesion skin was 56.5% and 88.2%, respectively. The ability of the test to discriminate between those with and without SLE, assessed by the area under the Receiver-Operating Characteristic curve, was 0.72 (0.61–0.84). The sensitivity and specificity of LBT on NLSE skin was 58.3% and 87.5% while those of NLSP skin, were 57.1% and 85.7%, respectively. We found no significant correlation between the positivity of LBT and overall disease activity. Types, number and pattern of deposited immunoreactants also showed no correlation with disease activity (all p > 0.05). Conclusions Used as a diagnostic adjunct, non-lesion LBT is still of value for diagnosing SLE in inconclusive cases.

scholarly journals Lymphocytes Tγδ in clinically normal skin and peripheral blood of patients with systemic lupus erythematosus and their correlation with disease activity

2001 ◽  
Vol 10 (4) ◽  
pp. 179-189 ◽  
Author(s):  
Ewa Robak ◽  
Hanna Niewiadomska ◽  
Tadeusz Robak ◽  
Jacek Bartkowiak ◽  
Jerzy Z. Bloński ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
T Cells ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Peripheral Blood ◽  
Normal Skin ◽  
Control Group ◽  
Systemic Lupus ◽  
Clinically Normal ◽  
Healthy Persons

Human Tγσ lymphocytes constitute from 1 to 15% of all peripheral blood lymphocytes. Recent work has demonstrated that this population plays a major role in the pathogenesis of infectious and immune diseases. Increased numbers of γσ T cells have been found in affected skin from systemic sclerosis and chronic cutaneous lupus erythematosus patients.In our study, we have determined the numbers of Tγσ lymphocytes and their subpopulations in peripheral blood from 29 patients with systemic lupus erythematosus (SLE) and in 19 healthy volunteers using flow cytometry and specific monoclonal antibodies. The same cells in uninvolved skin from SLE patients and human controls using immunohistochemical analysis were estimated. T-Cell receptor (TCR) delta chain gene rearrangement was identified with primers for Vσ1, Vσ2 and Vσ3 by the polymerase chain reaction. Statistical analysis showed a significantly decreased number of γσ T cells in SLE patients (26.4 Ī 16.9/μl) compared with the control group (55.3 Ī 20.6/μl) (p<0.001). The number of Vσ2 TCR+ and Vγ9 TCR+ subpopulations was also lower in SLE patients than in healthy persons. No statistical correlation between disease activity and the number of γσ T cells was demonstrated. The percentage of T γσ lymphocytes in clinically normal skin from SLE patients was twice (22.0 Ī 9.4%) that found in the skin from healthy persons (11.1 Ī 5.5%) (p<0.002). Higher percentages of the Vσ2 TCR+ and Vγ9 TCR+ subpopulation of lymphocytes were found in the skin from SLE patients. We have also found positive correlation between the percentage of Tγσ lymphocytes in skin and the activity of SLE (r=0.594, p<0.001), and between subpopulation Vσ3 TCR+ and disease activity (r=0.659, p<0.001). In conclusion, the results of our studies demonstrate that, in patients with SLE, accumulation of Tγσ lymphocytes can be seen in clinically normal skin, and the percentage of these cells correlates with the activity of the disease.

SAT0205 A MORE SPECIFIC INTEGRATED MODEL FOR IDENTIFYING BACTERIAL INFECTION IN SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1045-1046
Author(s):  
M. Feng ◽  
X. C. Zhao ◽  
J. Luo
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Bacterial Infection ◽  
Disease Activity ◽  
Sensitivity And Specificity ◽  
Lupus Erythematosus ◽  
Roc Curves ◽  
Systemic Lupus ◽  
Routine Examination ◽  
Tnf Α ◽  
Ifn Γ

