Soluble adhesive proteins L and E selectin in patients with systemic lupus erythromatosus: value in monitoring disease R mission after corticosteroid therapy

ABSTRACT

In this study, we aimed to examine circulating adhesive proteins L and E selectin levels in 33 patients with systemic lupus erythematosus SLE and to correlate levels of these proteins to disease activity parameters. L and E selectins were further investigated in a subgroup of patients with SLE who could be followed for 3 months duration and who found to be in disease remission after starting corticosteroid therapy. Results of the study showed significant decrease of L selectin and significant rise of E selectin levels in SLE patients versus healthy control subjects [720.5 +/- 213 ng/ml Vs 1008.7 +/- 237 ng/ml] and [71.5 +/- 14 ng/ml Vs 43.6 +/- 10 ng/ml], P < 0.002 and P < 0.001 respectively. E selectin was further elevated in SLE patients with organ [cardiopulmonary, renal and CNS] affection [n=15] versus those without organ affection [n=18] [78 +/- 8.2 Vs 47.6 +/- 12], P < 0.001 respectively. Correlation of L and E selectins to disease activity parameters showed significant association between L selectin and erythrocyte sedimentation rate and between E selectin and all parameters except hemoglobin. After starting corticosteroid therapy, no significant changes was observed in L selectin level within 3 months duration compared to the baseline level [708 +/- 159], [711 +/- 160] and [706 +/- 178] Vs [730 +/- 170], respectively. In contrast, significant decline of E selectin level compared to the baseline level was observed in the second and third month after starting corticosteroid therapy [59.8 +/- 9.9] and [61.9 +/- 6.8] Vs [43.6 +/- 10], P < 0.01 and P < 0.01 respectively. Results of the study indicate that L and E selectins are important contributing factors in the immunopathogenic mechanism of SLE. E selectin may be considered as a marker of disease activity and may aid in monitoring disease remission after starting corticosteroid therapy. It is justified to consider SLE as one of the disorders which could benefit from antiadbesive molecules therapy