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Greenan-Barrett J, Doolan G, Shah D, Virdee S, Robinson GA, Choida V, Gak N, de Gruijter N, Rosser E, Al-Obaidi M, Leandro M, Zandi MS, Pepper RJ, Salama A, Jury EC, Ciurtin C. Biomarkers Associated with Organ-Specific Involvement in Juvenile Systemic Lupus Erythematosus. Int J Mol Sci 2021; 22:7619. [PMID: 34299237 PMCID: PMC8306911 DOI: 10.3390/ijms22147619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 12/16/2022] Open
Abstract
Juvenile systemic lupus erythematosus (JSLE) is characterised by onset before 18 years of age and more severe disease phenotype, increased morbidity and mortality compared to adult-onset SLE. Management strategies in JSLE rely heavily on evidence derived from adult-onset SLE studies; therefore, identifying biomarkers associated with the disease pathogenesis and reflecting particularities of JSLE clinical phenotype holds promise for better patient management and improved outcomes. This narrative review summarises the evidence related to various traditional and novel biomarkers that have shown a promising role in identifying and predicting specific organ involvement in JSLE and appraises the evidence regarding their clinical utility, focusing in particular on renal biomarkers, while also emphasising the research into cardiovascular, haematological, neurological, skin and joint disease-related JSLE biomarkers, as well as genetic biomarkers with potential clinical applications.
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Affiliation(s)
- James Greenan-Barrett
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London WC1E 6DH, UK; (J.G.-B.); (G.D.); (D.S.); (G.A.R.); (V.C.); (N.d.G.); (E.R.)
| | - Georgia Doolan
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London WC1E 6DH, UK; (J.G.-B.); (G.D.); (D.S.); (G.A.R.); (V.C.); (N.d.G.); (E.R.)
| | - Devina Shah
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London WC1E 6DH, UK; (J.G.-B.); (G.D.); (D.S.); (G.A.R.); (V.C.); (N.d.G.); (E.R.)
| | - Simrun Virdee
- Department of Ophthalmology, Royal Free Hospital, London NW3 2QG, UK;
| | - George A. Robinson
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London WC1E 6DH, UK; (J.G.-B.); (G.D.); (D.S.); (G.A.R.); (V.C.); (N.d.G.); (E.R.)
| | - Varvara Choida
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London WC1E 6DH, UK; (J.G.-B.); (G.D.); (D.S.); (G.A.R.); (V.C.); (N.d.G.); (E.R.)
| | - Nataliya Gak
- Department of Rheumatology, University College London Hospital NHS Foundation Trust, London NW1 2BU, UK; (N.G.); (M.L.)
| | - Nina de Gruijter
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London WC1E 6DH, UK; (J.G.-B.); (G.D.); (D.S.); (G.A.R.); (V.C.); (N.d.G.); (E.R.)
| | - Elizabeth Rosser
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London WC1E 6DH, UK; (J.G.-B.); (G.D.); (D.S.); (G.A.R.); (V.C.); (N.d.G.); (E.R.)
| | - Muthana Al-Obaidi
- Department of Paediatric Rheumatology, Great Ormond Street Hospital, London WC1N 3JH, UK;
- NIHR Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Maria Leandro
- Department of Rheumatology, University College London Hospital NHS Foundation Trust, London NW1 2BU, UK; (N.G.); (M.L.)
- Centre for Rheumatology, Division of Medicine, University College London, London WC1E 6DH, UK;
| | - Michael S. Zandi
- Department of Neurology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK;
| | - Ruth J. Pepper
- Department of Renal Medicine, Royal Free Hospital, University College London, London NW3 2QG, UK; (R.J.P.); (A.S.)
| | - Alan Salama
- Department of Renal Medicine, Royal Free Hospital, University College London, London NW3 2QG, UK; (R.J.P.); (A.S.)
| | - Elizabeth C. Jury
- Centre for Rheumatology, Division of Medicine, University College London, London WC1E 6DH, UK;
| | - Coziana Ciurtin
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London WC1E 6DH, UK; (J.G.-B.); (G.D.); (D.S.); (G.A.R.); (V.C.); (N.d.G.); (E.R.)