Background:Systemic lupus erythematosus (SLE) is a multisystemic inflammatory disorder [1]. Given that immunosuppressive therapy is adopted as the predominant treatment option for SLE, up to half of SLE patients develop infections during their disease progress, and bacterial infection serves as the leading cause of morbidity and mortality in SLE patients [2]. Owing to the therapeutic regimen to bacterial infection and SLE flare are absolutely opposite, timely diagnosis and correct treatment are of vital importance, and improper treatment strategy may be fatal. No single biomarker, however, has exhibited sufficient sensitivity and specificity to serve as a standard tool for distinguishing bacterial infection from SLE flare.Objectives:To find a method by integrating cytokines, lymphocyte cells and routine examination biomarkers to observe its capacity for identifying bacterially infected SLE patients.Methods:Total 175 SLE patients (65 infected and 110 flare) were recruited into our study. The criteria of bacterial infection was positive isolation of bacteria, typical clinical symptoms and signs, imaging positive results and positive feedback on antibacterial treatment and lupus flare was regarded as three points higher than their previous SLEDAI. The disease activity of SLE patients was evaluated based on Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Lymphocyte cells (CD3+T, CD4+T, CD8+T, B, NK, Th1, Th2, Th17 and Treg) and cytokines [interleukin-2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ) and IL-17] were measured by flow cytometry. Blood routine examination, erythrocyte sedimentation rate (ESR), C-Reactive Protein (CRP) Complement 3 (C3), C4, procalcitonin (PCT), immunoglobulin M (IgM), IgA and IgG were also evaluated. Partial least square discriminant analysis (PLS-DA) and supervised orthogonal PLS-DA (OPLS-DA) were applied to perform multivariate analysis of the data and further group the patients with bacterial infection. Receiver operating characteristic (ROC) curves were also plotted to investigate the ability of individual indicator and the combination of multiple indicators to identify bacterial infection.Results:The PLS-DA model showed a clear identification effect by the performance of R2Y=0.991 and Q2=0.970. The OPLS-DA model (R2Y=0.996 and Q2=0.991) exhibited a better separation of patients with bacterial infection. And the Observed vs. predicted plot of the OPLS-DA model demonstrated that all SLE patients were correctly separated into infected or flare groups, indicating that the model had a strong predictive ability for bacterial infection. For single indicator, infected patients had higher WBC, neutrophil (NEUT), ESR, CRP and PCT (P=0.002, 0.019, 0.002, <0.001, <0.001, respectively), and lower Treg cells (P=0.012). The levels of serum IL-6, IL-10, IFN-γ and TNF-α (P<0.001, =0.022, 0.014, 0.011, respectively) were significantly increased in infected group. ROC curves showed that the combination of the ten indicators showed the largest AUC and the highest accuracy, as well as balanced and relatively high sensitivity and specificity. Furthermore, the AUC of the combination was greatly higher than that of WBC, NEUT, ESR, CRP, PCT, Treg, IL-6, IL-10, IFN-γ and TNF-α (P<0.001).Conclusion:PLS-DA, OPLS-DA models including cytokines, lymphocyte cells and routine biomarkers and combination of WBC, NEUT, ESR, CRP, PCT, Treg, IL-6, IL-10, IFN-γ and TNF-α in ROC curve may be more predictive for finding bacterial infection in SLE and may prompt clinicians more promptly and accurately to help them make correct medication.References:[1]Illescas-Montes R, Corona-Castro CC, Melguizo-Rodríguez L, et al. Infectious processes and systemic lupus erythematosus. Immunology 2019;158:153-160.[2]Furst DE, Breedveld FC, Kalden JR, et al. Updated consensus statement on biological agents for the treatment of rheumatic diseases. Ann Rheum Dis 2002; 61: ii2–7.Disclosure of Interests:None declared

Clinical Usefulness of Hematologic Indices as Predictive Parameters for Systemic Lupus Erythematosus

2020 ◽  
Vol 51 (5) ◽  
pp. 519-528 ◽  
Author(s):  
Amirhossein Peirovy ◽  
Aida Malek Mahdavi ◽  
Alireza Khabbazi ◽  
Mehrzad Hajialilo ◽  
Ebrahim Sakhinia ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Lymphocyte Count ◽  
Activity Index ◽  
Characteristic Curve ◽  
Inactive Disease ◽  
Systemic Lupus ◽  
Distribution Width ◽  
Lymphocyte Ratio

Abstract Objective This study assessed the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume, platelet distribution width, and red cell distribution width (RDW) in systemic lupus erythematosus (SLE) patients and their correlation with disease activity. Methods Two hundred eight SLE patients and 205 age- and sex-matched healthy controls were included. Disease activity was assessed using the systemic lupus erythematosus disease activity index 2000, and hematological indices were determined. Results Lymphocyte and platelet counts were significantly lower in SLE patients than in the controls, while the NLR, PLR, and RDW were significantly higher (P &lt; .05). In patients with active disease, the neutrophil counts, NLR, and PLR were significantly higher than in those with inactive disease (P &lt; .05), while the lymphocyte count was significantly lower (P &lt; .05). Based on receiver operating characteristic curve analyses, only for lymphocyte count and PLR. The area under curve was significantly higher (P = .001 and P = .053, respectively). Conclusion PLR can serve as a biomarker for indicating SLE disease activity.

