Objective:Accurate assessment of systemic lupus erythematosus(SLE)disease activity is critical.Most indices used are based on the frequency of clinical manifestations and laboratory results,however,indices with higher...Objective:Accurate assessment of systemic lupus erythematosus(SLE)disease activity is critical.Most indices used are based on the frequency of clinical manifestations and laboratory results,however,indices with higher sensitivity and specificity are needed.This study explored the relationship between the serum level of tumor necrosis factor-like weak inducer of apoptosis(TWEAK)and the Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)score as well as the role of TWEAK in guiding the glucocorticoid dosage in SLE treatment.Methods:This study was performed at The Second Affiliated Hospital of Xi'an Jiaotong University from March 31,2018 to July 31,2019,and involved 131 patients with SLE,34 with subacute cutaneous lupus erythematosus(SCLE),22 with discoid lupus erythematosus(DLE),and 32 healthy volunteers.The serum and urinary TWEAK levels were determined.Monomeric C-reactive protein(mCRP),anti-dsDNA IgG,antinuclear antibody(ANA),complements in serum,and urinary albumin level were measured.The SLEDAI 2000(SLEDAI-2K)was used to evaluate disease activity.The correlation of the SLEDAI-2K score with all biomarkers was determined.Methylprednisolone was orally administered to patients with SLE depending on the serum level of TWEAK.Bonferroni test or two-tailed Student’s t test was used to compare statistical differences between two groups.The chi-square test was used for sex-related comparisons.Linear regression was used to analyze the relationship between two parameters.Results:Serum TWEAK levels were higher in patients with SLE(250.02±21.84 pg/mL)or SCLE(74.52±12.78 pg/mL)than in patients with DLE(14.55±3.10 pg/mL)or healthy controls(6.64±1.17 pg/mL)(all P<0.05).The serum TWEAK level was positively correlated with the SLEDAI-2K score in patients with SLE(R2=0.36,P<0.001),and had the highest correlation coefficient of 0.603 among all of the biomarkers.Moreover,TWEAK-based glucocorticoid therapy was associated with lower SLEDAI-2K scores,better tapering of glucocorticoid doses,and fewer lupus flares in patients with SLE.Conclusions:Serum TWEAK is a useful biomarker reflecting SLE disease activity.Monitoring of the serum TWEAK level may improve the outcomes of glucocorticoid therapy in patients with SLE.展开更多
基金supported by the National Natural Science Foundation of China(Nos.82003367 and 81874241)the Key Research and Development Plan of Shaanxi Province(No.2020ZDLSF02-08).
文摘Objective:Accurate assessment of systemic lupus erythematosus(SLE)disease activity is critical.Most indices used are based on the frequency of clinical manifestations and laboratory results,however,indices with higher sensitivity and specificity are needed.This study explored the relationship between the serum level of tumor necrosis factor-like weak inducer of apoptosis(TWEAK)and the Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)score as well as the role of TWEAK in guiding the glucocorticoid dosage in SLE treatment.Methods:This study was performed at The Second Affiliated Hospital of Xi'an Jiaotong University from March 31,2018 to July 31,2019,and involved 131 patients with SLE,34 with subacute cutaneous lupus erythematosus(SCLE),22 with discoid lupus erythematosus(DLE),and 32 healthy volunteers.The serum and urinary TWEAK levels were determined.Monomeric C-reactive protein(mCRP),anti-dsDNA IgG,antinuclear antibody(ANA),complements in serum,and urinary albumin level were measured.The SLEDAI 2000(SLEDAI-2K)was used to evaluate disease activity.The correlation of the SLEDAI-2K score with all biomarkers was determined.Methylprednisolone was orally administered to patients with SLE depending on the serum level of TWEAK.Bonferroni test or two-tailed Student’s t test was used to compare statistical differences between two groups.The chi-square test was used for sex-related comparisons.Linear regression was used to analyze the relationship between two parameters.Results:Serum TWEAK levels were higher in patients with SLE(250.02±21.84 pg/mL)or SCLE(74.52±12.78 pg/mL)than in patients with DLE(14.55±3.10 pg/mL)or healthy controls(6.64±1.17 pg/mL)(all P<0.05).The serum TWEAK level was positively correlated with the SLEDAI-2K score in patients with SLE(R2=0.36,P<0.001),and had the highest correlation coefficient of 0.603 among all of the biomarkers.Moreover,TWEAK-based glucocorticoid therapy was associated with lower SLEDAI-2K scores,better tapering of glucocorticoid doses,and fewer lupus flares in patients with SLE.Conclusions:Serum TWEAK is a useful biomarker reflecting SLE disease activity.Monitoring of the serum TWEAK level may improve the outcomes of glucocorticoid therapy in patients with SLE.
