Sistemik Lupus Eritematozus Hastalığında C-Reaktif Protein ve Pentraksin-3 Düzeyleri Arasındaki İlişkinin Araştırılması

Year 2024, , 57 - 62, 29.02.2024

Şükran Aslantaş , Nurdan Oruçoğlu , Merve Türkegün Şengül , Senay Balcı , Lülüfer Tamer

https://doi.org/10.53446/actamednicomedia.1333600

Abstract

Amaç: Sistemik lupus eritematozus, çoklu otoantijenlere karşı poliklonal otoimmüniteyi içeren ve çok çeşitli klinik belirti spektrumuna sahip, öngörülemeyen seyirli otoimmün bir hastalıktır. Otoimmün hastalıklarda, uzun pentraksin ailesininden olan pentraksin-3 seviyelerinin dolaşımda arttığı bulunmuştur. Pentraksin-3, diğer pentraksinlerden farklı olarak periferal dokularda yerleşik ve doğal bağışıklık hücreleri tarafından, enflamatuar sinyallere cevap olarak üretilir. Bu çalışmada, kronik enflamasyon ve immün fonksiyon bozukluğu ile karakterize olan sistemik lupus eritematozus’da, inflamatuar belirteçlerden C-reaktif protein ve pentraksin-3 düzeyleri arasındaki ilişkinin araştırılması amaçlandı.
Yöntem: Çalışmaya, dahil edilme kriterlerine uyan, sistemik lupus eritematozus tanısı almış 56 hasta ve 55 sağlıklı birey dahil edildi. Tam kan sayımı, eritrosit sedimantasyon hızı, alanin transaminaz, kreatinin ve C-reaktif protein otoanalizörde çalışılırken; pentraksin-3 düzeyleri, serum örneklerinden, ELISA yöntemi ile çalışıldı.
Bulgular: Çalışma verileri incelendiğinde, hasta grubunda kontrol grubuna kıyasla hematolojik eritrosit sedimantasyon hızı sonuçları daha yüksek bulundu (p<0,0001). Sistemik lupus eritematozus hastalarında, CRP ve pentraksin-3 düzeyleri kontrol grubuna göre anlamlı yüksek bulundu (sırasıyla p= 0,003; p= 0,008). Pentraksin-3 ile diğer parametrelerin, grup içi düzeylerinin korelasyonu değerlendirildiğinde istatistiksel olarak anlamlı ilişki bulunmadı.
Sonuç: Sistemik lupus eritematozus, farklı doku ve organ tutulumları olan ve buna bağlı olarak farklı klinik belirtilere yol açan bir hastalıktır. Aynı zamanda bu belirtilerin spektrumu da oldukça geniştir. Bu nedenle, sistemik lupus eritematozus ile ilişkilendirilmiş genetik yatkınlık doku ve organ tutulumları ve hastalığın şiddeti ve aktifliğine göre gruplandırma yaparak daha ileri çalışmalar önermekteyiz.

Keywords

Sistemik Lupus Eritematozus, PTX-3, CRP

Supporting Institution

Mersin Üniversitesi Bilimsel Araştırma Projeleri Birimi

Project Number

BAP 2020-1-TP3-4072

Thanks

Bu çalışma BAP 2020-1-TP3-4072 kodlu proje olarak Mersin Üniversitesi Bilimsel Araştırma Projeleri Birimi tarafından desteklenmiştir

Investigation of the Relationship Between C-Reactive Protein and Pentraxin-3 Levels in Systemic Lupus Erythematosus Disease

