الفهرس 
Systemic Lupus ErythematosusOnly 14 pages are availabe for public view
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Abstract
The pathogenesis of SLE is mostly owing to incomplete apoptotic cell clearance. These cells deliver auto-antigen that may trigger defective immune reaction which stimulates activation of plasma cells, autoantibody release, and hyperactive memory B cells.
Progranulin is a protein excreted by many cell types including neurons, and cells of immune system. The PGRN is thought to play a proinflammatory role in the development of SLE partially through promoting the production of autoantibodies and enhancing Th1 and Th17 cell responses. Based on the aforementioned findings, it is hypothesized that PGRN might be a useful marker for prediction of disease activity.
This comparative cross-sectional controlled study aimed to assess the prognostic value of serum PGRN level in patients with SLE. The ultimate objective was to identify new marker of activity and organ damage that would aid in the management of these cases.
In the present study, we conducted a case-control study over a period of 8 months (from June 2022 to January 2023) at Ain Shams University Hospitals. The study included total number of 90 subjects who were divided into 50 patients were classified SLE according to EULAR/ACR-2019 criteria, 20 patients with autoimmune diseases other than SLE including 10 patients having RA, 5 patients having autoimmune thyroid diseases, 3 patients having T1DM and 2 patients having psoriasis, and 20 apparently healthy subjects as a control group. The SLE patients comprised 25 cases with no and low disease activity, and 25 SLE cases with high disease activity classified according to SLEDAI-2K score.
All study participants were subjected to complete history taking and s. PGRN assay by using a quantitative ELISA kit. For SLE patients, full clinical and laboratory data were collected from their records including SLEDAI-2K, SDI ESR, CRP, albuminurea, 24hUP, BUN, s. creatinine, eGFR, ANA, anti- dsDNA, C3, C4, LAC, ACL and CBC. All the laboratory investigations were performed at the Clinical Pathology Department, Ain Shams University Hospitals.
Descriptive statistics showed that the frequency of different clinical manifestations among patients with SLE were joint affection (100 %), malar rash (94%), oral ulcers (82%), constitutional manifestations (76%), photosensitivity (60%), alopecia (46%), serositis (36%), pulmonary manifestations (34%), cerebritis (28%), cardiac manifestations (18%), thrombotic complications (18%), and bleeding (10%).
As regards the demographic data (sex, age and duration of the disease) of the studied groups, no significant difference was found in sex and age between group I of SLE, group II of autoimmune diseases other than SLE, and group III of control. In addition, no significant difference was found as regards the disease duration between group I of SLE and group II of autoimmune diseases other than SLE
Statistical comparison between the two subgroups of SLE (group Ia, and Ib) as regards ESR, 24hUP, s. creatinine, eGFR, C3, C4, TLC and PLT count revealed a highly significant difference between them; as ESR and 24hUP were significantly increased in group Ib of SLE with high disease activity, while serum levels of C3 and C4 were significantly decreased in group Ib of SLE with high disease activity as compared to group Ia of SLE with no and low disease activity.
Comparative statistics showed that patients with SLE had significant increase of s. PGRN levels when compared with control group, as well as when compared to the group of patients with autoimmune diseases other than SLE. Similarly, patients with autoimmune diseases other than SLE had a significant increase of serum PGRN levels compared to control group. Serum PGRN levels showed significant increase in SLE patients with high disease activity compared to SLE patients with no and low disease activity.
Among group I of SLE, a highly significant positive correlation was found between s. PGRN level and SDI, SLEDAI-2k and 24hUP; while, a highly significant negative correlation was found between s. PGRN level and C3 and C4.On the other hand, there was no significant correlation between s. PGRN level and TLC and Plt count
from our pilot study, the ROC curve analysis revealed that s. PGRN level was able to differentiate between SLE patients with no and low disease activity and those with high disease activity at the cut-off value of >250ng/ml, with a sensitivity and a specificity of 100%, positive and negative predictive values of 100%. Area under the curve was