Che Maraina, Che Hussin
(2012)
Contribution of increased apoptosis in
monocytes and lymphocytes in the
etiopathogenesis of systemic lupus
erythematosus (SLE).
Other.
Pusat Pengajian Sains Perubatan.
(Submitted)
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organ
systems and production of a wide array of autoantibodies. The aetiopathogenesis remains
unknown but the complex combination of environmental trigger (infection and UV
exposure) and genetic factors seems to be involved. Data from human SLE reported an
increased apoptosis and defective clearance of apoptotic cells and suggested to have a
pathogenic role in development of SLE. Increased apoptosis of circulating and in vitro in
variety of cells such as monocytes, lymphocytes, neutrophils, as well as cell line was
demonstrated in SLE.
Previous reports suggested that the serum factors could induce apoptosis in SLE.
Therefore this study is conducted I) to compare the in vitro mean proportion of apoptosis
in monocytes and lymphocytes in active with inactive SLE patients, 2) to compare the in
vitro mean proportion of apoptosis in monocytes and lymphocytes in SLE patients with
normal controls and 3) to determine the correlation of apoptosis in SLE patients with
serum factors.
A total of248 subjects were enrolled in this study, 124 subjects for each group of healthy
controls and SLE patients ( 62 active SLE and 62 inactive SLE). All the patients fulfilled
four or more of the American Rheumarism Association Classification Criteria for SLE
(1987).Subjects recruited fulfilled the inclusion and exclusion criteria. Blood was
withdrawn into EDTA (I ml) for full blood count and plain tubes (9 ml) for apoptosis and
serum factors analysis. Statistical analyses were performed using the SPSS version 18.0.
Results revealed that both apoptotic lymphocytes and monocytes was significantly higher
in SLE patients compared to normal controls (p=O.OO I and p=0.030) respectively. Both
apoptotic lymphocytes and monocytes was also significantly higher in active SLE
compared to inactive SLE patients (p<0.042 and p<0.028) respectively. According to
Pearson's correlation test, apoptotic lymphocyte was significantly correlated with
C3(0.007), C4(0.034), TNFa(0.012), anti-dsDNa antibodies(0.029) and anti-Clq
autoantibodies(0.036) but not with C5a, sFas ligand and ACL antibodies. Apoptotic
monocytes was also significantly correlated with C3(0.00 1), C4(0.008) and TNFa(0.003).
The simple linear regression showed no significant relationship between both apoptotic
lymphocytes and monocytes with CRP (P>0.05).
The results of this study suggest that circulating factors in the serum of the SLE patients
are responsible for the apoptosis and may play a pathogenic role in SLE.
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