Value In Systemic Lupus Erythematosus Research Articles

Helios characterized circulating follicular helper T cells with enhanced functional phenotypes and was increased in patients with systemic lupus erythematosus

Helios was related to the immunosuppressive capacity and stability of regulatory T cells. However, the significance of Helios in follicular help T (TFH) and follicular regulatory T (TFR) cells is unclear. This research aimed to clarify the significance of Helios (IKZF2) in TFH and TFR cells and its clinical value in systemic lupus erythematosus (SLE). IKZF2 mRNA in different cell subsets was analyzed. Helios+ percentages in TFH and TFR cells were identified in the peripheral blood of 75 SLE patients and 62 HCs (healthy controls). PD-1 and ICOS expression were compared between Helios+ and Helios− cells. The capacity of TFH cells to secrete IL-21 and TFR cells to secrete IL-10 was measured. Correlation analysis and receiver operating characteristic (ROC) curve analysis were conducted to assess the clinical significance of Helios-related TFH and TFR cell subsets in SLE. There was Helios expression in TFH and TFR cells. PD-1 and ICOS were lower in Helios+ TFR than in Helios− TFR. ICOS was increased in Helios+ TFH cells compared with Helios− TFH cells, and ICOS in Helios+ TFH cells was downregulated in SLE. Helios+ TFH cells secreted more IL-21 than Helios− TFH cells, and Helios+ TFH cells from SLE patients had a stronger IL-21 secretion than HCs. Helios+ TFH percentages were negatively correlated with C3 and C4 and positively related to CRP and SLEDAI, and the AUC of Helios+ TFH to distinguish SLE from HC was 0.7959. Helios characterizes circulating TFH cells with enhanced function. Increased Helios+ TFH cells could reflect the autoimmune status of SLE.Graphical abstract

Anti-dsDNA, anti-nucleosome, anti-C1q, and anti-histone antibodies as markers of active lupus nephritis and systemic lupus erythematosus disease activity.

IntroductionPrevious studies of anti‐dsDNA, nucleosome (Nucl), histone (His), and C1q antibodies have revealed their clinical value in systemic lupus erythematosus (SLE). However, the correlation between four autoantibodies and SLE activity, lupus nephritis (LN) remains controversial, and data are insufficient on longitudinal monitoring. This study aimed at evaluating the value of these autoantibodies in active LN, and their performance on cross‐sectional evaluating and longitudinal monitoring of SLE disease activity.MethodsSerum levels of four autoantibodies in 114 SLE patients, 219 other autoimmune disease patients (OAD), and 59 healthy controls were assayed by a quantitative immunoassay. Sera of 38 inpatients were obtained again after treatment.ResultsWe found that serum levels of four autoantibodies were significantly higher in SLE than OAD patients (p < 001), active LN than non‐renal SLE patients (p < .05), and higher in SLE patients with moderate and severe disease activity than mild disease activity (p < .01). Horizontally, serum level of each autoantibody was correlated with SLE disease activity index (SLEDAI) (p < .05), and correlation coefficient of anti‐dsDNA was the highest (r = .585). For longitudinal monitoring, the decreased levels of four autoantibodies were found following treatment (p < .001). Serum level variations of these antibodies were positively correlated with variations of SLEDAI (p < .05). The correlation coefficient of anti‐Nucl was the highest (r = .629). Although the levels of C3 and C4 increased after treatment, the change was not related to the change of SLEDAI (p > .05).ConclusionsAnti‐C1q, anti‐dsDNA, anti‐Nucl, and anti‐His perform well in diagnosing active LN and monitoring SLE disease activity. They could be indicators of active LN and SLE disease activity.

Mean Platelet Volume on Systemic Lupus Erythematosus Patients with and without Thrombocytopenia in Dr Hasan Sadikin Hospital Bandung: A Descriptive Study

Abstract&#x0D; Background : The aim of the study is to provide an insight about mean platelet volume (MPV) value in systemic lupus erythematosus (SLE) with and without thrombocytopenia patient. MPV wa expected to be used to determine the cause thrombocytopenia in lupus, so the patient could be treated appropriately.&#x0D; &#x0D; Method : The study design was descriptive categoric, and the data were obtained by using cross-sectional method from patient’s medical record and lab examination result in the period from January 1st 2016 – January 31st 2018. The sampling method are done using total sampling. The inclusion criteria of this study were SLE patients which MPV and platelet count had been examined at the same time, the data used is data that was first discovered in the period of the study. The exclusion criteria were incomplete medical record data, patient with thrombocytosis, and SLE with comorbidity such as thrombotic disease (ischemic stroke and deep vein thrombosis), other high inflammatory overlap diseases (such as rheumatoid arthritis and inflammatory bowel disease), and infection.&#x0D; &#x0D; Result : From 75 patients that match with the inclusion criteria, all patients were female and based on the age of diagnosis, most patients were in age group of 25-34 years old (41,33%). Based on the lab results, group with normal platelet count have 53 data of normal MPV and 12 data of high MPV, while group with thrombocytopenia have 6 data of normal MPV and 4 data of high MPV.&#x0D; &#x0D; Conclusion : Group with normal MPV value and normal platelet count has the largest proportion, while the group with thrombocytopenia in lupus and high MPV value has the lowest proportion.

