scholarly journals Serum Complement Protein C3a Level is Associated With Anti dsDNA Ab in Systemic Lupus Erythematosus: a Brief Report

Author(s):  
Yao-Hua Cai ◽  
Jun Deng ◽  
Zhao-Lin Chen ◽  
Heng Mei ◽  
Liang Tang ◽  
...  

Abstract Objective. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is characterized by complement dysfunction and a wide range of autoantibody production. However, data about the relation between C3a and anti-ds DNA Ab in SLE are scarce. Methods.Thirteen SLE patients, diagnosed on the basis of SLICC classification criteria (6 patients positive for anti-Sm Ab, 7 patients positive for anti-dsDNA Ab) were enrolled in the present study. Serum levels of C3a, C1q were quantified by Western Blotting. Clinical, biochemical, serological and other markers of disease activity (anti-SM, anti-dsDNA) were measured by standard laboratory procedure.Results.Serum C3a levels were significantly higher in anti-dsDNA Ab (+) patients compared to anti-Sm Ab (+) patients (p < 0.01). And serum C3a levels positively correlated with SLE Disease Activity Index (SLEDAI) (p < 0.05, r = 0.6134). Interestingly, C3a was slightly correlated positively with D-Dimer, but no significant difference was found (p = 0.0983, r = 0.4783).Conclusion.C3a level is relative to SLE disease activity and may be a promising biomarker for monitoring thrombophilia in SLE.

Author(s):  
Worawit Louthrenoo ◽  
Thananant Trongkamolthum ◽  
Nuntana Kasitanon ◽  
Antika Wongthanee

Objectives: This study aims to compare pregnancy outcomes between systemic lupus erythematosus (SLE) patients who attained clinical remission based on the Definition of Remission in SLE (DORIS) and those with lupus low disease activity based on Low Lupus Disease Activity State (LLDAS). Patients and methods: Between January 1993 and June 2017, a total of 90 pregnancies (one twin pregnancy) from 77 patients (mean age: 6.9±4.8 years; range, 17.9 to 37.3 years) were included in the study. The clinical remission and the LLDAS groups were modified into modified clinical remission and LLDAS groups, respectively by omitting Physician Global Assessment (PGA). The clinical SLE disease activity index (cSLEDAI) score was used for LLDAS. Results: Pregnancies in 49 patients occurred, when they were in modified clinical remission and in 57 in modified LLDAS. There was no significant difference in demographic characteristics, disease activity, or medication received at conception between the two groups. Pregnancy outcomes were similar between the modified clinical remission and the modified LLDAS groups in terms of successful pregnancy (83.67% vs. 84.21%), full-term births (38.78% vs. 38.60%), fetal losses (16.33% vs. 15.79%), spontaneous abortions (14.29% vs. 14.04%), small for gestational age infants (18.37% vs. 19.30%), low birth weight infants (42.86% vs. 40.35%), maternal complications (46.94% vs. 49.12%), and maternal flares (36.73% vs. 40.35%). The agreement of pregnancy outcomes was very high between the two groups (91.11% agreement). Conclusion: Pregnancy outcomes in SLE patients who achieved modified clinical remission and modified LLDAS were comparable.


Lupus ◽  
2018 ◽  
Vol 28 (2) ◽  
pp. 181-188 ◽  
Author(s):  
Z Li ◽  
J Xiao ◽  
H Song ◽  
Q Chen ◽  
H Han ◽  
...  

