الفهرس 
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Systemic lupus erythematosus (SLE)Only 14 pages are availabe for public view
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Abstract
Systemic lupus erythematosus (SLE) is a chronic disease that causes inflammation in connective tissues, such as cartilage and the lining of blood vessels, which provide strength and flexibility to structures throughout the body. About 80% of patients with SLE have skin involvement and it is the first sign of SLE in about one-quarter of them Pentraxin 3 (PTX3) plays multifunctional roles at the crossroads between innate immunity, inflammation, matrix deposition and female fertility. However, aberrant production of PTX3 can cause damage to the host, possibly leading to tissue damage or subsequent development of autoimmunity due to abnormal release of PTX3. Therefore, PTX3 is one of new perspective markers of immune inflammation; produced by resident and innate immunity cells, in response to inflammatory signals. PTX3 may be elevated in various rheumatic diseases, such as rheumatoid arthritis (RA), giant cell arteritis, SLE, and small vessel vasculitis. In this study we aimed to evaluate serum PTX3 level in patients with SLE and to assess its relationship with disease activity and with skin manifestations of SLE. Thirty-four patients with SLE (17 patients with skin manifestations and 17 patients without skin manifestations) and 30 healthy controls were enrolled in the study. Patients were carefully examined for systemic and cutaneous manifestations of SLE, and assessed clinically using Systemic Lupus Erythematosus Disease Activity Index (SLEDIA-2k) and Cutaneous Lupus Erythematosus Activity and Severity Index (CLASI) scores. Serum PTX3 level was measured in patients and controls using ELISA. Our results showed that the most common skin manifestations were malar rash, alopecia and oral/nasal ulcers. Patients with skin manifestations had lower platelet and WBC count, higher ESR, higher triglyceride level, lower HDL-cholesterol level and also high SLEDAI-2k score compared to patients without skin manifestations. Serum PTX3 was elevated in SLE patients compared to healthy control, was higher in patients with skin manifestations than those without skin manifestations and it was especially associated with purpuric eruption and petechiae/ ecchymosis. In addition, serum level of PTX3 correlated positively with BMI, and triglyceride level and negatively correlated with platelet count, white blood cell count and HDL-cholesterol level. PTX3 was increased in patients with higher CLASI score. Conclusions Skin manifestations are associated with disease activity and with hematologic and lipid disturbances in SLE patients. Serum PTX3 level is elevated in SLE patients when compared with healthy controls, and is higher in SLE patient with skin lesions. Serum PTX3 is associated with cutaneous vasculitic lesions and some laboratory parameters including increased TG level, decreased HDL-C, WBC and platelets. PTX3 likely plays a role in the pathogenesis of lupus skin lesion, and may contribute to the recruitment of inflammatory cells in the skin. Recommendations: - Skin lesions, particularly cutaneous vasculitis may help as indicators of disease activity in SLE patients.
Serum PTX 3 may be useful biomarker of skin involvement in SLE patients. - Further longitudinal studies with large sample size are needed to evaluate the precise relationship between PTX3 and SLE. - Further research is required to identify other inflammatory biomarkers for SLE