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. 2024 Jan 19;22(1):20.
doi: 10.1186/s12969-024-00953-9.

Lymphocyte apoptosis and its association with the inflammatory markers and disease severity in juvenile-onset systemic lupus erythematosus patients

Eman Eissa  1 , Rania Kandil  2 , Dalia Dorgham  3 , Raghda Ghorab  2 , Naglaa Kholoussi  2
Affiliations

Lymphocyte apoptosis and its association with the inflammatory markers and disease severity in juvenile-onset systemic lupus erythematosus patients

Eman Eissa et al. Pediatr Rheumatol Online J. .

Abstract

Background: The defective clearance of apoptotic bodies in juvenile-onset systemic lupus erythematosus (jSLE) potentially leads to the persistence of autoreactive lymphocytes and the perpetuation of the autoimmune response. These factors contribute to the disturbance in lymphocyte apoptosis and show potential as key determinants in the clinical course and severity of jSLE. This study evaluates the role of peripheral blood (PB) lymphocyte apoptosis in prognosis of jSLE and as a predictor for disease activity.

Methods: The study involved 100 jSLE patients and 50 healthy controls. Flow cytometry was used to analyze percentages of lymphocyte apoptosis in PB of all study participants. Plasma levels of pro-inflammatory cytokines were determined using ELISA.

Results: Our results showed that percentages of lymphocyte apoptosis in PB of jSLE patients are significantly higher than those of healthy controls. These percentages are significantly positively associated with disease activity of patients (SLEDAI-2 K). Furthermore, plasma cytokine levels (IL-17, IFN-γ and TNF-α) are significantly elevated in jSLE patients compared to their levels in healthy controls. Also, there are weak significant positive correlations between percentages of PB lymphocyte apoptosis and each of IL-17 and IFN-γ plasma levels in jSLE patients. Moreover, PB lymphocyte apoptosis percentages among jSLE patients are higher in the presence of some clinical and laboratory features than those in their absence.

Conclusion: Peripheral apoptotic lymphocytes could contribute to the prognosis of jSLE and could be used as a predictor for disease activity in jSLE patients.

Keywords: Flow cytometry; IFN-γ; IL-17; Inflammatory cytokines; Juvenile-onset systemic lupus erythematosus; Lymphocyte apoptosis; TNF-α.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a. Comparison of percentages of PB lymphocyte apoptosis between jSLE patients and healthy controls (**: significant at p < 0.001, by Mann–Whitney U test). b Correlation between percentages of PB lymphocyte apoptosis and SLEDAI-2 K in jSLE patients (p < 0.001, by Spearman correlation). c Comparison between active and inactive jSLE patients regarding percentages of PB lymphocyte apoptosis (**: significant at p = 0.002, by Mann–Whitney U test)
Fig. 2
Fig. 2
Plasma levels of inflammatory cytokines in juvenile-onset SLE patients compared to healthy controls (**: significant at p < 0.001, by Mann–Whitney U test)
See this image and copyright information in PMC

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