Association between APRIL Gene Expression and Systemic Lupus Erythematosus
Mary Rizk1, Reem Jan2, Ashraf Genina3
1Internal Medicine Department, Cairo Medical School, 2Clinical Pathology Deparmtent, Cairo Medical School,3Internal Medicine Department, Beni Suef, Egypt.
Abstract: Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a high mortality risk if not properly treated. B cell hyperplasia has been implicated in the pathogenesis of the disease. B cells produce large quantities of autoantibodies, eventually leading to multiorgan complications. Treatments targeting B cell products appear particularly promising. APRIL is a TNF-like subclass ligand with yet unresolved implications in SLE. Some studies have accused its expression in the pathogenesis of SLE, while others negated it. Aim of work: This is to assess APRIL gene expression in SLE patients versus healthy controls and to correlate its presence with organ affection, and disease activity index. Materials and methods:This is a cross sectional study involving 40 SLE patients (35 females and 5 males), presenting in the Internal Medicine Department Cairo University. Ten healthy matched controls for age and sex were also involved. Age was 27.45 ± 8.85years. All subjects had a complete history and physical examination. Laboratory tests included CBC, ESR, urea, creatinine, ANA, antiDNA, SLEDAI, as well as APRIL gene expression. Results: We found 22 SLE patients were expressors (55%), while 18 patients (45%) were non expressers. None of the controls expressed the gene. We found astatistically significant association between APRIL gene expression in SLE patients and presence of neuropsychiatric (p<0.001) complications (fig.2), vasculitis (p< 0.05), and photosensitivity (p<0.007). There was a significantly positive correlationbetween APRIL gene expression and ACL IgG (r=0.6, p< 0.005), but not IgM or SLEDAI. Conclusion: APRIL gene expression is significantly elevated in SLE patients with vasculitis, cerebritis, and photosensitivity. It has a strong positive correlation to ACL IgG levelshence possibly correlated to antiphospholipid syndrome. This implies the future possible implementation of APRIL gene expression in prognosis and therapy targets for SLE patients.
[Mary Rizk, Reem Jan, Ashraf Genina. Association between APRIL Gene Expression and Systemic Lupus Erythematosus. Life Sci J 2013;10(1):3477-3483]. (ISSN: 1097-8135). http://www.lifesciencesite.com. 439
Key words:SLE, nephritis, vasculitis, APRIL gene, antiphospholipid syndrome. Full Text 439