Elevated B lymphocyte stimulator levels are associated with increased damage in an Irish systemic lupus erythematosus cohort
Elevated B lymphocyte stimulator levels are associated with increased damage in an Irish systemic lupus erythematosus cohort
复制标题
DOI：
10.1093/rheumatology/ket120
复制
发表时间：
2013-07-01
期刊：
影响因子：
5.5
通讯作者：
Jefferies, Caroline A.
中科院分区：
文献类型：
--
作者：
McCarthy, Eoghan M.;Lee, Ruth Z.;Jefferies, Caroline A.
Objective.本研究的总体目的是确定在同质白人SLE人群中与B淋巴细胞刺激因子（BLyS）升高相关的临床和血清学特征，从而确定最有可能从BLyS阻断中获益的患者。招募SLE患者（根据ACR标准）。记录临床病史、疾病活动指标和疾病实验室指标。ELISA法测定BLyS水平。BLyS升高定义为高于对照组中测量的BLyS水平的第95百分位数。将患者分为两组：BLyS水平升高的患者（组1，n = 23）和BLyS水平正常的患者（组2，n = 22）。BLyS水平升高与年龄较小和病程较短的患者显著相关。与以前的报告一致，BLyS水平升高的患者有更多的活动性疾病（SLEDAI 5.1 vs 0.86，P < 0.001）;然而，我们的分析还表明，BLyS升高与5年随访时器官损伤增加显著相关[系统性狼疮国际合作诊所/ACR损伤指数（SLICC/ACR DI）0.53 vs 0.13，P = 0.012]。此外，Sm自身抗体的存在显着预测升高的BLyS水平在高加索人群。BLyS水平在那些有肌肉骨骼受累、颧骨皮疹、肾脏疾病和免疫活性证据的患者中显著较高。如果在患有肾脏、肌肉骨骼和皮肤疾病的年轻白人患者的病程早期引入BLyS阻断剂，以减少长期损害，可能是最有益的。
Objective. The overall aim of this study is to identify clinical and serological features that are associated with B lymphocyte stimulator (BLyS) elevation in a homogeneous Caucasian SLE population and thereby identify patients who are most likely to benefit from BLyS blockade.Methods. Patients with SLE (as per ACR criteria) were recruited. Clinical history, disease activity measures and laboratory measures of disease were recorded. BLyS levels were determined by ELISA.Results. BLyS elevation was defined as being higher than the 95th percentile of BLyS levels measured in controls. Patients were divided into two groups: those with elevated BLyS levels (group 1, n = 23) and those with normal BLyS levels (group 2, n = 22). Elevated BLyS levels were significantly associated with patients of younger age and shorter disease duration. In keeping with previous reports, patients with elevated BLyS levels had more active disease (SLEDAI 5.1 vs 0.86, P < 0.001); however, our analysis also demonstrates that BLyS elevation was significantly associated with increased organ damage at 5-year follow-up [Systemic Lupus International Collaborating Clinics/ACR Damage Index (SLICC/ACR DI) 0.53 vs 0.13, P = 0.012]. Furthermore, the presence of Sm autoantibody significantly predicted elevated BLyS levels in a Caucasian population. BLyS levels were significantly higher in those with musculoskeletal involvement, malar rash, renal disease and evidence of immunological activity.Conclusion. BLyS blockade may be most beneficial if introduced early in the course of disease in young Caucasian patients presenting with renal, musculoskeletal and skin disease in an effort to reduce long-term damage.