Background Systemic lupus erythematosus (SLE) is an autoimmune disorder, which affects multiple organ systems and which aetiology still remains unknown. The newer markers of the disease activity based on the phenomenon of autoantibody formation (anti-nucleosome antibodies), endothelial cell activation or damage (sVCAM-1, sICAM-1, thrombomodulin), activation of T or B cells (the variety of cytokines or their receptors), macrophage activation (neopterin), apoptosis (fas ligand, bcl-2 expression), complement impairment (C1q, complement split products) are lacking a widely accepted consensus on their utility.
Objectives The objectives of this study was to assess the utility of measurement of thrombomodulin, anti-nucleosome antibodies, sVCAM-1, sICAM-1, neopterin, fas ligand, IL-10, sIL-2R in patients with SLE and to compare them to traditional markers of SLE activity (anti-dsDNA antibodies, C3, C4), ECLAM index of disease activity and to each other.
Methods The measurement was done during six months period in three consecutive time points in each proband of the 52 patients with SLE. Anti-dsDNA antibodies, thrombomodulin, anti-nucleosome antibodies, sVCAM-1, sICAM-1, neopterin, fas ligand, IL-10, sIL-2R were tested by ELISA methods, C3, C4 components of complement by nefelometry. Pearson correlation test and ANOVA test were used for statistical evaluation of results.
Results Fas ligand and IL-10 do not correlate significantly with ECLAM index (p > 0.05). The rest of markers shows significant correlation with the disease activity index (p < 0.05). Differences in plasma levels and fluctuation depending on the changes in disease activity index among the subgroups with stable, rising and dicreasing disease activity index are significant in the case of thrombomodulin and anti-dsDNA antibodies (ANOVA p < 0.05). Solubile VCAM-1, s-ICAM-1, sIL-2R, neopterin correlate with ECLAM index (p < 0.05), but their levels do not differ significantly between the subgroups (ANOVA p > 0.05). Levels of anti-nucleosome antibodies correlate with ECLAM index and they are positive also in 21 sera with negative anti-dsDNA titer, but their levels do not differ significantly between the subgroups (ANOVA p > 0.05).
Conclusion Thrombomodulin and anti-dsDNA antibodies reflect in the best way the changing trend in disease activity. Anti-nucleosome antibody seems to be a promising a marker useful in early diagnosis. Solubile VCAM-1, sICAM-1, neopterin and sIL-2R are interesting molecules playing role in the disease pathogenesis but their practical utility stayes limited.
The financial support by IGA ÈR NK 4616–3 OK 10
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