Abstract
Lupus nephritis (LN) is a major contributor to morbidity and mortality in patients with Systemic Lupus Erythematosus (SLE). This study aims to investigate the possible role of a functional polymorphism in the regulatory region of the monocyte chemo-attractant protein-1 (MCP-1) gene and MCP-1 blood level in the diagnosis of LN and in correlating the MCP-1 blood levels with disease activity. The study included 56 SLE patients and 56 controls. All the SLE patients suffered from LN. An analysis of MCP-1 gene polymorphism by polymerase chain reaction was performed followed by restriction fragment length polymorphism (PCR-RFLP) analysis and MCP-1 blood level was determined using the ELISA technique. Calculation of Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was performed. Serologic tests included the determination of antinuclear antibody (ANA) and anti-double-stranded (ds) DNA antibodies, Complement C3 and C4 levels. A significant increase in the frequency of genotype A/G and a decrease in the frequency of genotype A/A were found among patients with active LN compared to inactive LN. There was a statistically significant difference in the blood level of MCP-1 between LN patients and controls. Also, MCP-1 blood levels were significantly higher in active LN patients than inactive LN. A significant positive linear correlation was detected between MCP-1 blood level and SLEDAI, creatinine, and 24 hours protein in LN patients. These results suggest that an A/G genotype together with the measurement of the blood level of MCP-1 can be a useful tool for detection and follow up of active LN.
Highlights
Systemic Lupus Erythematosus (SLE) is a progressive autoimmune disease due to chronic stimulation of various components of the immune system affecting the skin, joints, kidneys, heart, and nervous system
Comparing the results obtained for healthy controls with those obtained for SLE patients having Lupus nephritis (LN), it was observed that there was no statistically significant difference in the distribution of the individual monocyte chemo-attractant protein-1 (MCP-1) genotypes between LN and controls
Our results show that in LN patients and the active LN subgroup, G allele carriers have significantly higher MCP-1 blood levels compared to A-allele carriers, which is in accordance with TUCCI et al (2004) and postulates that G allele carriage may predispose to the development of nephropathy rather than SLE itself
Summary
Systemic Lupus Erythematosus (SLE) is a progressive autoimmune disease due to chronic stimulation of various components of the immune system affecting the skin, joints, kidneys, heart, and nervous system. The etiology of SLE is unknown, and the clinical course is highly variable (DE LEEUW et al, 2006). The assessment of disease activity in patients affected by SLE is an extremely important issue. There is no golden standard to measure disease activity in patients affected by SLE (CECCARELLI et al, 2015). The assessment of SLE patients in routine clinical practice is mainly based on the experience of the treating physician; this carries a risk of unwanted variability that may have an impact on outcomes.
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