Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
Lupus Sci Med. 2022 Mar;9(1). doi: 10.1136/lupus-2021-000607.
Laboratory tests of blood and sometimes urine are used to diagnose and to monitor disease activity (DA) in SLE. Clinical practice would be simplified if non-invasive urine and salivary tests could be introduced as alternatives to blood samples. We therefore explored the levels of innate immunity-related biomarkers in matched serum, urine and saliva samples from patients with SLE.
A total of 84 patients with SLE selected to represent high and low general DA, and 21 controls were included. All participants underwent a thorough clinical examination. General DA and renal DA were measured. The levels of colony-stimulating factor (CSF)-1, interleukin (IL)-34, tumour necrosis factor (TNF)-α, interferon-γ-induced protein (IP)-10, monocyte chemoattractant protein (MCP)-1, calprotectin, macrophage inflammatory protein (MIP)-1α and MIP-1β were analysed by immunoassays and related to DA.
CSF-1, TNF-α, IP-10 and MCP-1 in saliva, serum and urine, as well as calprotectin in saliva and urine were increased in patients with SLE as compared with controls (p<0.05). TNF-α, IP-10 and MCP-1 in saliva, serum and urine, and CSF-1 in saliva and serum distinguished patients with SLE from controls (area under the curve >0.659; p<0.05 for all). CSF-1 in serum and urine, and calprotectin in saliva and urine, as well as TNF- α, IP-10 and MCP-1 in urine correlated positively with measures of general DA (p<0.05). Patients with SLE with active renal disease presented elevated levels of TNF-α, IP-10 and MCP-1 in urine and CSF-1 and IP-10 in serum as compared with patients with SLE with non-active renal disease.
Our investigation demonstrates that saliva is a novel alternative body fluid, with potential for surveillance of general DA in patients with SLE, but urine is more informative in patients with SLE with predominantly renal DA.
实验室检测血液，有时是尿液，用于诊断和监测系统性红斑狼疮（SLE）的疾病活动度（DA）。如果可以引入非侵入性尿液和唾液检测作为血液样本的替代方法，临床实践将得到简化。因此，我们探索了 SLE 患者匹配的血清、尿液和唾液样本中固有免疫相关生物标志物的水平。
共纳入 84 例 SLE 患者，代表高和低一般 DA，以及 21 例对照者。所有参与者均接受全面临床检查，评估一般 DA 和肾脏 DA，通过免疫分析检测集落刺激因子（CSF）-1、白细胞介素（IL）-34、肿瘤坏死因子（TNF）-α、干扰素-γ诱导蛋白（IP）-10、单核细胞趋化蛋白（MCP）-1、钙卫蛋白、巨噬细胞炎性蛋白（MIP）-1α和 MIP-1β的水平，并与 DA 相关。
与对照组相比，SLE 患者唾液、血清和尿液中的 CSF-1、TNF-α、IP-10 和 MCP-1 以及唾液和尿液中的钙卫蛋白增加（p<0.05）。与对照组相比，SLE 患者唾液、血清和尿液中的 TNF-α、IP-10 和 MCP-1，以及唾液和血清中的 CSF-1 可区分 SLE 患者和对照组（曲线下面积>0.659；p<0.05）。血清和尿液中的 CSF-1，唾液和尿液中的钙卫蛋白，以及尿液中的 TNF-α、IP-10 和 MCP-1 与一般 DA 指标呈正相关（p<0.05）。与无活动期肾脏疾病的 SLE 患者相比，有活动期肾脏疾病的 SLE 患者尿液中的 TNF-α、IP-10 和 MCP-1 以及血清中的 CSF-1 和 IP-10 水平升高。
我们的研究表明，唾液是一种新型替代体液，具有监测 SLE 患者一般 DA 的潜力，但尿液在以肾脏 DA 为主的 SLE 患者中更具信息量。
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