- Department of Rheumatology, University College London Hospital NHS Foundation Trust, London NW1 2BU, UK; (N.G.); (M.L.)
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Sahin S, Adrovic A, Barut K, Canpolat N, Ozluk Y, Kilicaslan I, Caliskan S, Sever L, Kasapcopur O. Juvenile systemic lupus erythematosus in Turkey: demographic, clinical and laboratory features with disease activity and outcome. Lupus 2017; 27:514-519. [PMID: 29233038 DOI: 10.1177/0961203317747717] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Objectives This paper aims to assess in a retrospective fashion the clinical and laboratory features, severity and outcome of juvenile systemic lupus erythematosus (jSLE) from a referral center in Turkey. Methods We have included all jSLE patients ( n = 92) diagnosed according to the revised American College of Rheumatology 1997 criteria between January 2004 and January 2017. Results The most prevalent clinical feature in our cohort was mucocutaneous manifestations (97.8%), followed by constitutional (81.5%), hematological (59.8%) and musculoskeletal manifestations (56.5%). Renal involvement was observed in 38% ( n = 35) of the patients, whereas biopsy-proven lupus nephritis was detected in 29.3% ( n = 27) of the cohort. Neurologic involvement was seen in 15 (16.3%) individuals. Among the patients positive for anticardiolipin IgM and/or IgG ( n = 11, 12%), only three developed antiphospholipid antibody syndrome. The mean SLEDAI-2K scores at disease onset (10.5 ± 4.8) showed a substantial decrease at last visit (4.3 ± 4.6). One-quarter of the patients (26.1%, n = 24) had damage according to the PedSDI criteria with a mean score of 0.45 ± 1.0 (range 0-7). When the PedSDI damage items were evaluated individually, growth failure was the most frequent damage criterion ( n = 6), followed by seizure ( n = 5). Two patients died during the designated study period of end-stage renal disease. The five-year and 10-year survival rate of our cohort was 100% and 94.4%, respectively. Conclusions Given the lower frequency of nephritis and central nervous system disease and lower basal disease activity and damage scores, we could conclude that children with jSLE in Turkey have a more favorable course compared to Asian and African American children, as expected from Caucasian ethnicity.
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Affiliation(s)
- S Sahin
- 1 Department of Pediatric Rheumatology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - A Adrovic
- 1 Department of Pediatric Rheumatology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - K Barut
- 1 Department of Pediatric Rheumatology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - N Canpolat
- 2 Department of Pediatric Nephrology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Y Ozluk
- 3 Department of Pathology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - I Kilicaslan
- 3 Department of Pathology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - S Caliskan
- 2 Department of Pediatric Nephrology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - L Sever
- 2 Department of Pediatric Nephrology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - O Kasapcopur
- 1 Department of Pediatric Rheumatology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
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Pranzatelli MR, McGee NR, Wang ZY, Agrawal BK. Characteristics and pharmacodynamics of severe neuroinflammation in a child with neurolupus. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2016; 4:e316. [PMID: 27957509 PMCID: PMC5141525 DOI: 10.1212/nxi.0000000000000316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/03/2016] [Indexed: 01/07/2023]
Affiliation(s)
- Michael R Pranzatelli
- National Pediatric Neuroinflammation Organization, Inc. (M.R.P., N.R.M.), Orlando, FL; Department of Neurology, University of Louisville (Z.Y.W.), KY; and Department of Neurology, Santa Clara Valley Medical Center (B.K.A.), San Jose, CA
| | - Nathan R McGee
- National Pediatric Neuroinflammation Organization, Inc. (M.R.P., N.R.M.), Orlando, FL; Department of Neurology, University of Louisville (Z.Y.W.), KY; and Department of Neurology, Santa Clara Valley Medical Center (B.K.A.), San Jose, CA