Background The coagulation status of patients with systemic lupus erythematosus (SLE) is quite complicated, and there are currently no simple efficient methods for its evaluation. We explored the feasibility of thromboelastography (TEG) for this purpose. Methods Paediatric SLE patients were divided into different groups based on Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores. TEG parameters were compared between patients and healthy controls (HCs) and in patients by level of disease activity. Six patients treated with pulse methylprednisolone were also analysed before and after treatment. Results Thirty-nine children with SLE were enrolled, one of whom had bleeding and three of whom had thrombosis. The four TEG tracings of these four children were different. The TEG parameters of the patients (except the four children mentioned above) showed hypercoagulability, shortened R and K times, increased α-angle and maximum amplitude (MA), decreased LY30 and increased clot index (CI) compared with the parameters of the HCs ( P < 0.05). With respect to disease activity, patients with higher SLEDAI scores showed more obvious hypercoagulability with shortened R and K times and increased α-angle and CI ( P < 0.05). Furthermore, there was a negative correlation between both the R time and K time and SLEDAI scores ( r = –0.435, P < 0.01 and r  =  –0.572, P  < 0.001, respectively) and a positive correlation between both α-angle and CI and SLEDAI scores ( r = 0.581, P  < 0.001 and r  =  0.544, P  < 0.01, respectively). No significant difference in coagulation status was found between pre- and post-pulse therapy. Conclusions Compared with the HCs, paediatric SLE patients showed hypercoagulability caused by increased coagulation and decreased fibrinolysis. These coagulation changes were associated with disease activity. TEG could be a potential tool for evaluating the coagulation status of children with SLE.


2016 ◽  
Vol 11 ◽  
pp. IMI.S40035 ◽  
Author(s):  
Nouran M. Abaza ◽  
Reem M. El-Mallah ◽  
Asmaa Shaaban ◽  
Sameh A. Mobasher ◽  
Khaled F. Al-hassanein ◽  
...  

Background The emerging role of vitamin D in immunology and autoimmune disorders has been a worldwide interest in the last decade. Systemic lupus erythematosus (SLE) patients are particularly at a delicate position predisposing them to suffer from vitamin D deficiency due to the multiple risk factors accompanying the disease. Whether vitamin D deficiency is also involved as a risk factor for developing SLE and affecting its course is a considerable concern. Objectives The objective of this study was to estimate the prevalence of vitamin D deficiency in SLE patients and its relation to disease. MATERIALS AND METHODS: In our observational cross-sectional study, serum levels of vitamin D [25(OH)D] in 60 SLE patients and 30 age- and sex-matched healthy controls were assessed and estimated for deficiency and insufficiency at 10 and 30 ng/mL, respectively. Disease activity was evaluated by SLE disease activity index (SLEDAI), irreversible organ damage by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI), and severity by Severity of Disease Index. Fatigue was measured by visual analog scale. Results Significantly lower levels of 25(OH)D were found in SLE patients (17.6 ± 6.9 ng/mL) in comparison to controls (79.0 ± 28.7 ng/mL), with a statistically high significant difference ( t = -11.2, P < 0.001). High prevalence of vitamin D insufficiency and deficiency was detected as 73.3% and 23.3%, respectively. Vitamin D had a highly significant negative correlation with SLEDAI ( r = -0.495, P < 0.001), SLICC ( r = -0.431, P < 0.05), and fatigue ( r = -0.436, P < 0.05). Conclusion Vitamin D deficiency and insufficiency were found to be prevalent in SLE patients in our study and related to disease activity and fatigue. If needed, routine screening and consequent repletion of vitamin D are recommended in SLE patients. Restoring adequate vitamin D levels in SLE patients should be more explored as a potential yet simple measure to their usual management to improve their condition.


2020 ◽  
Vol 14 (4) ◽  
pp. 23-30
Author(s):  
E. A. Aseeva ◽  
S. K. Solovyev ◽  
N. Yu. Nikishina ◽  
G. M. Koilubaeva ◽  
T. A. Lisitsyna ◽  
...  

