Serum myeloperoxidase level as A marker of activity in patients with systemic lupus erythematosus with lupus nephritis class III and IV
Mostafa, M., Salem, M., Ibrahim, A., Ahmad, A. (2024). Serum myeloperoxidase level as A marker of activity in patients with systemic lupus erythematosus with lupus nephritis class III and IV. EKB Journal Management System, 5(2), 150-163. doi: 10.21608/ejmr.2022.157365.1266
Mona Megahed Mostafa; Mohammed Nabil Salem; Asmaa Fathelbab Ibrahim; Asmaa Mohamad Ahmad. "Serum myeloperoxidase level as A marker of activity in patients with systemic lupus erythematosus with lupus nephritis class III and IV". EKB Journal Management System, 5, 2, 2024, 150-163. doi: 10.21608/ejmr.2022.157365.1266
Mostafa, M., Salem, M., Ibrahim, A., Ahmad, A. (2024). 'Serum myeloperoxidase level as A marker of activity in patients with systemic lupus erythematosus with lupus nephritis class III and IV', EKB Journal Management System, 5(2), pp. 150-163. doi: 10.21608/ejmr.2022.157365.1266
Mostafa, M., Salem, M., Ibrahim, A., Ahmad, A. Serum myeloperoxidase level as A marker of activity in patients with systemic lupus erythematosus with lupus nephritis class III and IV. EKB Journal Management System, 2024; 5(2): 150-163. doi: 10.21608/ejmr.2022.157365.1266

Serum myeloperoxidase level as A marker of activity in patients with systemic lupus erythematosus with lupus nephritis class III and IV

Egyptian Journal of Medical Research
Volume 5, Issue 2, April 2024, Pages 150-163    PDF (527.43 K)
Document Type: Original Article
DOI: 10.21608/ejmr.2022.157365.1266
Authors
Mona Megahed Mostafa* 1; Mohammed Nabil Salem2; Asmaa Fathelbab Ibrahim3; Asmaa Mohamad Ahmad2
1Resident of internal medicine, Beni-Suef University Hospital, Beni-Suef, Egypt.
2Internal medicine department, Beni-Suef University Hospital, Beni-Suef University, Egypt.
3Clinical and chemical pathology department, Faculty of medicine, Beni-Suef University, Egypt.
Abstract
Aim: The aim of the study was to assess serum levels of MPO in lupus nephritis class III and IV patients and their relationship with disease activity parameters.Methods: Forty patients with Systemic Lupus Erythematosus (SLE) and forty healthy controls were investigated in this study diagnosed according to European league against rheumatism &American colleague of rheumatology 2019(EULAR/ ACR) Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and laboratory parameters, including erythrocyte sedimentation rate, ANA, anti-ds DNA antibody, complement 3, complement 4 levels and CRP were analyzed. The serum myeloperoxidase (MPO) was determined using enzyme-linked immunosorbent assay. Results: The mean Anti ds DNA, complement 3&4, ESR, and ANA titer were significantly higher among cases than controls. The mean myeloperoxidase marker was significantly higher among cases than controls (p value <0.001*). Serum myeloperoxidase had a significant role in prediction of lupus nephritis at a cut off more than 178.5; it can predict the LN with 80% sensitivity, 50% specificity, 61.5% PPV and 71.4% NPV. The A/C ratio seemed to be highly predictor for LN than the serum myeloperoxidase as at a cut off more than 30, it can predict the LN with 100% sensitivity, 97.5% specificity, 97.6% PPV and 100% NPV. Conclusion:   This study suggests a good correlation between MPO and SLE disease activity index indicating its direct involvement in inflammatory conditions associated with disease.
Keywords
Myeloperoxidase; SLE; SLEDAI; EULAR/ ACR
References

