The possible effect of expressive plasma level of miRNA-21-5P on the serum level of IL-23 in with and without lupus nephritis patients

Abstract

Systemic lupus erythematosus (SLE) is a highly heterogeneous autoimmune disease characterized by a breakdown in immunological tolerance that causes the immune system to assault normal tissues. Patients with active SLE are at risk for life-threatening consequences because it leads to developing the signs and symptoms of lupus nephritis (LN). SLE patients continue to face a big hurdle in lupus nephritis, a kidney inflammation resulting in chronic and irreparable organ damage. The study's goal was to investigate if there was a link between miR-21 and IL-23 in Iraqi patients with and without lupus nephritis. A total of 80 SLE patients, SLE who met the American College of Rheumatology (ACR) criteria (40 SLE and 40 LN groups) and 40 healthy controls were included in this case-control study. The expressions of miR-21 were estimated using quantitative RT-PCR, while the levels of IL-23 were evaluated using ELISA. The systemic lupus erythematosus disease activity index (SLEDAI 2000 score) of patients was also evaluated. The potential relationships between microRNA-21 and IL-23 and clinical parameters were also calculated. Subsequent study demonstrated that miR-21-5p in plasma of patients with SLE and LN were significantly up-regulated when compared with healthy controls (0.73 (0.04–46.79) (P = 0.00006) vs. (P = 0.0005) in SLE and LN respectively). The results revealed that miR-21 was highly expressed in SLE patients compared to LN and controls. The study also demonstrated that IL-23 in serum of patients with SLE and LN were significantly upregulated when compared with healthy controls (61.87 (13.25–88.26) (P = 0.034) vs. (P = 0.0004) in SLE and LN, respectively). The results revealed that IL-23 level is high in LN patients compared to SLE and control. We provide evidence that IL-23 and miRNA-21 are detectable in patients' serum and plasma. Their levels are linked to clinical disease activity and commonly used laboratory tests such as C3, C4, anti-dsDNA antibodies, kidney function indicators. In both groups of patients, we found that miR21 was negatively correlated with IL-23 level. Although the study was during the follow-up, the levels of IL-23 remained high, as did the variance in miRNA-21 expression in the patients compared to the healthy group. It seems that the medicines used to treat SLE are ineffective against them.