Serum interferon-alpha level in first degree relatives of systemic lupus erythematosus patients: correlation with autoantibodies titers

Interferon-alpha [IFN-alpha], a cytokine with both antiviral and immune-regulatory functions, was suggested as a useful tool which can evaluate current systemic lupus erythematosus [SLE] disease activity and identify patients who are at risk of future disease flares. In the current study, serum IFN-alpha levels and associated demographic, and serological features in Egyptian SLE patients and their first degree relatives [FDRs] in comparison to unrelated healthy controls [UHCs] were examined, in order to identify individuals at the greatest risk for clinical illness. Methods In a cross-sectional study, blood samples were drawn from 54 SLE patients, 93 of their FDRs who consented to enroll into the study and 76 UHCs. Measurement of serum IFN-alpha by a modified ELISA was carried out. Data were analyzed for associations of serum IFN-alpha levels with autoantibodies titer. Results Mean serum IFN-alpha in FDRs was statistically higher than the UHCs and lower than in SLE patients [P < 0.0001] and it was correlated with ANA titer [r = 0.6, P < 0.0001] and anti ds DNA titer [r = 0.62, P < 0.0001]. Conclusion IFN-alpha is a crucial player in the complicated autoimmune changes that occur in SLE and serum IFN-alpha can be a useful marker identifying persons who are at risk of future disease development

Hepatitis C virus infection in patients with systemic lupus erythematosus: clinical and immunological study

This study aimed at detecting the prevalence of HCV infection in systemic lupus erythematosus patients [SLE] and its clinical and immunological impact on these patients. 75 patients with SLE were randomly selected and 100 volunteers of blood donors were enrolled as a control group. After full careful clinical assessment, disease activity index [SLEDAI] was determined to all patients and all subjects were investigated by complete blood picture, liver enzymes and HCV antibodies by third generation ELISA. Subjects with positive antibodies were further investigated for viremia by HCV PCR. Immunological tests included C3, C4, ANA, Anti ds-DNA and cryoglobulin. Patients were divided into 2 groups according to presence or absence of HCV antibodies. Thirty two of SLE patients [43%] had positive HCV antibodies compared to 1 2[12%] of the control group while only 8 [11%] patients with SLE had detected viremia by PCR. Eighty eight percent of SLE patients with positive HCV antibodies had higher frequency of high disease activity index, 75% had elevated liver enzymes, 59% showed hypocomplementenemia and 63% had cryoglobulinemia. Cutaneous manifestations of SLE were found in 74% of SLE patients without HCV compared to 38% of those with HCV infection. SLE patients had higher prevalence of HCV infection than the general population. SLE HCV patients have less cutaneous manifestation, more frequent high disease activity index, hypocomlementenemia and cryoglobulinemia. Differentiating patients with HCV infection with clinical finding mimicking that of SLE [lupus like syndrome] from those with SLE associated with HCV infection is difficult. In this regard cutaneous manifestation could be a helpful sign. However, more specific serum markers for SLE are needed especially in our locality