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Reduced purine 5'-nucleotidase activity in lymphocytes of
patients with systemic lupus erythematosus: results of a pilot study
a Departments of
Rheumatology, b Paediatrics (Laboratory of Purine
and Pyrimidine Metabolism), c and Haematology, d University
Hospital Nijmegen, Nijmegen, the Netherlands
Correspondence to: Dr J N Stolk, Department of Rheumatology, University Hospital Nijmegen, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
Accepted for publication 2 November 1998
OBJECTIVE
To
investigate purine metabolism in patients with systemic lupus
erythematosus (SLE) for possible abnormalities that might be related to
their overall impaired immune function.
METHODSThis
pilot study included 17 patients with SLE (2 men, 15 women). Enzyme
activities of the purine enzymes 5'-nucleotidase (5'NT), purine
nucleoside phosphorylase (PNP), and
hypoxanthine-guanine-phosphoribosyltransferase (HGPRT) were measured in
peripheral blood mononuclear cells (PBMC) and also in fractions of T
cells (differentiation antigen CD3+) (n = 12) and B cells (CD19+) (n = 9). The activity of the thiopurine enzyme thiopurine-methyltransferase
(TPMT) was measured in red cell lysate. Routine blood tests and indices
of disease activity were measured as well. Results were compared with
those of healthy volunteers.
RESULTSCompared with
their controls, the female SLE patients had a more than 50% reduced
activity of 5'NT in the T cell fraction (p = 0.001) and in PBMC (p < 0.000). 5'NT activity was also lower in B cells, but this was not
statistically significant. Enzyme activities did not correlate with
indices of disease activity, disease duration or the B cell/T cell
ratio and no influence of medication was found.
CONCLUSIONReduced
lymphocyte 5'NT activity is a novel finding in SLE. These results
indicate that purine metabolism in SLE may be disturbed. Consequences
of a low 5'NT activity may be an intracellular accumulation of
(deoxy)purine nucleotides and a reduction of adenosine production. It
is hypothesised that these factors may play a part in the overall impaired immune function and in the chronicity of inflammation in SLE.
© 1999 by Annals of the Rheumatic Diseases
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