Lymphocyte sensitivity assay as a marker for glucocorticoid resistance in lupus: report of two sisters with systemic lupus erythematosus

Glucocorticoid sensitivity can be measured invitro using the lymphocyte sensitivity assay (LSA). In this test, dexamethasone is used to inhibit the proliferation of peripheral blood mononuclear cells (PBMC) in response to mitogens. If the proliferation of PBMC is suppressed the subjects are considered to be GC sensitive; if not, they are considered to be resistant. The LSA has been used to test GC sensitivity in some inflammatory diseases but its clinical value in systemic lupus erythematosus (SLE) has not been determined. Herein, we present the results of the LSA from two sisters with SLE who had different disease outcomes. Patient 1 presented with higher disease activity and damage accrual, and poorer response to corticosteroids than patient 2. In the LSA, patient 1 had a lower dexamethasone suppression of mitogen-stimulated PBMC than patient 2 and one control subject. The LSA could be helpful in identifying patients with GC resistance, thus allowing the consideration of alternative immunosuppressive drugs.

Skin lesions--an indicator of disease activity in systemic lupus erythematosus?

Cutaneous manifestations have great diagnostic value for systemic lupus erythematosus (SLE). In this study we tried to establish a correlation between lupus erythematosus LE-specific and LE-nonspecific cutaneous lesions and disease activity measured by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Sixty-six patients with SLE were evaluated. They were divided into three groups having: (1) only LE-specific lesions (38 or 58.46%); (2) only LE-nonspecific lesions (4 or 6.15%); and (3) both types of lesions (23 or 35.38%). Results were analyzed using the Student t-test. Patients with LE-nonspecific skin manifestations had significantly increased disease activity compared to those with only LE-specific lesions. The number of different skin lesion types also correlated with disease activity. It was significantly increased in a group with three different types of lesion, either specific or nonspecific. Patients with only one type of lesion had mild disease. An intermediate disease activity was found in the group with two different lesion types. Lupus-specific skin manifestations serve primarily as an important diagnostic clue. In conclusion, patients with LE-nonspecific lesions have significantly more active SLE than those with LE-specific lesions and may therefore require more intensive therapy and disease monitoring.

Autoantibodies in systemic lupus erythematosus.

Research on pathogenic and nonpathogenic anti-DNA antibodies has shown that the charge and affinity for double-stranded DNA may not be adequate predictors of their pathogenicity. In turn, anti-DNA-induced renal damage could be caused by differences in fine specificities. Penetration of anti-double-stranded DNA monoclonal antibodies into live cells appears to require DNA or a DNA-like membrane receptor. Anti-U1 ribonucleoproteins penetrate live cells and induce apoptosis. HLA-DRB1*1501 or HLA-DRB1*1503, DQA1*0102, and DQB1*0602 haplotypes were increased in patients with systemic lupus erythematosus with anti-ribosomal protein P (anti-P) antibodies, particularly in whites, blacks, and Mexican-Americans. Anti-Ro/Sjögren's syndrome antigen A antibodies had a strong predictive diagnostic value for systemic lupus erythematosus among patients positive for antinuclear antibodies and negative for double-stranded DNA but had no utility among those positive for both antinuclear antibodies and anti-DNA antibodies. True antiphospholipid murine monoclonal antibodies display an unusual number of cationic residues in the H-chain CD3 region, whereas anti-beta 2-glycoprotein-I monoclonal antibodies lack them. The association of IgG anti-beta 2-glycoprotein-I with a history of thrombosis in systemic lupus erythematosus has been largely confirmed. Apoptotic thymocytes bind antiphospholipid antibodies in a beta 2-glycoprotein-I-dependent manner and may constitute a source of immunogen in autoimmune disease.

Anti-Sm: its predictive value in systemic lupus erythematosus.

The clinical manifestations of 131 rheumatic disease patients with anti-Sm antibody were studied. A variety of standard tests was utilized in the study, namely, the FANA test with mouse kidney as substrate for the assay of ANA, the Crithidia test for anti-double stranded DNA (anti-dsDNA) and double immunodiffusion for detecting antibodies to extractable nuclear antigens. The patients were grouped according to the presence of anti-Sm alone, or anti-Sm with some other antibodies. There were 17 with anti-Sm alone; 55 with anti-Sm+anti-RNP; 15 with anti-Sm+anti-dsDNA; and 44 with anti-Sm+anti-RNP. The result of our study showed that although anti-Sm could be found in other diseases, it was exclusively detected in SLE only if anti-dsDNA was also present. Further, the SLE patients with anti-Sm alone had more frequent central nervous system manifestations than other groups of patients. The renal manifestation was observed more frequently in the group of SLE patients with anti-Sm+anti-dsDNA (92.9%). Among other major manifestations, haematologic involvement had a tendency to be less common in the group of patients with anti-Sm alone. The study concludes that the presence of anti-Sm antibody may be of some value to predict the clinical outcome.

The use of methotrexate in steroid‐resistant systemic lupus erythematosus

Although the use of methotrexate (MTX) is gaining acceptance in the treatment of several connective tissue diseases, there is little evidence of its therapeutic value in systemic lupus erythematosus (SLE). We examined the response to MTX in patients with steroid-resistant SLE in an open, unblinded study. Of 10 SLE patients treated with MTX (7.5 mg/weekly), 7 showed improvement. The other 3 stopped therapy because of lack of response or because of side effects. Improvements were noted within 3 months in responding patients. These promising observations suggest that controlled studies of MTX for the treatment of SLE are justified.