Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Accelerated atherosclerotic disease has been widely recognized in patients with SLE. Circulating endothelial cells (CECs) are a rare cell population believed to detach from the vessel wall as a result of vascular injury. Increased numbers of CECs have been reported previously in patients with SLE. However, the interaction between complement and CECs with regard to inflammatory vascular injury in SLE has not been explored. Previous studies have shown that complement activation product C4d is present specifically on platelets of SLE patients and correlates with cerebrovascular disease. These observations led us to hypothesize that increased numbers of CECs bearing C4d may serve as a sensitive and specific biomarker of SLE-associated vascular diseases.
To verify this hypothesis, a pilot study investigating CEC numbers and CEC-bound C4d levels was conducted using the blood samples taken from 129 patients with SLE, 125 patients with other immune-inflammatory diseases, and 30 healthy individuals. Peripheral blood mononuclear cells were isolated, and CECs therein were detected and analyzed for surface-bound C4d by flow cytometry.
Preliminary results showed that CEC numbers per se were not significantly elevated in patients with SLE. Notably, however, the levels of CEC bearing C4d (CEC-C4d) were significantly elevated in patients with SLE (specific median fluorescence intensity (SMFI) = 16.7), compared to patients with other diseases (SMFI = 5.7; p <0.001) and healthy controls (SMFI = 3.5; p <0.001). In a preliminary cross-sectional analysis, CEC-C4d measure was 45% sensitive and 100% specific for SLE versus healthy controls, and 86% specific for SLE versus other diseases. Furthermore, there was a correlation between CEC-C4d and platelet-bound C4d levels (Spearman r = 0.40, p <0.001). Because platelets play important roles in hemostasis and thrombosis and have increasingly been recognized as being important mediators of inflammation, this finding suggests an interactive participation of platelets and CECs in SLE-associated inflammatory vascular disease.
The results obtained indicate that CEC-C4d is a potential diagnostic marker of SLE and possibly a stratification biomarker for vasculature-specific SLE disease activity.
To cite this abstract in AMA style:Liu CC, Manzi S, Ahearn J. Circulating Endothelial Cell (CEC) and CEC-Bound C4d Levels As Biomarkers of Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/circulating-endothelial-cell-cec-and-cec-bound-c4d-levels-as-biomarkers-of-systemic-lupus-erythematosus/. Accessed July 11, 2020.
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