CONCISE REPORT

Raised serum APRIL levels in patients with systemic lupus erythematosus

T Koyama, H Tsukamoto, Y Miyagi, D Himeji, J Otsuka, H Miyagawa, M Harada, T Horiuchi

Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka 812-8582, Japan

Correspondence to:
Dr H Tsukamoto
tsukamot{at}intmed1.med.kyushu-u.ac.jp

Objective: To determine whether serum levels of a proliferation-inducing ligand (APRIL) are raised in patients with systemic lupus erythematosus (SLE) and correlate with autoantibody titres or disease activity, or both.

Methods: Serum samples from 48 patients with SLE, 41 normal healthy subjects, and 21 patients with rheumatoid arthritis (RA) were assayed for APRIL by enzyme linked immunosorbent assay. Medical charts were retrospectively reviewed for autoantibody titres and immunoglobulin levels. Disease activity was assessed using the British Isles Lupus Assessment Group (BILAG) index.

Results: The APRIL levels in the serum samples from patients with SLE were significantly higher than in those from healthy controls and those from patients with RA. Serum APRIL levels did not correlate with serum IgG and IgM levels, but had a tendency to correlate with anti-double stranded DNA antibody titres. Moreover, serum APRIL levels correlated significantly with musculoskeletal manifestations among patients with SLE when assessed by the BILAG index.

Conclusion: APRIL may be an important factor in raised autoantibody titres and musculoskeletal disease in patients with SLE. Patients with raised serum APRIL levels may be ideal candidates for therapeutic targeting of APRIL.

Abbreviations: ACR, American College of Rheumatology; APRIL, a proliferation-inducing ligand; BAFF, B cell activation factor; BCMA, B cell maturation antigen; BILAG, British Isles Lupus Assessment Group; ELISA, enzyme linked immunosorbent assay; RA, rheumatoid arthritis; SLE, systemic lupus erythematosus; SLEDAI, Systemic Lupus Erythematosus Disease Activity Index; TACI, transmembrane activator and CAML interactor

Keywords: APRIL; ELISA; systemic lupus erythematosus

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