Increased IgE serum levels are unrelated to allergic and parasitic diseases in patients with juvenile systemic lupus erythematosus

Abstract

OBJECTIVE:The aim of this study was to assess the IgE serum levels in juvenile systemic lupus erythematosus patients and to evaluate possible associations with clinical and laboratory features, disease activity and tissue damage.METHODS:The IgE serum concentrations in 69 consecutive juvenile systemic lupus erythematosus patients were determined by nephelometry. IgG, IgM and IgA concentrations were measured by immunoturbidimetry. All patients were negative for intestinal parasites. Statistical analysis methods included the Mann-Whitney, chi-square and Fisher's exact tests, as well as the Spearman rank correlation coefficient.RESULTS:Increased IgE concentrations above 100 IU/mL were observed in 31/69 (45%) juvenile systemic lupus erythematosus patients. The mean IgE concentration was 442.0±163.4 IU/ml (range 3.5-9936.0 IU/ml). Fifteen of the 69 patients had atopic disease, nine patients had severe sepsis and 56 patients presented with nephritis. The mean IgE level in 54 juvenile systemic lupus erythematosus patients without atopic manifestations was 271.6±699.5 IU/ml, and only nine of the 31 (29%) patients with high IgE levels had atopic disease. The IgE levels did not statistically differ with respect to the presence of atopic disease, severe sepsis, nephritis, disease activity, or tissue damage. Interestingly, IgE concentrations were inversely correlated with C4 levels (r = -0.25, p = 0.03) and with the SLICC/ACR-DI score (r = -0.34, p = 0.005). The IgE concentration was also found to be directly correlated with IgA levels (r = 0.52, p = 0.03).CONCLUSIONS:The present study demonstrated for the first time that juvenile systemic lupus erythematosus patients have increased IgE serum levels. This increase in IgE levels was not related to allergic or parasitic diseases. Our results are in line with the hypothesis that high IgE levels can be considered a marker of immune dysregulation.

140 Atopy in children with juvenile systemic lupus erythematosus is associated with severe disease

“…The total serum IgE levels did not statistically differ with respect to the SLEDAI-2K score (at the baseline, r = 0.16, p = 0.147; at the 18th month, r = 0.21, p = 0.057; at the end of follow-up, r = -0.03, p = 0.81, respectively; Fig 2). Our research was in accordance with recent studies, which suggested that increased serum IgE levels were unrelated to allergic diseases and disease activity in patients with JSLE or adult SLE [34][35][36]. However, the diagnosis of atopy in our study was based on patients' specific-IgE or SPT, which is evidently different from the total IgE.…”

“…In the present study, JSLE patients with atopy at the disease onset had markedly higher total serum IgE and no evident difference in total serum IgE was observed at the end of follow-up. Elevated total serum IgE levels have been described in patients with SLE that are driven by the aberrant production of interferon and self-damaging autoantibodies [35]. Thus, we analyzed the correlations between total serum IgE and SLE-DAI-2K at the baseline, 18th month, and end of the follow-up.…”

“…But these potential associations of SLE with atopic disorders are inconsistent because they propose potential common underlying risk factors or a shared mechanism of allergic and autoimmune phenotype [34,35]. The dysregulation of immune tolerance also results in aberrant Th2 responses and polyclonal activation of B lymphocytes along with the production of autoantibodies, including those of IgE isotype [35,38,39]. Human Th2 responses, characterized by the significance of IL-4, IL-5, IL-10, and IgE, are mainly observed in atopic disease [8].…”

Pediatric Immunological Disorders Biorepository (PIDBioRep) at University of São Paulo Medical School, Brazil

“…Since the clinicallaboratory database and biorepository was established it has collaborated on 44 presented abstracts, two dissertations, three theses, eight published articles and five ongoing research projects. 3,4,[8][9][10][11][12][13][14][15] What are the most valuable/highest priority cases in your biobank?…”

“…In addition, researchers have used clinical-laboratory information and human biological samples collected by this facility, resulting in a series of works. 3,4,[8][9][10][11][12][13][14][15] Therefore, as a pioneer initiative, this clinical-laboratory database and biorepository will supply researchers with important information and an apparatus that can illuminate the causative factors of autoimmune diseases and primary immunodeficiencies. …”