Abstract

Aim: Systemic lupus erythematosus is an autoimmune disease with an unpredictable course that includes polyclonal autoimmunity against multiple autoantigens and has a wide spectrum of clinical manifestations. In autoimmune diseases, levels of pentraxin-3, a member of the long pentraxin family, have been found to be increased in the circulation. Pentraxin-3 is produced by innate and resident immune cells in peripheral tissues in response to inflammatory signals. In this study, it was aimed to investigate the relationship between CRP and pentraxin-3 levels in systemic lupus erythematosus, which is characterized by chronic inflammation and immune dysfunction.
Method: Fifty-six patients with SLE and 55 healthy individuals who met the inclusion criteria were included in the study. CBC, ESR, ALT, creatinine and CRP were analyzed by autoanalyzer; pentraxin-3 levels were studied by ELISA from serum samples.
Results: According to the control group in patients; hematological parameters, creatinine and ALT levels were lower, sediment results are higher, CRP and pentraxin-3 levels were found to be higher (respectively p= 0.003; p= 0.008). When the correlation between Pentraxin-3 and other parameters and within-group levels was evaluated, no statistically significant correlation was found.
Conclusion: Systemic lupus erythematosus is a disease that has different tissue and organ involvement and accordingly causes different clinical symptoms. At the same time, the spectrum of these symptoms is quite wide. Therefore, we suggest further studies by grouping according to genetic susceptibility, tissue and organ involvement, and severity and activity of the disease associated with systemic lupus erythematosus.