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide range of clinical manifestations. Numerous observations and surveys of patients have shown that the most common symptom of SLE is fatigue complaints in 51 to 90% of patients.Objective: to determine the significance of fatigue in the general health status of RENAISSANCE cohort patients with SLE who were hospitalized in the Clinic, V.A. Nasonova Research Institute of Rheumatology.Patients and methods. The investigation included SLE patients aged 18 years and older who met the 2012 SLICC criteria. The standard examination accepted in the management of patients with SLE was made. Disease activity was determined by SLEDAI-2K; irreversible lesions in various organs were identified using the SLICC damage index. The SF-36 and the LupusQoL questionnaires were used to assess health-related quality of life (HRQOL) and the FACIT-Fatigue scale was applied to measure fatigue.Results and discussion. The investigation enrolled 328 patients, mainly women (91%); the mean age was 34.4±11.5 years; the duration of the disease was 106.3±97.9 months. In this group, moderate and high disease activities (SLEDAI-2K scores of 6–10 and 11–19, respectively) were observed at approximately the same frequency. At the time of inclusion, more than half (56.5%) of the patients already had various irreversible organ lesions. At Visit 1, the FACIT-Fatigue scale showed that fatigue was present in 148 (45%) of the 328 patients. According to the presence of fatigue, the patients were divided into two groups. Group 1 included 148 patients with fatigue; Group 2 consisted of 180 patients without fatigue. The Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and anti-DNA antibody levels were significantly higher in the fatigue group (p=0.01 and p=0.02, respectively); the patients also had decreased HRQOL according to 7 LupusQol domains (p<0.001). The patients with fatigue were significantly more likely to receive intravenous glucocorticoids and rituximab. At 12 months after the start of treatment, the patients with fatigue were found to have a statistically significant reduction in disease activity, as well as normalization of anti-DNA antibody levels, improvements in HRQOL according to the LupusQol domains, and less severity of fatigue according to the FACIT-Fatigue scale.Conclusion. Fatigue was detected in almost half (45–53%) of SLE patients. It is associated with a higher disease activity by SLEDAI-2K and with a high anti-DNA antibody level. The patients with fatigue are observed to have an obvious worsening of HRQOL according to all LupusQol domains.


2018 ◽  
Vol 6 (8) ◽  
pp. 1323-1327 ◽  
Author(s):  
Blondina Marpaung ◽  
Andi Raga Ginting ◽  
OK Moehad Sjah

BACKGROUND: Midkine (MK) induces inflammation and could inhibit inducible regulatory T cell differentiation. These reports suggest that MK may play a role in the pathogenesis of autoimmune disease including SLE, but data about MK in SLE patients was still limited, and the role of Midkine in SLE is largely unknown.AIM: The purpose of this study was to compare serum level MK in SLE patients and control, also analysed the relationship between the serum MK level and disease activity in SLE.METHODS: This cross-sectional study was conducted in Adam Malik Hospital from January-June 2017. Diagnosis of SLE was established according to the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria, and disease activity was assessed using the Mexican Systemic lupus erythematosus disease activity index (MEX-SLEDAI). Subjects with evidence of malignancy and systemic disease (pulmonary, kidney, liver, metabolic disorder, etc.) were excluded. Data analysis was performed using SPSS 22nd version. P < 0.05 was considered statistically significant.RESULTS: There were 90 subjects and divided into 2 groups: SLE patients group (n=40) and healthy control groups (n = 50). Midkine levels were increased in the serum of SLE patients compared by health control. There was a significant difference in the median serum Midkine levels between SLE patients and healthy control (P < 0.001). Elevated Midkine serum levels were a significant difference between active disease and remission (P = 0.018).CONCLUSION: Elevated Midkine serum level could be a marker of SLE disease activity and have a role in the pathogenesis of SLE.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1496.1-1497
Author(s):  
A. Abdalla ◽  
F. I. Abdelrahman