  1. Somers, E. C., Marder, W., Cagnoli, P., Lewis, E. E., DeGuire, P., Gordon, C., ... & McCune, W. J. (2014). Population‐based incidence and prevalence of systemic lupus erythematosus: the Michigan Lupus Epidemiology and Surveillance program. Arthritis & rheumatology, 66(2), 369-378.
  2. Sproston, N. R., & Ashworth, J. J. (2018). Role of C-reactive protein at sites of inflammation and infection. Front Immunol. 2018; 9: 754. URL: https://www. frontiersin. org/articles/10.3389/fimmu.
  3. Tsokos, G. C., Lo, M. S., Reis, P. C., & Sullivan, K. E. (2016). New insights into the immunopathogenesis of systemic lupus erythematosus. Nature Reviews Rheumatology, 12(12), 716-730.
  4. Touma, Z., Gladman, D. D., Ibañez, D., & Urowitz, M. B. (2011). Development and initial validation of the systemic lupus erythematosus disease activity index 2000 responder index 50. The Journal of rheumatology, 38(2), 275-284.
  5. Cambridge, G., Wallace, H., Bernstein, R. M., & Leaker, B. (1994). Autoantibodies to myeloperoxidase in idiopathic and drug-induced systemic lupus erythematosus and vasculitis. Rheumatology, 33(2), 109-114.
  6. Telles, R. W., Ferreira, G. A., Silva, N. P. D., & Sato, E. I. (2010). Increased plasma myeloperoxidase levels in systemic lupus erythematosus. Rheumatology international, 30(6), 779-784.
  7. Aringer, M., Costenbader, K., Daikh, D., Brinks, R., Mosca, M., Ramsey‐Goldman, R., ... & Johnson, S. R. (2019). 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Arthritis & rheumatology, 71(9), 1400-1412.
  8. Weening, J. J., D'agati, V. D., Schwartz, M. M., Seshan, S. V., Alpers, C. E., Appel, G. B., ... & Nagata, M. (2004). The classification of glomerulonephritis in systemic lupus erythematosus revisited. Kidney international, 65(2), 521-530.
  9. Mok C, Penn H, Chan K, Tse SM, Langman LJ , Jannetto PJ. 2016.Hydroxychloroquine serum concentrations and flares of systemic lupus erythematosus: a longitudinal cohort analysis. Arthritis Care Res. 68(9):1295–302.
  10. Nasr, S. H., D'Agati, V. D., Park, H. R., Sterman, P. L., Goyzueta, J. D., Dressler, R. M., ... & Markowitz, G. S. (2008). Necrotizing and crescentic lupus nephritis with antineutrophil cytoplasmic antibody seropositivity. Clinical Journal of the American Society of Nephrology, 3(3), 682-690.
  11. Jennette, J. C., Falk, R. J., Hu, P., & Xiao, H. (2013). Pathogenesis of antineutrophil cytoplasmic autoantibody–associated small-vessel vasculitis. Annual review of pathology, 8, 139.
  12. Pieterse, E., & van der Vlag, J. (2014). Breaking immunological tolerance in systemic lupus erythematosus. Frontiers in immunology, 5, 164.
  13. Brinkmann, V., Reichard, U., Goosmann, C., Fauler, B., Uhlemann, Y., Weiss, D. S., ... & Zychlinsky, A. (2004). Neutrophil extracellular traps kill bacteria. science, 303(5663), 1532-1535.
  14. Fuchs, T. A., Abed, U., Goosmann, C., Hurwitz, R., Schulze, I., Wahn, V., ... & Zychlinsky, A. (2007). Novel cell death program leads to neutrophil extracellular traps. The Journal of cell biology, 176(2), 231-241.
  15. Hirai, Y., Iyoda, M., Shibata, T., Ashikaga, E., Hosaka, N., Suzuki, H., ... & Akizawa, T. (2008). Lupus nephritis associated with positive MPO-ANCA in a patient with underlying autoimmune hemolytic anemia. Clinical and Experimental Nephrology, 12(5), 393-397.
  16. Said, D., Rashad, N. M., Abdelrahmanc, N. S., & Dawaa, G. A. (2021). Antineutrophil cytoplasmic antibody in lupus nephritis: correlation with clinicopathological characteristics and disease activity. Current Rheumatology Reviews, 17(2), 213-221.
  17. Morgan, P. E., Sturgess, A. D., & Davies, M. J. (2005). Increased levels of serum protein oxidation and correlation with disease activity in systemic lupus erythematosus. Arthritis & Rheumatism, 52(7), 2069-2079.
  18. Olson, S. W., Lee, J. J., Poirier, M., Little, D. J., Prince, L. K., Baker, T. P., ... & Abbott, K. C. (2017). Anti-myeloperoxidase antibodies associate with future proliferative lupus nephritis. Autoimmune diseases, 2017.
  19. Li, C., Wang, J. J., Zhou, M. L., Liang, D. D., Yang, J., Zhu, H. X., ... & Zhang, H. T. (2019). Differences in clinico-pathological characteristics and outcomes between proteinase 3-ANCA positivity and myeloperoxidase-ANCA positivity in lupus nephritis. Lupus, 28(9), 1111-1119.
  20. Yu, F., Tan, Y., Liu, G., Wang, S. X., Zou, W. Z., & Zhao, M. H. (2009). Clinicopathological characteristics and outcomes of patients with crescentic lupus nephritis. Kidney international, 76(3), 307-317.
Statistics
Article View: 160
PDF Download: 83