CD44v3 and CD44v6 isoforms on T cells are able to discriminate different disease activity degrees and phenotypes in systemic lupus erythematosus patients

Lupus ◽  
2019 ◽  
Vol 28 (5) ◽  
pp. 621-628 ◽  
Author(s):  
L Novelli ◽  
C Barbati ◽  
F Ceccarelli ◽  
C Perricone ◽  
F R Spinelli ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
T Cells ◽  
T Cell ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Characteristic Curve ◽  
Disease Activity Index ◽  
Systemic Lupus ◽  
Active Patients

Background Adhesion molecule CD44 contributes to T cell migration into target organs. A higher expression of CD44v3 and v6 isoforms has been identified on T cells from systemic lupus erythematosus (SLE) patients. The aim of this study was to investigate the expression of CD44v3/v6 on T cells of SLE patients in order to evaluate their correlation with clinical features. Methods Sixteen healthy subjects (HSs) and 33 SLE female patients were enrolled. Fifteen patients were in remission (Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) = 0) and 18 patients had an active disease (SLEDAI-2K ≥ 4). Experiments were conducted by flow cytometry. Results Expression of CD44v3 on CD4+ and CD8+ T cells was higher in active patients compared to HSs ( p = 0.0097 and p = 0.0096). CD44v3 on CD8+ T cells was also higher in active patients compared to patients in remission ( p = 0.038). CD44v6 was higher on CD4+ and CD8+ T cells from active patients compared to HSs ( p = 0.003 and p = 0.0036) and to patients in remission ( p = 0.01 and p = 0.02). In active patients the ratio CD44v3/v6 was unbalanced towards isoform v6 on both T cell populations. In a receiver operating characteristic curve analysis, CD44v6 on CD4+ T cells was the most sensitive and specific one (specificity of 81.8%, sensitivity of 75%). Expression of CD44v6 on CD4+ and CD8+ T cells correlated with the SLEDAI-2K ( p = 0.03, r = 0.38 and p = 0.02, r = 0.39). CD44v6 and CD44v3 on CD8+ T cells associated with nephritis and arthritis ( p = 0.047 and p = 0.023). Conclusions CD44v3/v6 can be used as biomarkers of disease activity and phenotypes; isoform v6 on CD4+ T cells can be useful as a diagnostic biomarker.

Cell-bound complement activation products (CB-CAPs) have high sensitivity and specificity in pediatric-onset systemic lupus erythematosus and correlate with disease activity

Lupus ◽  
2018 ◽  
Vol 27 (14) ◽  
pp. 2262-2268 ◽  
Author(s):  
J S Hui-Yuen ◽  
Y Gartshteyn ◽  
M Ma ◽  
T O’Malley ◽  
J Conklin ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Sensitivity And Specificity ◽  
Lupus Erythematosus ◽  
Complement Activation ◽  
Operating Characteristics ◽  
Systemic Lupus ◽  
Mixed Effect ◽  
Activation Products ◽  
Pediatric Onset

Objective Elevated levels of cell-bound complement activation products (CB-CAPs) (C4d deposition on B lymphocytes (BC4d) and/or erythrocytes (EC4d)) are sensitive and specific in diagnosis and monitoring of adult systemic lupus erythematosus (SLE). Our objective was to evaluate the role of CB-CAPs for diagnosis and monitoring of pediatric-onset SLE (pSLE). Methods A prospective cohort study of 28 pSLE and 22 juvenile arthritis patients was conducted. SLE disease activity was determined using a clinical Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) that excluded serologies. Autoantibodies were measured using solid-phase immunoassays, C3 and C4 using immunoturbidimetry, and CB-CAPs using quantitative flow cytometry. Abnormal CB-CAPs were defined as EC4d or BC4d above the 99th percentile for healthy adults (>14 and > 60 net mean fluorescence intensity (MFI), respectively). Performance characteristics of CB-CAPs were assessed using area under the curve (AUC) for receiver operating characteristics. Linear mixed effect models evaluated the correlation between CB-CAPs and clinical SLEDAI over 6 months. Results BC4d yielded higher AUC (0.91 ± 0.04) than C3 (0.63 ± 0.08) and C4 (0.67 ± 0.08) ( p < 0.05). Abnormal CB-CAPs were 78% sensitive and 86% specific for diagnosis of pSLE (Youden’s index = 0.64 ± 0.11). In contrast to BC4d, EC4d levels correlated with clinical SLEDAI ( p < 0.01). Conclusion CB-CAPs (EC4d and BC4d) have higher sensitivity and specificity than low complement in pSLE, and may help with diagnosis of pSLE. EC4d could provide a useful biomarker for disease activity monitoring.