Background:Cancer is known as one of the causes of morbidity and mortality in systemic lupus erythematosus (SLE) patients. It has been thought that SLE activity and stimulation of the immune system predisposes the risk of cancer (1).Objectives:To investigate the correlation between SLE disease activity and the cancer incidence.Methods:The study included a cohort of SLE patients, diagnosed according to the American College of Rheumatology classification criteria(2)attending the Rheumatology department, Aswan University in the period from January 2018 to June 2019. We used a questionnaire to screen patients who were diagnosed with cancer. We collected demographic and laboratory data on all screened patients and their disease activity using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)(3). For the patients diagnosed with cancer, we recorded age of onset of SLE, age of diagnosis of cancer, type of cancer, treatment received, immunosuppressive regimen (dosage and duration) and cancer outcomes.Results:The study included 117 patients (95 female, 22 male), mean age (25.6 ± 6.5) years with mean SLE duration(7.3 ±6.3) years and mean SLEDAI(9± 8.9). 76% had lupus nephritis, 62.2% had hematological abnormalities and 17.8%had neurophsycatric lupus. 91% were on corticosteroids (CCS), 33% on mycophenolate mofetil (MMF), 43% on azathioprine, 14% on cyclosporin. 56.8% were either receiving or had received intravenous cyclophosphamide (CYC) with a mean cumulative dose (7.5 ± 4.7) gm. We found 18 (15.3%) patients (13 female and 5 males) were diagnosed with cancer during the course of SLE with mean age at onset (31±3.7), mean age at cancer diagnosis (39.28±10.77), mean SLE duration(18.17±6.02) and mean SLEDAI (7.39±4.19). Most of SLE patients with cancer had lupus nephritis (89%) and all cancer patients were on a median dose of CCS 10 (2.5- 20) mg daily for median 10 (4-24) years. 83.5% of them had received intravenous CYC prior to the development of cancer with mean total cumulative dose of (6.7±4.6) gm, 67% received MMF, 33% received cyclosporine and 50% received azathioprine. Types of cancer were as follow; 22.2% lymphoma, 16.7% cancer cervix, 16.7% cancer breast, 11.1% colorectal cancer, 11.1% squamous cell carcinoma, 5.6% leukemia, 5.6% bronchogenic carcinoma, 5.6% prostate cancer and 5.6% cancer thyroid. 66.7% of them had been successfully treated, 27.8% had metastasis, 5.6% had died. There was no significant difference in SLEDAI between patients with cancer and patients without. Whereas malignancy is correlated to longer disease duration (p= 0.01) and older age of SLE onset with significant difference (p= 0.001).Conclusion:Although we have detected an increasing incidence of cancer in SLE patients in comparison to normal population, our study didn’t find a signficant correlation between SLE disease activity and the risk of cancer. We should closely observe SLE patients with old age at onset and/or long disease duration because of their higher risk for cancer development.References:[1]Bernatsky S, Ramsey-Goldman R, Joseph L, et al (2014). Lymphoma risk in systemic lupus: effects of disease activity versus treatment. Ann Rheum Dis, 73, 138–42.[2]Hochberg MC (1997). Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum, 40, 1725.[3]Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH (1992) Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum:630–640.Disclosure of Interests:None declared


Lupus ◽  
2020 ◽  
Vol 29 (2) ◽  
pp. 182-190
Author(s):  
W Batista Cicarini ◽  
R C Figueiredo Duarte ◽  
K Silvestre Ferreira ◽  
C de Mello Gomes Loures ◽  
R Vargas Consoli ◽  
...  

We have explored the relationship between possible hemostatic changes and clinical manifestation of the systemic lupus erythematosus (SLE) as a function of greater or lesser disease activity according to Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) criteria. Endothelial injury and hypercoagulability were investigated in patients with SLE by measuring thrombomodulin (TM), D-dimer (DDi) and thrombin generation (TG) potential. A total of 90 participants were distributed into three groups: 1) women with SLE presenting with low disease activity (laSLE) (SLEDAI-2K ≤ 4), 2) women with SLE presenting with moderate to high disease activity (mhaSLE) (SLEDAI-2K > 4), and 3) a control group comprising healthy women. Levels of TM and DDi were higher both in the laSLE and mhaSLE groups compared to controls and in mhaSLE compared to the laSLE group. With respect to TG assay, lagtime and endogen thrombin potential, low concentrations of tissue factor provided the best results for discrimination among groups. Analysis of these data allow us to conclude that TM, DDi and TG are potentially useful markers for discriminating patients with very active from those with lower active disease. Higher SLE activity may cause endothelial injury, resulting in higher TG and consequently a hypercoagulability state underlying the picture of thrombosis common in this inflammatory disease.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Priscila B. S. Medeiros ◽  
Roberta G. Salomão ◽  
Sara R. Teixeira ◽  
Diane M. Rassi ◽  
Luciana Rodrigues ◽  
...  

