О р и г и н а л ь н ы е и с с л е д о в а н и я ФГБНУ «Научноисследовательский институт ревматологии им. В.А. Насоновой»,

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Background The B lymphocyte stimulator signaling pathway by BAFF and its homologue APRIL has an important role in the selection, maturation and survival of B cells and plays a significant role in the pathogenesis of systemic lupus erythematosus (SLE). Objectives The aim of the study is to evaluate BAFF and APRIL in patients with SLE. Methods The 30 pts (80% female, age 31,0 [28,0-45,0 years] (mediana [interquartile range 25%>75%])) with SLE (ACR criteria, 1982) and 27 controls (93% female without any rheumatic and infectious diseases, age 27,0 [26,0-30,0] years) were examined. We considered SLE-related factors: disease duration, clinical features, SLE Disease Activity Index (SLEDAI 2K), Systemic Lupus International Collaborating Clinics (SLICC) damage index and treatment. All patients were evaluated for laboratory data (ESR, CRP, immunoglobulin G, A and M, complement fragments C3 and C4 and others), autoantibodies (ANA, antiDNA, ENA-SSA, -SSB, -Sm, aPL) and CD19 B lymphocytes subpopulation. The concentration of soluble BAFF and APRIL (ng/ml) were determined in serum samples by ELISA (Bender MedSystem GmbH, Austria). B cells were detected by flow cytometry. Statistical analysis has been performed with STATISTICA program, version 8.0. Results The mean disease duration of SLE was 7,0 [2,0-10,0] years, SLEDAI 2K score - 4 [2-13], SLICC damage index score - 0 [0-1], current prednisone dose – 10,0 [7,5-25,0] mg/day. SLE pts did not differ from healthy controls in BAFF (0,02 [0,02-0,08] vs 0,02 [0,02-0,02] ng/ml) and APRIL (0,01 [0,01-0,62] vs 0,01 [0,01-0,01] ng/ml) levels. Among SLE pts BAFF level correlated with lupus anticoagulant (r=0,88, p<0,05) and ESR (r=0,43, p<0,05); APRIL level correlated with SLEDAI 2K (r=0,55, p<0,01), CRP (r=0,50, p<0,01), antiDNA (r=0,38, p<0,05), creatinine level (r=0,39, p<0,05), current prednisone dose (r=0,55, p<0,01) and CD19 B lymphocytes absolute count (r=0,89, p<0,05). We divided SLE pts on two groups: the 1st- pts with high activity (SLEDAI 2K≥8), the 2nd – pts with low (SLEDAI 2K<8). The patients of 1st group had higher level of APRIL (1,69 [0,01-4,0] vs 0,01 [0,01-0,01] ng/ml, p<0,05) compared to 2nd group and control, there is no difference in BAFF level in these groups. Conclusions In our study there are no differences in BAFF and APRIL levels in patients with SLE and healthy control. This result may be explained by successful therapy and suppression of disease activity in our patients. Patients with high activity of SLE had increased level of APRIL, there is no correlation in disease activity and BAFF level. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.3582

ObjectivesThe aim of this study was to determine NT-proBNP serum levels in patients with untreated SLE, thus ruling out any potential effect of SLE therapy: to analyze any possible correlation between NT-proBNP values and traditional risk factors (TRF), inflammatory markers and myocardial function parameters.MethodsThe study included 28 pts (82% females, aged 28,5 [25,0–32,0] years (median [interquartile range 25%>75%]) with untreated SLE (ACR criteria, 1997) and 27 healthy controls (89% females, age 30,0 [23,0–49,0] years). None of SLE pts was treated either with prednisone or cytotoxic drugs at the moment of inclusion, 5 (18%) pts received hydroxychloroquine 200 mg/day. SLE-related factors, including disease duration, clinical features, SLE Disease Activity Index (SLEDAI 2K) and Systemic Lupus International Collaborating Clinics damage index (SLICC/DI) were evaluated in parallel with relevant laboratory findings (blood and urine tests, CRP, IL-6, INF-α, immunoglobulins G, A and M, C3 and C4 complement fragments and others), autoantibodies (ANA, antiDNA, ENA-SSA, -SSB, -Sm, -RNP-70, aPL), echocardiography was performed using standard techniques. Serum levels of NT-proBNP (pg/ml) were measured using electrochemiluminescence method Elecsys proBNP II (Roche Diagnostics, Switzerland). Normal NT-proBNP levels should vary within ≤125,0 pg/mL.ResultsMean SLE duration was 21,0 [5,0–60,0] months, SLEDAI 2K score - 11 [8–9], SLICC/DI score - 0 [0–0]. SLE pts had higher levels of NT-proBNP vs control (160,7 [88,6–335,4] vs 55,2 [36,6–70,3] pg/ml, p<0,001). Elevated levels of NT-proBNP (>125,0 pg/ml) was detected in 18 (64%) SLE pts. In SLE pts NT-proBNP serum levels showed positive correlation with creatinine (r=0,480, p<0,01), uric acid (r=0,427, p<0,05), ACL IgG (r=0,710, p<0,001), antiDNA (r=0,395, p<0,05), ANA levels (r=0,256, p<0,05), left ventricle (LV) end-systolic dimension (r=0,442, p<0,05), mean pulmonary artery pressure (r=0,486, p<0,05); and negative correlation with hemoglobin level (r=-0,493, p<0,01), C4 complement component (r=-0,475, p<0,05), glomerular filtration rate (r=-0,558, p<0,01) and LV ejection fraction (r=-0,505, p<0,01); left ventricular diastolic dysfunction (DDLV) was only in pts with NT-proBNP levels >125,0 pg/ml. Mean NT-proBNP concentration in verified DDLV cases (n=5 (18%)) considerably exceeded normal values, reaching up to 799,2 [276,6–1777,0] pg/ml.ConclusionsUntreated SLE patients without a history of myocardial infarction, coronary procedure or any evidence of heart failure demonstrated higher NT-proBNP concentration as compared to healthy controls (p<0,001). NT-proBNP levels showed correlation with numerous SLE markers (ACL IgG, ANA, antiDNA, C4 fragment of complement), kidney function (creatinine, uric acid, glomerular filtration rate) and myocardial function (end-systolic dimension of the LV, mean pulmonary artery pressure, LV ejection fraction). No correlation was documented between NT-proBNP concentration and TRF or inflammatory markers (CRP, IL-6, INF-α). All abovementioned data s...

