Background Psychological stress has been known as one of triggering factors in systemic lupus erythematosus (SLE). Saliva can be obtained easily without any invasive or painful procedure. Previously it has not been studied to measure disease related markers in saliva in patients with SLE.
Objectives We investigated the salivary stress hormones, disease related biomarkers and two questionnairs about stress and depression among SLE patients and healthy controls.
Methods Saliva were collected from patients with SLE (n=110) and healthy normal controls (NC, n=59). Salivary cortisol, α-amylase, interleukin-1β (IL-1β) and antichromatin antibody were measured by enzyme-linked immunosorbent assay. Also, perceived stress scale (PSS) and Beck depression index (BDI) were surveyed from all participants.
Results The mean levels of salivary α-amylase were higher in SLE than in the NC (128.09±60.61 U/ml vs 101.56±54.30 U/ml, p =0.004) Also, antichromatin antibody was higher (50.7±114.3 AU vs 14.1±17.2 AU, p =0.002). However, those of cortisol and IL-1β were not different between the SLE and the NC. The mean value of BDI was more increased in the SLE than that in the NC (10.86±9.25 vs 5.37±4.82, p <0.001), but there was no difference in the PSS. Salivary α-amylase was correlated with only ESR, and salivary IL-1β was correlated with BDI, disease duration, and ESR. Salivary antichromatin antibody was correlated with oral ulcer, and leukocyte count. SLE patients whose SLEDAI has been elevated had higher PSS scores and high titers of salivary antichromatin antibody 4 or 5 months before.
Conclusions Salivary α-amylase and antichromatin antibody were elevated in patients with SLE. The SLE patients were suggested be more depressed than normal healthy control. There was no difference in recognizing stress, however, the activity of SLE became worse with increasing perceived stress levels.
Kozora E, Ellison MC, Waxmonsky JA, Wamboldt FS, Patterson TL. Major life stress, coping styles, and social support in relation to psychological distress in patients with systemic lupus erythematosus. Lupus 2005; 14:363-372.
Van der Goes MC, Bossoma ER, Hartkamp A, Godaert GL, Jacobs JW, Kruize AA et al. Cortisol during the day in patients with systemic lupus erythematosus or primary Sjogren's syndrome. J Rheumatol 2011; 38;285-288.
Disclosure of Interest None declared