Association of Triglycerides With Systemic Lupus Erythematosus-associated Kidney Injury

2021 ◽  
Author(s):  
Haitao Yu ◽  
Danyang Li ◽  
Jiajia Li ◽  
Hengtong Han ◽  
Lili Jiang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Characteristic Curve ◽  
Kidney Injury ◽  
Disease Activity Index ◽  
Systemic Lupus ◽  
Potential Biomarker ◽  
High Triglyceride

Abstract Background: Kidney injury of systemic lupus erythematosus (SLE) contributes to major mortality of SLE. To explore biomarkers is necessary for diagnosing and supervising SLE-associated kidney injury. However, few effective biomarkers can be used for it.Methods: Apriori algorithm of association rules was employed to identify laboratory biomarkers related to SLE-associated kidney injury. Logistic regression analysis was conducted to identify its risk factors, and spearman correlation analysis was used to evaluate the correlation between biomarkers and disease activity of SLE-associated kidney injury.Results: Ten biomarkers were mined by association rule mining. Among them, triglycerides, lactate dehydrogenase and α-hydroxybutyrate dehydrogenase were significantly higher, and haemoglobin and haematocrit were significantly lower in patients with SLE-associated kidney injury than in those without kidney injury. Furthermore, triglycerides were an independent risk factor for SLE-associated kidney injury. There were more patients with SLE-associated kidney injury, SLE disease activity index 2000, blood urea nitrogen, creatinine, proteinuria and urine pathology cast (P-CAST) in the high-triglyceride group. Triglycerides were positively correlated with proteinuria and P-CAST, and they were negatively correlated with albumin and immunoglobulin G. The area under the receiver operating characteristic curve for triglycerides was 0.72,and the optimal cut-off level was 1.84 mmol/l, which provided 64.4% sensitivity and 75.9% specificity in predicting SLE-associated kidney dysfunction. 50% SLE-associated kidney injuries patients with negative proteinuria could be identified by high triglyceride levels. In addition, higher levels of triglycerides were found at the time of onset of kidney injury. With the change in SLE-associated kidney injury, the variation in triglyceride levels is opposite to the evaluated glomerular filtration rate.Conclusion: triglycerides are associated with SLE-associated kidney injury and may be a potential biomarker for auxiliary diagnosis of SLE-associated kidney injury.

Assessment of Quality of Life (QoL) in Systemic Lupus Erythematosus Patients at a Tertiary Care Hospital in Egypt

2019 ◽  
Vol 15 (4) ◽  
pp. 304-311
Author(s):  
Mervat E. Behiry ◽  
Sahar A. Ahmed ◽  
Eman H. Elsebaie
Keyword(s):  
Quality Of Life ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Tertiary Care ◽  
Damage Index ◽  
Life Questionnaire ◽  
Care Hospital ◽  
Systemic Lupus

: Systemic Lupus Erythematosus (SLE) has a profound impact on quality of life. Objective: The objective of this study was to explore the quality of life among Egyptian SLE patients and to assess its relationships with demographic and clinical features. Methods: One hundred sixty-four SLE patients were recruited for this study. Demographic information; clinical parameters; disease activity, as evaluated by the systemic lupus erythematosus Disease Activity Index; and organ damage, as assessed by the systemic lupus international Collaborative Clinics/American College of Rheumatology Damage Index, were reported. Quality of life was assessed with a quality of life questionnaire specifically designed for patients with systemic lupus erythematosus; the questions are grouped in the following six domains: physical function, sociooccupational activities, symptoms, treatment, mood, and self-image. Higher values indicate poorer quality of life. Conclusion: Poor quality of life among Egyptian SLE patients and disease activity are strongly related to impaired lifestyles in these patients.

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