Assessment of disease activity in Systemic Lupus Erythematosus: Lights and shadows

Ceccarelli, Fulvia; Perricone, Carlo; Massaro, Laura; Cipriano, Enrica; Alessandri, Cristiano; Spinelli, Francesca Romana; Valesini, Guido; Conti, Fabrizio

doi:10.1016/j.autrev.2015.02.008

Cited by 59 publications

(38 citation statements)

References 63 publications

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“…For example, serum IL-34 levels correlated with SLEDAI, anti-dsDNA Ab, CRP and C3. In particular, SLEDAI was most frequently used to assess SLE disease activity [ 20 ]. CRP is the acute-phase reaction protein and is elevated in most active SLE patients.…”

Section: Discussionmentioning

confidence: 99%

Serum Interleukin-34 Levels Are Elevated in Patients with Systemic Lupus Erythematosus

2016

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Interleukin-34 (IL-34) was initially identified as an alternative ligand for the colony-stimulating factor-1 receptor (CSF-1R) to mediate the biology of mononuclear phagocytic cells. Recently, IL-34 was found to be associated with chronic inflammation, such as in rheumatoid arthritis (RA). Both RA and systemic lupus erythematosus (SLE) are multifactorial autoimmune diseases and are characterized by excessive immune and inflammatory responses. Thus, we investigated whether IL-34 is involved in the pathogenesis of SLE. In all, 78 SLE patients and 53 healthy controls were enrolled in the research. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the concentrations of serological IL-34. Then serum IL-34 levels between the SLE group and healthy controls were analyzed by the Mann-Whitney U test. Meanwhile, the correlations between the serum IL-34 levels and disease activity indexes and other established serum markers were assessed. Furthermore, the serum IL-34 levels of 20 active SLE patients were reevaluated when diseases were in the remission stage from corticosteroids or immunosuppressive drugs. Serum IL-34 levels were significantly higher in SLE patients compared to healthy controls. Their levels were remarkably associated with accumulation of the clinical features of SLE. Additionally, IL-34 titers were positively correlated with the SLE disease activity indexes, anti-double-stranded DNA antibody (anti-dsDNA) titers and C-reactive protein (CRP) levels, and inversely with complement3 (C3) levels. Moreover, serum IL-34 levels were significantly decreased after successful treatment of SLE. Serum IL-34 could be a candidate biomarker for SLE as there are elevated serum levels in treatment-naive SLE patients and we saw a significant decrease after effective treatment.

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Section: Discussionmentioning

confidence: 99%

Serum Interleukin-34 Levels Are Elevated in Patients with Systemic Lupus Erythematosus

2016

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“…The presentation, disease course, and outcomes of SLE are unpredictable. Approximately 60-70% of patients exhibit relapsing-remitting and active disease patterns [2]. Pediatric lupus patients typically have a more severe disease [3].…”

Section: Introductionmentioning

confidence: 99%

Differential Parameters between Activity Flare and Acute Infection in Pediatric Patients with Systemic Lupus Erythematosus

Luo

Yang

Lin

et al. 2020

Preprint

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Background: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease. SLE patients are vulnerable to infections. Infections might mimic and even trigger SLE flares. To distinguish acute infection from activity flare always remains a clinical challenge.We aim to explore the approach to differentiate active infection from disease activity in pediatric SLE patients.Methods: Fifty pediatric SLE patients presenting with 185 clinical episodes were collected.The associations betweenrelevant data encompassing both clinical and laboratory parameters and the outcome groups were analyzed using generalized estimating equations (GEEs)facilitatingthe analysis of data collected in longitudinal and repeated-measures designs.We also used a multinomial logistic regression model for simultaneous prediction of different outcome groups. Finally, we ran the GLIMMIX procedure to track trends of changes in parameters over time.Results: These 185 episodes were divided into 4 outcome groups: infected-active (n=102), infected-inactive (n=11), noninfected-active (n=59), and noninfected-inactive (n=13) episodes. Multivariate GEE analysis showed that SDI, SLEDAI-2K, neutrophil‐to‐lymphocyte ratio (NLR), hemoglobin, platelet, RDW-to-platelet ratio (RPR), and C3 are predictive of flare (combined calculated AUC of 0.8964 and with sensitivity of 82.2 % and specificity of 90.9%). Multivariate GEE analysis showed that SDI, fever temperature, CRP, procalcitonin, lymphocyte percentage, NLR, hemoglobin, and renal score in SLEDAI-2k are predictive of infection (combinedcalculated AUC of 0.7886 and with sensitivity of 63.5% and specificity of 89.2%). We developed regression equations for simultaneous prediction of 4 different outcome groups.We could differentiate noninfected-active from infected-active episodes by different change patterns of ESR, NLR, lymphocyte, C3, and C4 over time.Conclusions: The proposed approach could differentiateflares from infections in pediatric SLE patients. Combination of parameters from four different domains simultaneously, including inflammation (CRP, ESR, PCT), hematology (Lymphocyte percentage, NLR, PLR), complement (C3, C4), and clinical status (SLEDAI, SDI), is effective to make appropriate judgement and treatment decisions.

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“…The evaluation of disease activity by possible application of specific indices is important and recommended in the assessment of different subset of SLE patients . SACQ SLE is a special subgroup of SLE.…”

Section: Discussionmentioning

confidence: 99%

Impaired phagocytosis of apoptotic cell material in serologically active clinically quiescent patients with systemic lupus erythematosis

Huang

Tso

et al. 2015

Int J of Rheum Dis

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Assessment of disease activity in Systemic Lupus Erythematosus: Lights and shadows

Cited by 59 publications

References 63 publications

Serum Interleukin-34 Levels Are Elevated in Patients with Systemic Lupus Erythematosus

Serum Interleukin-34 Levels Are Elevated in Patients with Systemic Lupus Erythematosus

Differential Parameters between Activity Flare and Acute Infection in Pediatric Patients with Systemic Lupus Erythematosus

Impaired phagocytosis of apoptotic cell material in serologically active clinically quiescent patients with systemic lupus erythematosis

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