Background/Purpose:

Systemic lupus erythematosus (SLE) is a chronic multi-systemic autoimmune disease, with a broad spectrum of clinical manifestations and unpredictable disease course with periods of flares and remission. Over the past few years, several biomarkers have been reported to be elevated in SLE, though the utility of these markers in monitoring disease progression remains unclear. The main objective of the current study is to assess the performance of serum FAS, sTNFRII, Igfbp2 and Ferritin as biomarkers for tracking lupus flares in non-renal SLE patients.

Methods:

Serum samples were obtained over 4 consecutive visits (<4 months apart) from 29 SLE patients from Oklahoma Medical Research Foundation (OMRF). All patients met ACR requirements for diagnosis of SLE and none of them had lupus nephritis, though they had mucocutaneous and/or musculoskeletal disease manifestations. Serum FAS, sTNFRII, Igfbp2 and ferritin were assayed in all 29 patients by ELISA and related to SLEDAI and BILAG disease activity indices.

Results:

All four tested serum proteins correlated significantly with SLEDAI and BILAG in SLE: FAS (r= 0.36, p < 0.0001 for SLEDAI & r= 0.29, p= 0.0002 for BILAG), Ferritin (r= 0.13, p=0.0494 for SLEDAI & r= 0.22, p= 0.0035 for BILAG), Igfbp2 (r= 0.24, p= 0.0013 for SLEDAI & r= 0.18, p= 0.0106 for BILAG) and sTNFRII (r= 0.30, p <0.0001 for SLEDAI & r= 0.19, p= 0.0112 for BILAG). We next examined serial changes in all 4 biomarkers with changes in disease activity. In some patients 2-3 of the tested biomarkers were predictive of changes in disease activity while in others all 4 tested markers emerged as good indicators of disease activity changes. In studying a total of 72 patient follow-up intervals, FAS and Ferritin exhibited the highest concordance with concurrent disease activity (58-62%), followed by Igfbp2 (50%) and sTNFRII (46%), all of which were superior to the performance of complement C3, C4 and anti-DNA. Furthermore, combining FAS to other tested molecules increased its ability to track concordant disease activity changes in SLE (81% for FAS±Ferritin; 76% for FAS±Igfbp2 and FAS±sTNFRII).

Conclusion:

Serum FAS and Ferritin emerge as potential serum markers for predicting mucocutaneous and musculoskeletal disease flares in SLE patients.

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/serum-fas-ferritin-igfbp2-stnfr2-as-markers-for-tracking-mucocutaneous-and-musculoskeletal-flares-in-sle-patients/