The Potential Role of Neutrophil Reactivity Intensity and Reactive Lymphocytes as Extended Hematological Parameters to Detect Active Systemic Lupus Erythematosus.

Abstract

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by the presence of autoantibodies against nuclear antigens and immune complex deposition. The pathogenesis of SLE is not fully understood; however, there are alterations in neutrophils and lymphocytes. Recent parameters assessing both neutrophil activations (Neut-RI, Neut-GI, IG) and activated lymphocytes (Re-Lymp, As-Lymp) can be used to assess the activation of immune cells. The aim of this study was to explore the potential role of this parameter in detecting active SLE. Cross-sectional study using secondary data from Hasan Sadikin Lupus Registry. Parameters were examined using Sysmex XN-1500. Lupus activity was determined according to SLEDAI-2K. This study included 30 active (SLEDAI 2K ≥ 4) and 30 inactive SLE patients. Compared to inactive SLE, active SLE showed significantly higher Neut-RI (51.5 vs. 49.6 FL, p = 0.004), and lower Re-Lymph (0.09 vs. 0.14 × 103/mm3, p = 0.024). There was no significant difference in Neut-GI (150 vs. 151.6 SI, p = 0.359), As-Lymp (0.02 vs. 0.01 × 103/mm3, p = 0.621), and IG (0.11 vs. 0.06 × 103/mm3, p = 0.384) between active and inactive SLE. Neut-RI/Re-Lymp ratio cutoff > 0.47 could distinguish between active and inactive SLE with AUC 0.689, 66.7% sensitivity, and 70.0% specificity. In active SLE, there is an elevation in Neut-RI and a reduction in Re-Lymp. Neut-RI/Re-Lymp ratio exceeding 0.47 could be used to detect active SLE.