APOPTOSIS PARAMETERS IN SLE- A LACK OF CORRELATION TO DISEASE CLINICAL ACTIVITY?

Background: Systemic lupus erythematosus (SLE) is a prototype of organ non-specific autoimmune disease. It is characterized by variety of symptoms and by differentiated clinical course. The apoptosis plays one of the key roles in the pathogenesis of SLE.Objectives: The aim of the study was the evaluation of the relation of some apoptotic markers to the clinical disease activity.Methods: The evaluation was performed in the group of 24 SLE patients, mean age 40 years. As the control group 15 blood donors were used. The apoptosis index of neutrophiles was measured by the flow cytometry with use of annexin V double and triple staining. The serum levels of selected apoptosis parameters were assessed by the commercial ELISA tests. The levels of C3, C4 complement components were measured by nephelometry, anti-dsDNA and anti-nucleosome antibodies by ELISA test. The clinical disease activity was assessed using the ECLAM score. Statistical evaluation of results were performed by descriptive analysis, Pearson correlation test and ANOVA.Results: a)There is significantly higher portion of apoptotic neutrophiles in patients with SLE in comparison to the control group (M=17.5±12.1% vs 10±4.8%, p=0.001).b)Serum levels of sCD30 are significantly higher in SLE patients (M=56.3±46.4 ng/ml) vs controls (M=37.4±14.3 ng/ml, p=0,009)c)Traditional disease activity markers (anti-dsDNA, antinucleosome Ab, C3, C4) correlate with and disease activity index (ECLAM).d)There is lack of correlation between selected apoptosis markers and disease activity and C3, C4, anti dsDNA anti anti-nucleosome levels.e)Serum levels of sFasL, anti annexinne V, sCD40L were not significantly different on SLE group vs healthy controlsConclusion: SLE is a disease characterized by hyperactivity of B cells and overproduction of organ non-specific antibodies and production and organ deposition of immune complexes. Some recent studies suggested the theory of the defected clearance of apoptotic material associated perhaps with insufficient fagocytosis and with (in SLE common) complement deficiency, which may play important role in SLE pathogenesis. The defected clearance of apoptosis products can be a source of the over exposition of the genetically predisposed organism to the nucleosome, which leads to the auto-focusation of the immune system. The study tries to find possible practical usefulness of some apoptosis parameters in the clinical situations.Citation: , volume , supplement , year 2002, page Session: Anti-phospholipid syndrome