Objective. Systemic lupus erythematous (SLE) is a systemic autoimmune disease, and both genetic and environmental factors are implicated in its pathogenesis. The aim of this study was to assess cellular and nuclear morphology of SLE using a buccal micronucleus cytome assay.Methods. This study included 58 SLE patients and 58 healthy age-and sex-matched controls. Patients' baseline characteristics were recorded, and a buccal micronucleus cytome assay was used to measure cellular and nuclear abnormalities in both groups.Results. Significantly higher frequencies of micronuclei, nuclear buds, binucleated cells, basal cells, condensed chromatin cells, karyorrhectic cells, pyknotic cells, and karyolytic cells were seen in SLE patients as compared to controls. A buccal micronucleus cytome assay score of >4 had the highest accuracy (93.1%), almost perfect positive predictive value (98.1% at 50% pretest probability and 99.8% at 90% pretest probability), 87.9% sensitivity, and 98.3% specificity for the diagnosis of SLE.Conclusion. Biomarkers of DNA damage, proliferative potential, and cell death were significantly increased in SLE patients. The buccal micronucleus cytome assay was a valid and easy way for clinicians to assess individuals at high risk of developing SLE.Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder with a variety of proposed pathogeneses. Apoptosis is one of several important mechanisms involved in the pathogenesis of SLE. A previous study has demonstrated that lymphocyte apoptosis is increased and removal of apoptotic cells is impaired in SLE. Furthermore, apoptosis was found to be higher in active SLE as compared to inactive SLE (1).Several lines of evidence have demonstrated the close relationship between apoptosis and autoantibodies. Delayed clearance of apoptotic residue, such as histone H3, may result in the activation of antigenpresenting cells and the formation of autoantibodies; further, the antigenicity of autoantibodies is mostly against apoptotic cells (2). Studies have linked lymphocyte and leukocyte apoptosis with SLE and titers of autoantibodies (3).The buccal micronucleus cytome assay is a noninvasive method used to study DNA damage, chromosomal instability, cell death, and the regenerative potential of human buccal mucosal tissue (4). To our knowledge, no studies have as yet assessed buccal cell micronuclei in patients with connective tissue diseases or inflammatory arthritis. This study was designed to assess cellular and nuclear morphology in SLE using a buccal micronucleus cytome assay.
PATIENTS AND METHODSStudy design. This case-control study was conducted at the Baghdad Teaching Hospital Rheumatology Unit from September 2012 to May 2013. We screened SLE patients who were eligible for inclusion in the study and then compared patients to matched healthy controls; buccal micronucleus cytome biomarkers were measured in both groups. Informed consent was obtained from all participants, and this study was approved by the ethics committee of Baghdad University, College...