Extended report
Soluble CD95 concentrations are increased in patients with severe
systemic lupus erythematosus, but not in their first degree relatives
M W van der Lindena, T van Lopikc, L A Aardenc, R G J Westendorpa, T W J Huizingab
a Department of
Clinical Epidemiology, Leiden University Medical Centre, The
Netherlands, b Department of Rheumatology, Leiden University
Medical Centre, c Department
of Autoimmune Diseases, Central Laboratory of the Blood Transfusion
Service, and Laboratory for Experimental and Clinical Immunology,
Academic Medical Centre, University of Amsterdam, Amsterdam, The
Netherlands
Correspondence to: Dr T W J Huizinga, Department of Rheumatology, Building 1, C4-R Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands TWJHuizinga{at}rheumatology.azl.nl
Accepted for publication 25 July 2000
OBJECTIVE
Plasma
concentrations of soluble CD95 (sCD95) are raised in patients with
systemic lupus erythematosus (SLE) before clinical relapses become
manifest. Increased sCD95 concentrations may therefore be a familial
characteristic that is associated with susceptibility to severe
disease. To test this, sCD95 concentrations were measured in healthy
first degree relatives of patients with severe and non-severe SLE.
METHODSSeventy seven
first degree relatives of 26 patients with severe, and 72 relatives of
25 patients with non-severe lupus were studied. Controls were 42 first
degree relatives of 17 patients with chronic cutaneous lupus
erythematosus (CCLE) and 63 partners of the patients with their first
degree relatives. Severe lupus was defined as both multi-organ disease
and cyclophosphamide treatment, non-severe lupus as neither. Organ
damage was assessed with the SLICC-ACR index, disease activity with SLEDAI.
RESULTSSoluble CD95
concentrations in relatives of patients with severe SLE were similar to
those in relatives of patients with non-severe SLE, relatives of
patients with CCLE, and controls (median (interquartile range) sCD95
concentration 0.59 (0.52-0.66) v 0.57 (0.50-0.63), 0.56 (0.51-0.71), and 0.55 (0.49-0.61) ng/ml, p=0.25,
p=0.94, and p=0.17, respectively). Increased concentrations of sCD95, however, were found in patients with severe SLE compared with those in
patients with non-severe SLE, patients with CCLE, and control relatives
(0.77 (0.70-0.97) v 0.60 (0.54-0.67), 0.57 (0.54-0.71), and 0.57 (0.52-0.63) ng/ml, respectively, p<0.001).
Concentrations of sCD95 were significantly correlated with damage index
scores (rs=0.47, p<0.01). Basic
and clinical characteristics of patients with SLE, including SLEDAI
scores, could not explain these observations.
CONCLUSIONSoluble
CD95 concentrations are associated with severity of the disease and not
with susceptibility for severe SLE.
© 2001 by Annals of the Rheumatic Diseases
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