Lisboa Renata Valente, de Oliveira Fabiola Reis, Quaresma Thaise Oliveira, de Almeida Rafael Moura, Ribeiro Oliveira Rene Donizeti, Junior Paulo Louzada
Ribeirão Preto Medical School, Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Center of Research in Inflammatory Diseases (CRID), Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Biomark Insights. 2022 Oct 22;17:11772719221131470. doi: 10.1177/11772719221131470. eCollection 2022.
Systemic lupus erythematosus (SLE) is a chronic, multi phenotypic, autoimmune inflammatory disease and renal involvement significantly worsens its prognosis. Apoptosis dysregulation plays a key pathogenic role. Survivin, a protein from the apoptosis inhibitors family, has been considered a promising strategy in cancer therapy and evaluated as one of the regulatory pathways in the scenario of immune-mediated disorders.
This study aims to explore survivin behaviour in SLE patients with lupus nephritis (LN), assessing its potential as a therapeutic and prognostic biomarker.
297 SLE patients were classified based on the American College of Rheumatology (ACR) 1997 criteria, from 2000 to 2015. In a cross-sectional study, the serum level of survivin was measured by an ELISA test and compared between 200 SLE individuals and healthy controls. In a longitudinal cohort, 97 patients with active LN had the concentration of survinin measured, before and after treatment with cyclophosphamide pulse therapy.
The serum concentration of survivin was significantly lower in the SLE group than in healthy controls, regardless of concomitant NL or disease activity. The longitudinal evaluation revealed a significant reduction in survivin serum level after treatment. However, survivin rates were not able to discriminate groups that achieved remission from those that maintained nephritis activity.
Our study suggests that survivin levels in SLE patients are lower than in the general population. Even so, its use as a biomarker in SLE seems limited, not reflecting disease activity or response to LN treatment, as in other contexts.
系统性红斑狼疮（SLE）是一种慢性、多表型的自身免疫性炎症性疾病，肾脏受累会显著恶化其预后。细胞凋亡失调起着关键的致病作用。生存素是凋亡抑制蛋白家族中的一种蛋白质，被认为是癌症治疗中有前景的策略，并被评估为免疫介导疾病情况下的调控途径之一。
本研究旨在探讨狼疮性肾炎（LN）患者中生存素的表现，评估其作为治疗和预后生物标志物的潜力。
根据美国风湿病学会（ACR）1997年标准，对2000年至2015年期间的297例SLE患者进行分类。在一项横断面研究中，通过酶联免疫吸附测定（ELISA）检测200例SLE患者和健康对照者的血清生存素水平并进行比较。在一项纵向队列研究中，对97例活动性LN患者在环磷酰胺脉冲治疗前后测定生存素浓度。
无论是否伴有LN或疾病活动，SLE组血清生存素浓度均显著低于健康对照组。纵向评估显示治疗后生存素血清水平显著降低。然而，生存素水平无法区分达到缓解的组和维持肾炎活动的组。
我们的研究表明，SLE患者的生存素水平低于一般人群。即便如此，其在SLE中作为生物标志物的用途似乎有限，不像在其他情况下那样反映疾病活动或对LN治疗的反应。
