الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 103 |  |  |
| | | from | 103 | | |
Abstract
Systemic lupus erythematosus is an autoimmune disease that affects many organs. It is common in women during age of reproduction with a ratio of female to male 10:1 . It exhibits variable clinical manifestations affecting body organs and may lead to life threating conditions.
SLE is linked to the existence of multiple autoantibodies and immune complexes formation and deposition leading to tissue damage.
The manifestations of SLE are variable ranging from mild to life threating conditions . Most SLE patients state that constitutional , muco-cutaneous and musculoskeletal manifestations are the most prevalent and early symptoms
Interleukin-26 is a cytokine that stimulate the release of cytokines of inflammation by myeloid cells that participate in the transformation of naïve CD4 T Cells into T helper (Th17) cells.Th17cell also produce IL-26 causing an inflammatory amplification loop.
The present study was carried out at Clinical Pathology Department, Faculty of Medicine, Minia University. It was conducted on 85 subjects during the period from April 2022 to October 2022. They were selected from the Rhumatology Clinic , Faculty of Medicine, Minia University .The hospital ethics committee approved this study and a written consent was obtained from each patient.
Subjects included in the study were selected from Rhumatology Clinic and divided into three groups:
• group I ( SLE patients in active state): It included 45 patients with SLE (40 females and 5 males),their ages ranged from 18 to 40 years.
• group II (SLE patients in inactive state): It included 20 patients with SLE(19 females and 1 male),their ages ranged from 18 to 40 years.
• group III(Control group):It included 20 apparently healthy individuals (16 females and 4 males),their ages ranged from 19 to 40 years.
Inclusion criteria:
Patients diagnosed as systemic lupus depending on clinical data and laboratory investigations. They were diagnosed according to The European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) 2019 criteria for SLE.
Exclusion criteria:
• Other autoimmune diseases e.g. rheumatoid arthritis.
• Patients with hepatic and renal impairment.
All subjects included in the study were subjected to following:
2. History taking:
Considering age, sex, fever, alopecia, oral ulcers, cutaneous lupus,arthritis,serositis,myositis,vasculitis,seizure,psychosis,delirium,headache duration of disease and treatment.
2-Clinical examination
3-Laboratory investigations:
A.Routine investigations included:
(1) Complete Blood count ( CBC).
(2) Erythrocyte sedimentation rate (ESR).
(3) Renal function tests (Urea and Creatinine).
(4)Albumin/Creatinine ratio(A/C).
(5)liver enzymes(ALT and AST).
(6) C reactive protein (CRP).
(7) ANA
(8)Anti ds DNA antibodies.
(9)C3,C4.
B-Special investigations:
Interleukin- 26 assay by EIA.
The results of this study were summarized as follow:
There was no significant statistically difference between studied groups regarding age ,sex and duration of disease.
Regarding treatment ,there was statistically significant difference between studied groups. 91.1% of SLE patients with activity were treated with steroid and hydroxychloroquine plus immunosuppressive .On the other hand ,75% of inactive patients with SLE were treated with steroid and hydroxychloroquine.
Concerning SLEADI score, it was higher in group I than group II giving statistically significant difference between them.
Regarding hematological data (Hb,TLC,PLT ),there was statistically significant decrease between studied groups concerning Hb and PLT ,but there was no statistically significant difference concerning TLC.
There was statistically significant difference between studied groups regarding urea, A/C ratio, while there was no statistically significant difference regarding creatinine and liver enzymes.
About ANA ,it was positive in both group I and II and negative in group III
ESR , CRP , Anti-dsDNA , C3 and C4 showed statistically significant difference between studied groups.
Concerning IL 26 ,it was higher in group I than group II and higher in group II than group III giving statistically significant difference between studied groups .
Also IL-26 showed the highest level among patients receiving hydroxychloroquine, steroid and immunosuppressive therapy and higher level among those receiving steroid and hydroxychloroquine than those receiving hydroxychloroquine only giving statistically significant difference between studied groups.
There was significant positive correlation between IL-26 and (SLEADI score, A/C ratio , Anti –ds DNA and ESR )and significant negative correlation between IL-26 and(C3 and C4).
Conclusions:
1- IL-26 can be considered as a good marker for assessment of SLE activity as well as other SLE serological markers, so it can help to guide treatment .
2- IL-26 can be used as a marker for lupus nephritis as it positively correlated with A/C ratio.
3- IL-26 can be used as an inflammatory marker for SLE.
Recommendations:
1-The study need to be done on a larger prospective cohort to assure use of IL-26 as a good marker for assessment of SLE activity.
2-Study of correlation between IL-26 and other inflammatory markers.
3-Study of correlation between IL-26 level and renal biopsy in lupus nephritis.