Abstract Background Systemic lupus erythematosus (SLE) is an independent risk factor for cardiovascular events. The present study determined the prevalence of subclinical atherosclerosis in childhood-onset SLE using the carotid intima-media thickness (CIMT) measurement and investigated associations between traditional and nontraditional risk factors for atherosclerosis, such as medications, SLE Disease Activity Index - SLEDAI-2 K and SLICC-ACR damage index and CIMT. Methods Cross-sectional prospective study between 2017 and 2018. CIMT was assessed by ultrasonography. Data were collected by chart review, nutritional evaluation and laboratory tests and analyzed by Fisher, Wilcoxon-Mann-Whitney tests, multiple linear and log binomial regression. Results Twenty-eight patients (mean age 13.9 years, SD 3) were enrolled. The prevalence of subclinical atherosclerosis was 32% (95% CI 14.8, 49.4). The mean CIMT was 0.43 ± 0.035 mm. The most common traditional risk factors observed were dyslipidemia (82.1%), uncontrolled hypertension (14.2%), obesity (14.3%), and poor diet (78.6%). Uncontrolled hypertension (p = 0.04), proteinuria (p = 0.02), estimated glomerular filtration rate < 75 ml /min/1.73 m2 (p = 0.02) and SLEDAI-2 K > 5 (P = 0.04) were associated with subclinical atherosclerosis. SLEDAI-2 K > 5 maintained association with CIMT after adjusting for control variables. Conclusion Subclinical atherosclerosis is frequently observed in cSLE, mainly in patients with moderate to severe disease activity.


Lupus ◽  
2019 ◽  
Vol 28 (6) ◽  
pp. 748-754 ◽  
Author(s):  
R C Li ◽  
J Guo ◽  
L C Su ◽  
A F Huang

Objective This study aimed to assess IL-24 levels and their association with clinical manifestations in patients with systemic lupus erythematosus (SLE). Methods There were 75 patients with SLE and 58 healthy controls recruited in this study. Serum levels of IL-24 were measured by enzyme-linked immunosorbent assays, and mRNA levels of IL-24 were tested by quantitative real-time polymerase chain reaction . The area under the curve of the receiver operating characteristic (ROC) curve was used for diagnostic ability of the inflammatory cytokine. Results Serum IL-24 levels were significantly higher in SLE patients than that in healthy controls. SLE patients with nephritis had higher IL-24 levels than those without nephritis. Active SLE patients showed higher expression of IL-24 as compared to less active disease patients. The mRNA levels of IL-24 were much higher in SLE patients. Correlation analysis showed significant correlation between serum IL-24 levels and SLE disease activity index. In addition, ROC analysis may suggest good ability of serum IL-24 in differentiating SLE. Conclusion The inflammatory cytokine correlated with SLE disease activity, and may be involved in this disease pathogenesis.


2021 ◽  
Vol 10 (10) ◽  
pp. 2137
Author(s):  
Ning-Sheng Lai ◽  
Ming-Chi Lu ◽  
Hsiu-Hua Chang ◽  
Hui-Chin Lo ◽  
Chia-Wen Hsu ◽  
...  

Background and Aim: The aim of this study was to compare the correlation of a recently developed systemic lupus erythematosus disease activity score (SLE-DAS) with the SLE disease activity index 2000 (SLEDAI-2K) with the Lupus Quality of Life questionnaire (LupusQoL) in Taiwanese patients with SLE. Methods: A cross-sectional study was conducted in a regional teaching hospital in Taiwan from April to August 2019. Adult patients with a clinician-confirmed diagnosis of SLE based on the 1997 American College of Rheumatology revised criteria or the 2012 Systemic Lupus International Collaborating Clinics Classification Criteria were recruited. SLE disease activity was measured with both SLEDAI-2K and SLE-DAS. Disease-specific quality of life was assessed using the LupusQoL. Results: Of the 333 patients with SLE in this study, 90.4% were female and 40% were between the ages of 20 and 39 years. The median SLEDAI-2K score was 4.00 (interquartile range [IQR] 2.00–7.50) and the median SLE-DAS score was 2.08 (IQR 1.12–8.24) in our patients with SLE. After adjusting for sex and age intervals, both SLEDAI-2k and SLE-DAS were significantly and inversely associated with all eight domains of LupusQoL. The magnitudes of the mean absolute error, root mean square error, Akaike Information Criterion, Bayesian Information Criterion, and coefficient of determination were comparable between SLEDAI-2K and SLE-DAS. Conclusions: There were no clear differences in the use of SLE-DAS over SLEDAI-2K in assessing HRQoL in patients with SLE. We suggest that, in this aspect, both SLEDAI-2K and SLE-DAS are effective tools for measuring disease activity in patients with SLE.


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