Keywords

Systemic Lupus Erythematosus, PTX-3, CRP, Inflammation

Project Number

BAP 2020-1-TP3-4072

References

• 1. Doria A, Iaccarino L, Ghirardello A, et al. Long-term prognosis and causes of death in systemic lupus erythematosus. Am J Med. 2006;119:1497-9. doi:10.1016/j.amjmed.2005.11.034
• 2. Hahn BH, Kelly WN, Harris ED, et al. Systemic lupus erythematosus and related syndromes In Text-book of Rheumatology WB Saunders Company; 1997:1015-1056.
• 3. Petri M. Epidemiology of systemic lupus erythematosus. Best Pract Res Clin Rheumatol. 2002;16:847-858. doi:10.1053/berh.2002.0259
• 4. Graham RR, Kozyrev SV, Baechler EC, et al. A common haplotype of interferon regulatory factor 5 (IRF5) regulates splicing and expression and is associated with increased risk of systemic lupus erythematosus. Nat Genet. 2006;38:550-555. doi:10.1038/ng1782
• 5. Rahman A, Isenberg DA. Systemic lupus erythematosus. N Engl J Med. 2008;358:929-939. doi:10.1056/NEJMra071297
• 6. Fortuna G, Brennan MT. Systemic lupus erythematosus: epidemiology, pathophysiology, manifestations, and management. Dental Clinics. 2013;57(4):631-655. doi:10.1016/j.cden.2013.06.003
• 7. Garlanda C, Bottazzi B, Bastone A, Mantovani A. Pentraxins at the crossroads between ınnate ımmunity, ınflammation, matrix deposition, and female fertility. Annual Review of Immunology. 2005;23:337-366. doi:10.1146/annurev.immunol.23.021704.115756
• 8. Pepys MB, Hirschfield G. C-Reactive Protein: A Critical Update. Journal of Clinical Investigation. 2003;111(12):1805-1812. doi:10.1172/JCI18921
• 9. Lu J, Marnell LL, Marjon KD, Mold C, Du Clos TW, Sun PD. Structural recognition and functional activation of fcγr by innate pentraxins. Nature. 2008;456(7224):989-992. doi:10.1038/nature07468
• 10. Gaitonde S, Samols D, Kushner I. C-reactive protein and systemic lupus erythematosus. Arthritis Rheum. 2008;59:1814-1820. doi:10.1002/art.24316
• 11. Morrow WJ, Isenberg DA, Parry HF, Snaith ML. C-reactive protein in sera from patients with systemic lupus erythematosus. J. Rheumatol. 1981;8:599-604. PMID: 7299761
• 12. Lu J, Marnell LL, Marjon KD, Mold C, Du Clos TW, Sun PD. Structural recognition and functional activation of FcgammaR by innate pentraxins. Nature. 2008;456(7224):989-92. doi:10.1038/nature07468
• 13. Ganrot PO, Kindmark CO. C-reactive protein--a phagocytosis-promoting factor. Scand J Clin Lab Invest. 196;24(3):215-9. doi:10.3109/00365516909080155
• 14. Mortensen RF, Osmand AP, Lint TF, Gewurz H. Interaction of C-reactive protein with lymphocytes and monocytes: complement-dependent adherence and phagocytosis. J Immunol. 1976;117(3):774-81. doi:10.4049/jimmunol.117.3.774
• 15. Gaitonde S, Samols D, Kushner I. C‐reactive protein and systemic lupus erythematosus. Arthritis Care & Research. 2008;59(12):1814-1820. doi:10.1002/art.24316
• 16. Eloranta ML, Rönnblom L. Cause and consequences of the activated type I interferon system in SLE. J. Mol. Med. 2016;94:1103-1110. doi:10.1007/s00109-016-1421-4
• 17. de Weerd NA, Nguyen T. The interferons and their receptors--distribution and regulation. Immunol Cell Biol. 2012;90:483-491. doi:10.1038/icb.2012.9
• 18. Enocsson H, Sjöwall C, Skogh T, Eloranta ML, Rönnblom L, Wetterö J. Interferon-alpha mediates suppression of C-reactive protein: Explanation for muted C-reactive protein response in lupus flares? Arthritis Rheum. 2009;60:3755-3760. doi:10.1002/art.25042
• 19. Enocsson H, Karlsson J, Li HY, et al. The complex role of C-reactive protein in systemic lupus erythematosus. Journal of Clinical Medicine. 2021;10(24):5837. doi:10.3390/jcm10245837
• 20. Suh CH, Chun HY, Ye YM, Park HS. (2006). Unresponsiveness of C-reactive protein in the non-infectious inflammation of systemic lupus erythematosus is associated with interleukin 6. Clinical Immunology. 2006;119(3):291-6. doi:10.1016/j.clim.2005.11.006
• 21. Ter Borg EJ, Horst G, Limburg PC, Van Rijswijk MH, Kallenberg CG. C-reactive protein levels during disease exacerbations and infections in systemic lupus erythematosus: a prospective longitudinal study. The Journal of Rheumatology. 1990;17(12):1642-1648. PMID: 2084238
• 22. CieŚlik P, Hrycek A. Long pentraxin 3 (PTX3) in the light of its structure, mechanism of action and clinical implications. Autoimmunity. 2012;45(2):119-128. doi:10.3109/08916934.2011.611549
• 23. Cieślik P, Hrycek A. Pentraxin 3 as a biomarker of local inflammatory response to vascular injury in systemic lupus erythematosus. Autoimmunity. 2015;48(4):242-250. doi:10.3109/08916934.2014.983264
• 24. Sahin S, Adrovic A, Barut K, et al. Pentraxin-3 levels are associated with vasculitis and disease activity in childhood-onset systemic lupus erythematosus. Lupus. 2017;26(10):1089-1094. doi:10.1177/0961203317699
• 25. Huang XL, Zhang L, Duan Y, Wang YJ, Wang J. Association of pentraxin 3 with autoimmune diseases: a systematic review and meta-analysis. Archives of Medical Research. 2016;47(3):223-231. doi:10.1016/j.arcmed.2016.05.006
• 26. Wu Q, Guan SY, Dan YL, et al. Circulating pentraxin-3 levels in patients with systemic lupus erythematosus: a meta-analysis. Biomarkers in Medicine. 2019;13(16):1417-1427. doi:10.2217/bmm-2019-0161
• 27. Daigo K, Mantovani A, Bottazzi B. The yin-yang of long pentraxin PTX3 in inflammation and immunity. Immunology Letters. 2014;161(1):38-43. doi:10.1016/j.imlet.2014.04.012