Measurement of serum interferon alpha in Egyptian patients with systemic lupus erythematosus and evaluation of its effect on disease activity: a case-control study

Abstract

Much evidence highlighted the role of interferon alpha (IFN-α) in systemic lupus erythematosus (SLE) and suggested its possible role in assessing disease activity. We measured serum IFN-α in Egyptian SLE patients in order to determine a cutoff value that can be used to distinguish patients from healthy controls and explored its clinical value in monitoring disease activity and different aspects of the disease, in particular lupus nephritis. This cross-sectional, case-control study was conducted on 59 SLE patients and 30 healthy controls. Serum IFN-α was measured in all participants using sensitive enzyme-linked immunosorbent assay (ELISA). SLE patients underwent assessment of disease activity using the SLE disease activity index-2000 (SLEDAI-2K) as well as an evaluation of proteinuria, complement C3 and C4, and serology. Patients with evidence of renal involvement underwent renal biopsy. The median serum IFN-α was 81.8 pg/mL (interquartile range [IQR] 63.4:102.4), which was significantly higher than in healthy controls (median 10.3 pg/mL [IQR 7.3:11.6]) (p<0.001). At serum level of 14.7 pg/mL, IFN-α has high sensitivity and specificity to discriminate SLE patients from controls, with high positive and negative predictive values. Serum IFN-α was not associated with markers of disease activity, clinical features and anti-double stranded DNA. Furthermore, it was not associated with markers of renal activity, including proteinuria, C3 and C4 complement factors and histopathology renal classes. Despite elevated levels of serum IFN-α in SLE patients, it is not possible to use it as a biomarker for disease activity.

Evaluation of Interferon Alpha (IFN-α) in Women with Systemic Lupus Erythematosus in Iraq

“…The IFN-α serum levels were not associated with SLEDAI. This result goes with what was reported formerly, that IFN-α had no role with the disease activity [31]. Contrast results were found in various studies that reported the significant association between IFN-α serum levels and SLEDAI [39][40][41].…”

“…Contrast results were found in various studies that reported the significant association between IFN-α serum levels and SLEDAI [39][40][41]. The laboratory investigations in total showed an insignificant correlation with IFN-α, similar conflicting results were described [31,33]. The negative correlation observed in the current study between hematological parameters that include WBCs count, Hb level and IFN-α, may provide further evidence for the suggestion said leucopenia and anemia could be connected to chemokines [42] and adhesion particles that drive lymphocytes out of the vascular space and increase leukocytes adhesion to vessel wall [43].…”

“…The current work did not reveal any significant difference in mean of IFN-α serum levels between SLE patients and healthy control. On the contrary in the majority of previous studies, that done in USA [29,30] or Egypt [31,32]. Also, Shahin et al have suggested the IFN-α as a useful biomarker for identifying SLE patients [33].…”

Type I interferon, the need for glucocorticosteroids and comorbidities in patients with systemic lupus erythematosus

“…При этом в дебюте заболевания пациентам с юСКВ назначалась более высокая доза ГКС, что говорит о том, что интерфероновый механизм развития СКВ в разной степени представлен при юСКВ и вСКВ. Это определяет различную активность СКВ с разным возраст-ным дебютом и разный коморбидный профиль взрослых пациентов, заболевших до и после 18 лет [16].…”

Biomarkers Associated with Drugs for the Treatment of Lupus Nephritis

“…IFN-α was an important pathogenic factor in the occurrence and development of LN. Although it was elevated in the serum of patients, it could not be used as a biomarker of disease activity [57]. Current IFN-α monoclonal antibodies include sifalimumab, rontalizumab, anifrolumab, IFN-α-kinoid and ASG-009.…”