Background Oxidative stress is increased in Systemic Lupus Erythematosus (SLE) patients, and contributes to the immune system imbalance, abnormal activation of apoptotic processes, autoantibodies production and the development of serious complications, such as cardiovascular comorbidities.
Objectives To evaluate the influence of oxidative stress as an additional factor to the classical cardiovascular risk ones, in SLE patients.
Methods Cross-sectional prospective study of SLE patients according to the SLICC-2012 criteria, coming from the Rheumatology Service of Arnau de Vilanova Hospital and La Fe Hospital. In all patients we analyzed the serum concentration of GS-Nem (GSH) and GSSG by UPLC-MS/MS (Acquity UPLC System). We have also taken healthy individuals as negative controls, who had the same blood-test. In patients was also made a complete blood-test, and clinical, treatment and biometric data were collected by personal interview. Biostatistical analysis was performed by the R software version 3.2.3., using a simple, binominal and logistic lineal regression.
Results A total of 140 patients were evaluated; (95% women) with 33.39±13.63 year-old average at the diagnosis time with a 10.05± 11.42 year-evolution of SLE. We used GSH/GSSG ratio to assess the oxidative stress rate, being this value higher in patients than in healthy controls (P=0.005).
We observed a statistically significant relationship between the presence of oxidative stress and accumulated damage assessed by SLICC-ACR (P<0.0001). No differences according to the disease activity, specific autoimmune profile or by organ or systems affected. However, we found a slight difference in the GSH/GSSG ratio among patients who have had a CVD (1±0.39) and those who have not suffered CVD (1.19±0.55). No differences in the levels of oxidative stress are observed according to treatment with folic acid or the administration of biological therapies.
Conclusions We observed increased levels of oxidative stress in our SLE patients compared to healthy controls. Data suggest a rise of oxidative stress in patients with a greater cumulative damage, which is consistent with the presence of severe comorbidities in these patients. It seems to be a slight tendency to increased oxidative stress levels measured with GSH/GSSG ratio in patients with SLE and cardiovascular involvement, but more independent studies are needed to confirm it.
Disclosure of Interest None declared