BackgroundB lymphocyte stimulator signaling pathway by BAFF and its homologue APRIL has an important role in the selection, maturation and survival of B cells and plays a significant role in the pathogenesis of systemic lupus erythematosus (SLE).ObjectivesThe aim of this study is to determine serum levels of BAFF and APRIL in patients with untreated SLE, excluding the influence of the therapy.MethodsThe study included 27 pts (81% females, age 30.0 [26.0-33.0] years (median [interquartile range 25%>75%]) with untreated SLE (ACR criteria, 1997) and 47 controls (96% females without any rheumatic and infectious diseases, age 31.0 [26.0-49.0] years). None of SLE pts was treated with either prednisone or cytotoxic drugs at the moment of the study, 3 (11%) pts received hydroxychloroquine 200 mg/day. SLE-related factors, including disease duration, clinical features, SLE Disease Activity Index (SLEDAI 2K) and Systemic Lupus International Collaborating Clinics (SLICC) damage index were evaluated in parallel with relevant laboratory findings (blood and urine tests, CRP, immunoglobulins G, A and M, complement C3 and C4 fragments and others), autoantibodies (ANA, antiDNA, ENA-SSA, -SSB, -Sm, -RNP-70, aPL) and CD19 B lymphocytes subpopulation count. Serum levels of BAFF and APRIL (ng/ml) were measured by ELISA (Bender MedSystem GmbH, Austria). B cells were detected by flow cytometry. Statistical analyses were performed with STATISTICA program, version 8.0.ResultsMean SLE duration was 1.0 [0.5-5.0] years, SLEDAI 2K score - 10 [7-19], SLICC damage index score - 0 [0-0]. SLE pts had higher levels of APRIL vs control (3.04 [2.01-4.05] vs 0.01 [0.01-4.36] ng/ml, p<0.05), with no difference in BAFF level (0.07 [0.01-0.69] vs 0.02 [0.01-0.03] ng/ml). In SLE pts serum APRIL level correlated with leucocytes (r=-0.47, p<0.05) and lymphocytes absolute counts (r=-0.77, p<0.01), creatinine level (r=0.61, p<0.001) and glomerular filtration rate (r=-0.67, p<0.001); BAFF level correlated with SLEDAI 2K (r=0.43, p<0.05), antiβ2-GP-1 IgM (r=-0.60, p<0.05), glomerular filtration rate (r=-0.42, p<0.05) and hemoglobin level (r=-0.40, p<0.05). We divided SLE pts on two groups: Group 1 included pts with lupus nephritis (n=16 (59%)), Group 2 – SLE pts without nephritis (n=11 (41%)). Pts from Group 1 had higher levels of BAFF as compared to Group 2 levels (0.5 [0.03-1.20] vs 0.01 [0.01-0.07] ng/ml, p<0.05) or control group levels (0.5 [0.03-1.20] vs 0.02 [0.01-0.03] ng/ml, p<0.05), with no difference in APRIL levels between the groups.ConclusionsUntreated SLE patients had high disease activity and increased serum levels of APRIL as compared to healthy control (p<0.05). BAFF level was associated with disease activity. Patients with lupus nephritis had higher BAFF concentration as compared to control and SLE patients without nephritis.Disclosure of InterestNone declared