Serum ceramide levels in systemic lupus erythematosus patients: A novel biomarker for renal impairment

Abstract

Background In between 30 and 80% of SLE patients, lupus nephritis (LN) develops. Thus, we aimed to evaluate the accuracy of serum ceramide (Cer.) in predicting LN in patients with SLE. Patients and methods Forty five patients with SLE with or without renal impairment were diagnosed as SLE according to SLICC classification criteria 2012, besides 20 healthy control subjects. Patients were divided into two groups: group (1); 20 SLE without renal impairment, and group (2); 25 patients confirmed to have LN by renal biopsy before starting treatment and follow-up after 3 cycles of treatment. Those Patients received IV methylprednisolone for 3 days and IV 0.5 gram of cyclophosphamide monthly, for 3 consecutive months. Baseline laboratory data and total serum Cer. levels were assessed by ELISA kit at base line to all studied groups and after 3 consecutive months for SLE patients with LN. Results Total Serum Cer. was significantly higher among patients with LN in comparison to SLE without LN group (60.11 ± 14.14 vs. 40.47 ± 12.34 (ng/ml); P=0.04) and control group (60.11 ± 14.14 vs. 31.14 ± 5.98 (ng/ml); P<0.001). SLE without LN patients group had significantly higher Cer. in comparison to controls (40.47 ± 12.34 vs. 31.14 ± 5.98 (ng/ml); P=0.03). Interestingly we found a significant reduction in serum Cer. levels with the follow-up after three cycles of therapy. Conclusion Serum Cer. is a novel promising biomarker for early detection of LN in patients with SLE. Future studies are warranted to confirm these findings.