| | - Zeng Y Wang
- National Pediatric Neuroinflammation Organization, Inc. (M.R.P., N.R.M.), Orlando, FL; Department of Neurology, University of Louisville (Z.Y.W.), KY; and Department of Neurology, Santa Clara Valley Medical Center (B.K.A.), San Jose, CA
| | - Brajesh K Agrawal
- National Pediatric Neuroinflammation Organization, Inc. (M.R.P., N.R.M.), Orlando, FL; Department of Neurology, University of Louisville (Z.Y.W.), KY; and Department of Neurology, Santa Clara Valley Medical Center (B.K.A.), San Jose, CA
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Soliman S, Mohan C. Lupus nephritis biomarkers. Clin Immunol 2016; 185:10-20. [PMID: 27498110 DOI: 10.1016/j.clim.2016.08.001] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 07/30/2016] [Accepted: 08/01/2016] [Indexed: 12/13/2022]
Abstract
Lupus nephritis (LN), a potentially destructive outcome of SLE, is a real challenge in the management of SLE because of the difficulty in diagnosing its subclinical onset and identifying relapses before serious complications set in. Conventional clinical parameters such as proteinuria, GFR, urine sediments, anti-dsDNA and complement levels are not sensitive or specific enough for detecting ongoing disease activity in lupus kidneys and early relapse of nephritis. There has long been a need for biomarkers of disease activity in LN. Such markers ideally should be capable of predicting early sub-clinical flares and could be used to gauge response to therapy, thus obviating the need for serial renal biopsies with their possible hazardous complications. Since urine can be readily obtained, it lends itself as an obvious biological substrate. In this review, the use of urine and serum as sources of lupus nephritis biomarkers is described, and the results of biomarker discovery studies using candidate and proteomic approaches are summarized.
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Affiliation(s)
- Samar Soliman
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204, United States; Rheumatology & Rehabilitation Dept., Faculty of Medicine, Minya University, Egypt
| | - Chandra Mohan
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204, United States.
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Ru JL, Zhao Y, Xie XX, Che GZ, Cheng CF, Zhao HM, Jin ZY, Sun HP, Li XF. Clinical applications of the indirect immunofluorescence assay for detection of anticell membrane-associated DNA antibodies in juvenile systemic lupus erythematosus. Pediatr Res 2015; 77:376-80. [PMID: 25406901 DOI: 10.1038/pr.2014.182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 08/15/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Juvenile-onset systemic lupus erythematosus (JSLE) has a higher mortality risk compared to adult-onset SLE. We compared the diagnostic value of anti-cmDNA antibodies with that of antinucleosome antibodies (AnuA), anti-Sm antibodies, and anti-dsDNA antibodies and human B lymphocyte Raji cells with that of human promyelocytic leukemia HL60 cells as substrates in an indirect immunofluorescence assay to detect anti-cmDNA antibodies in JSLE patients. METHODS We recruited 92 JSLE patients and 71 patients with other juvenile-onset rheumatic diseases. Anti-cmDNA antibodies and antinuclear antibodies (ANA) were detected in patient sera using indirect immunofluorescence assays. Anti-dsDNA antibodies were detected by combining ELISA and indirect immunofluorescence. Anti-Sm antibodies were detected by double immunodiffusion assay and immunoblotting, while AnuA were detected by ELISA. RESULTS The JSLE group had a significantly higher percentage of patients positive for anti-cmDNA compared to patients with other rheumatoid diseases. Using one antibody for diagnosis, anti-cm DNA antibodies had the highest accuracy at 84.0%; using two antibodies, the combination of anti-cm DNA and anti-dsDNA antibodies had 90.8% accuracy. Raji cells used as substrate demonstrated a stronger intensity of fluorescent patterns compared to HL60 cells. CONCLUSION The high sensitivity, specificity, and accuracy of detection of anti-cmDNA antibodies make it a valuable diagnostic tool for JSLE.
