Serum Mediated Phagocytosis Of Necrotic Material By Polymorphonuclear Leukocytes May Be Used As a Tool To Predict Clinical Manifestations In Systemic Lupus Erythematosus

Michele Compagno¹, Birgitta Gullstrand², Andreas Jönsen³, Lennart Truedsson², Gunnar Sturfelt⁴ and Anders A. Bengtsson³, ¹Department of clinical sciences - Rheumatology, Lund University, Lund, Sweden, ²Department of Laboratory Medicine, Section of Microbiology, Immunology and Glycobiology, Lund University, Lund, Sweden, ³Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden, ⁴Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Lund, Sweden

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Clinical research, flow cytometry, leukocytes, phagocytosis and systemic lupus erythematosus (SLE)

Session Information

Title: Systemic Lupus Erythematosus-Clinical Aspects III: Biomarkers, Quality of Life and Disease Indicators, Late Complications

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Polymorphonuclear (PMNs) leukocytes with engulfed necrotic cell material (NCM), as formerly used in the LE-cell test, are frequently seen in SLE and associated to severe clinical manifestations.

The aim of this study was to investigate if phagocytosis of NCM could predict or was associated with specific clinical phenotypes and/or disease activity in patients affected by SLE.

Methods:

Sixty-nine SLE-patients were followed longitudinally for a median time of 2.1 years. A total of 1074 serum samples were taken approximately every 60 days together with registration of an extensive set of clinical and laboratory variables. NCM was generated by heat treatment of mononuclear cells from healthy donors, and PMNs from healthy donors were isolated by density gradient centrifugation. Sera from SLE-patients were incubated with PMNs and NCM, and phagocytosis was assessed by flow cytometry. Association and prediction of relevant clinical phenotypes were evaluated with logistic regression and odds ratio (OR) and 95% confidence intervals (CI) were calculated.

Results:

In serum samples from 46 of the 69 SLE patients, phagocytosis of NCM by PMNs was seen at least once and totally 417 times. Significant association between phagocytosis of NCM by PMNs was found with clinical phenotypes such as lupus nephritis (OR=1.7, CI=1.2-2.5), mucocutaneous involvement (OR=1.45, CI=1.1-1.9) and also with increased disease activity (SLEDAI score) (OR=1.41, CI=1.0-2.0). Arthritis, though, was inversely associated with phagocytosis of NCM (OR=0.51, CI= 0.3 -0.8). Furthermore, phagocytosis of NCM by PMNs could predict alopecia (OR=2.22, CI=1.3-3.7) while arthritis was inversely related (OR=0.38, CI=0.1-1.0).

Conclusion:

In SLE, high capacity of serum mediated phagocytosis of NCM by PMNs is commonly seen. It is associated with disease activity and certain clinical phenotypes and was a predictor for alopecia and inversely related to arthritis. The assessment of phagocytosis of NCM by PMNs may be used as a complementary laboratory tool in management of SLE-patients.

Disclosure:

M. Compagno,
None;

B. Gullstrand,
None;

A. Jönsen,
None;

L. Truedsson,
None;

G. Sturfelt,
None;

A. A. Bengtsson,
None.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/serum-mediated-phagocytosis-of-necrotic-material-by-polymorphonuclear-leukocytes-may-be-used-as-a-tool-to-predict-clinical-manifestations-in-systemic-lupus-erythematosus/