Objective. Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by unpredictable flares of disease activity and irreversible damage to multiple organ systems. An earlier study showed that SLE patients carrying an interferon (IFN) gene expression signature in blood have elevated serum levels of IFN-regulated chemokines. These chemokines were associated with more-severe and active disease and showed promise as SLE disease activity biomarkers. This study was designed to validate IFN-regulated chemokines as biomarkers of SLE disease activity in 267 SLE patients followed up longitudinally.Methods. To validate the potential utility of serum chemokine levels as biomarkers of disease activity, we measured serum levels of CXCL10 (IFN␥-inducible 10-kd protein), CCL2 (monocyte chemotactic protein 1), and CCL19 (macrophage inflammatory protein 3␤) in an independent cohort of 267 SLE patients followed up longitudinally over 1 year (1,166 total clinic visits).Results. Serum chemokine levels correlated with lupus activity at the current visit (P ‫؍‬ 2 ؋ 10 ؊10 ), rising at the time of SLE flare (P ‫؍‬ 2 ؋ 10 ؊3 ) and decreasing as disease remitted (P ‫؍‬ 1 ؋ 10 ؊3 ); they also performed better than the currently available laboratory tests. Chemokine levels measured at a single baseline visit in patients with a Systemic Lupus Erythematosus Disease Activity Index of <4 were predictive of lupus flare over the ensuing year (P ‫؍‬ 1 ؋ 10 ؊4 ).Conclusion. Monitoring serum chemokine levels in SLE may improve the assessment of current disease activity, the prediction of future disease flares, and the overall clinical decision-making.Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease defined by autoantibodies to nuclear components, immune complex deposition, and systemic vasculitis (1). Many organ systems are targeted, including the skin, joints, blood cells, kidneys, and nervous system. The disease affects 0.1% of the US population, with a striking 9:1 preponderance in women. The factors that contribute to the onset and progression of SLE are not well understood; however, genetic, environmental, and hormonal factors are likely to be important. SLE disease activity can be difficult to monitor, and flares are unpredictable, both in frequency and in severity. Certain clinical laboratory tests, including antidouble-stranded DNA (anti-dsDNA) antibody titers, complement factor levels, and the erythrocyte sedimen-

These results suggest that serum IL-6 production and the type I IFN gene signature are candidate biomarkers for disease activity in adult and juvenile DM. Coregulation of the expression of IFN-driven chemokines and IL-6 suggests a novel pathogenic linkage in DM.

Successful cutaneous tissue repair depends on the viability of the principal cell types involved (fibroblasts and keratinocytes). Toxicity indexes provide helpful guidelines for subsequent in vivo evaluations and clinical applications. The study findings also suggest that judicious use of these supposedly innocuous agents should be considered in a clinical setting.