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Affiliation(s)
- Jin-li Ru
- Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China
| | - Yue Zhao
- Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China
| | - Xiao-xiang Xie
- Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China
| | - Guo-zhu Che
- Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China
| | - Chuan-fang Cheng
- Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China
| | - Hua-ming Zhao
- Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China
| | - Zhi-yong Jin
- Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China
| | - Hui-ping Sun
- Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China
| | - Xiao-feng Li
- Department of Rheumatology and Immunology, The Second Hospital of Shanxi Medical University, Taiyuan, China
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Mohammed MF, Belal D, Bakry S, Marie MA, Rashed L, Eldin RE, El-Hamid SA. A study of hepcidin and monocyte chemoattractant protein-1 in Egyptian females with systemic lupus erythematosus. J Clin Lab Anal 2014; 28:306-9. [PMID: 24578220 DOI: 10.1002/jcla.21685] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 08/21/2013] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lupus nephritis is one of the most serious manifestations of systemic lupus erythematosus (SLE). Novel biomarkers are necessary to enhance the diagnostic accuracy, prognostic stratification, monitoring of treatment response, and detection of early renal flares. METHODS Our study was conducted on 90 participants. They were divided into three groups, group I (controls) encompassed 30 ages and sex-matched healthy personnel. Group II included 30 non-nephritic SLE patients and finally group III included 30 SLE nephritic patients. Urinary monocyte chemoattractant protein-1 (UMCP-1) and hepcidin were evaluated by ELISA technique, compared and correlated in different groups, with each other and with other routine variables and with renal biopsy done to study group (III). RESULTS Both UMCP-1 and hepcidin in group III showed significant increase compared to other two groups (controls and group II) (468 ± 128, 111 ± 12, 252 ± 56 pg/ml, respectively, for UMCP-1 and 40 ± 12, 11 ± 2, 20 ± 5 ng/ml, respectively, for hepcidin, P < 0.01). Also both UMCP-1 and hepcidin in group III showed significant increase in diffuse proliferative subgroup compared to focal proliferative and mesangioproliferative subgroups (580 ± 43, 502 ± 46, and 352.6 ± 100 pg/ml, respectively, for UMCP-1 and 47.8 ± 9.5, 41.4 ± 6, and 32.9 ± 10.8 ng/ml, respectively, for urinary hepcidin, P < 0.05). CONCLUSION UMCP-1 and hepcidin could be associated with the susceptibility of lupus nephritis.
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Yavuz S, Ece A. Mean platelet volume as an indicator of disease activity in juvenile SLE. Clin Rheumatol 2014; 33:637-41. [DOI: 10.1007/s10067-014-2540-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 02/10/2014] [Accepted: 02/12/2014] [Indexed: 02/04/2023]
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Evaluation of a multiplex ELISA for autoantibody profiling in patients with autoimmune connective tissue diseases. Autoimmune Dis 2014; 2014:896787. [PMID: 24527209 PMCID: PMC3914292 DOI: 10.1155/2014/896787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 10/30/2013] [Indexed: 01/22/2023] Open
Abstract
The performance of immunoassays for the detection of autoantibodies is of critical importance in the diagnosis and assessment of patients with autoimmune connective tissue diseases (ACTD). Our objective was to compare the features of two multiplexed assays—INNO-LIA ANA and Gennova-PictArray ENA ELISA—for measurement of multiple autoantibodies and their utility as a clinical tool in ACTD diagnosis. The antigens included SS-A/Ro (60 and 52), SSB/La, Sm, Sm/RNP, CENP-B, Jo-1, and Scl-70. Stored sera from 85 ACTD patients and 80 controls consisting of patients with vasculitis, rheumatoid arthritis and infectious diseases, as well as healthy subjects were analyzed jointly with clinical and laboratory data. Agreement between the two methods varied between 58 and 99% (Cohen's kappa: 0.21–0.71) mostly for SSA and SSB. The frequency of specific autoantibodies measured using the two methods was more variable for SSA, SSB, and RNP/Sm. There were a higher number of ambiguous results when using INNO-LIA. The optimized cut-off values of the Gennova-PictArray resulted in over 99% specificities in samples obtained from the control group. Sensitivity patterns were more accurate in Gennova-PictArray than in INNO-LIA, as suggested in previously reported studies. A third method could be applied to determine which of the two methods is more accurate.
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