| Abstract | Cilj: Ispitati razine serumskog kalprotektina u bolesnika oboljelih od SLE-a i ustanoviti jesu
li više u odnosu na zdrave ispitanike, ali i ovise li o samoj aktivnosti bolesti, popratnim
vaskularnim događajima te koreliraju li s vrijednostima SLEDAI-a.
Ispitanici i metode: U istraživanju je sudjelovalo ukupno 40 ispitanika, od čega 27 oboljelih
od SLE-a i 13 zdravih ispitanika. Svi se naši bolesnici liječe u Zavodu za reumatologiju i
kliničku imunologiju KBC-a Split. U Dnevnoj bolnici Zavoda ispitanicima je u svibnju i
lipnju 2023. godine uzet uzorak venske krvi koji je potom analiziran koristeći Buhlmann
sCAL dijagnostički test ELISA metodom u Zavodu za medicinsko laboratorijsku dijagnostiku
KBC-a Split. Koristeći SLEDAI indeks, odvojili smo naše bolesnike u one s aktivnom i
inaktivnom bolešću, uzevši SLEDAI jednak i viši od 6 kao vrijednost aktivne bolesti.
Proučavanjem medicinske dokumentacije definirali smo bolesnike u kojih se SLE
manifestirao kroz neki vaskularni događaj, u kliničkom smislu kao definirani APS i NPSLE, i
usporedili smo vrijednosti serumskog kalprotektina s onima u kojih se bolest nije
manifestirala kroz vaskularni događaj.
Rezultati: Vrijednosti serumskog kalprotektina bile su više u bolesnika sa SLE-om u odnosu
na kontrolu skupinu (1,1 (0.53-1.8) prema 0,7 (0,38-1,1), P=0,02). Nadalje, vrijednost
serumskog kalprotektina bila je viša u bolesnika s aktivnim SLE-om u odnosu na bolesnike u
remisiji (1,6 (1,1-3,0) prema 0,8 (0,2-1,4), P=0,02). Štoviše, vrijednost serumskog
kalprotektina u bolesnika sa SLE-a koji su u remisiji nije se statistički značajno razlikovala
od vrijednosti serumskog kalprotektina u zdravih ispitanika (0,85 (0,4-1,4) prema 0,7 (0,38-
0,93), P=0,330). Dokazali smo i da su vrijednosti serumskog kalprotektina u skupini
bolesnika koji su u anamnezi imali nekakav vaskularni incident u sklopu SLE-a bile više u
odnosu na one bolesnike u čijoj anamnezi nije bilo takvih zbivanja (1,7 (1,15-3) prema 1
(0,225-1,375), P=0,015). Dokazali smo i da je postojala pozitivna korelacija između
vrijednosti SLEDAI-a i serumskog kalprotektina u svih oboljelih od SLE-a (ρ=0.532,
P=0.0043), još izraženija u aktivnih bolesnika (ρ=0.673, P=0.0017). Dokazali smo da nije
bilo korelacije između vrijednosti SLEDAI-a i serumskog kalprotektina u bolesnika u remisiji
(ρ=0.0678, P=0.818).
Zaključak: Naše istraživanje dokazalo je da su vrijednosti serumskog kalprotektina više u
oboljelih od SLE-a, posebno u onih u aktivnoj bolesti, u odnosu na zdrave ispitanike.
Dokazali smo i da postoji veza između vaskularnih manifestacija SLE-a i vrijednosti
serumskog kalprotektina, kao i pozitivna korelacija SLEDAI-a i serumskog kalprotektina u
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lupusnih bolesnika, izražena u skupine aktivnih bolesnika, a statistički beznačajna u onih u
remisiji. |
| Abstract (english) | Objective: To examine the levels of serum calprotectin in patients with systemic lupus
erythematosus and to determine whether they are higher in the patients compared to healthy
subjects, but also whether they depend on the activity of the disease, vascular events and,
lastly, to investigate their correlation with SLEDAI.
Subjects and methods: A total of 40 subjects participated in the study, of which 27 were
SLE patients and 13 healthy subjects. Patients are treated at the Department of Rheumatology
and Clinical Immunology of the Clinical Hospital Center in Split. In May and June 2023, a
venous blood sample was taken from the subjects in the Daily Hospital of the Institute, which
was later analyzed using the Buhlmann sCAL diagnostic test by ELISA method at the
Institute for Medical Laboratory Diagnostics of the Clinical Hospital Center in Split. Using
the SLEDAI index, we separated our patients into those with active and inactive disease,
taking SLEDAI 6 as the cut-off value for active disease. By studying the medical records, we
defined patients in whom SLE manifested through a vascular event, in the such as
antiphospholipid syndrome and neuropsychiatric lupus, and we compared the values of serum
calprotectin with those in whom the disease did not manifest through a vascular event.
Results: Serum calprotectin values were higher in patients with SLE compared to the control
group (1.1 (0.53-1.8) vs. 0.7 (0.38-1.1), P=0.02). Furthermore, the value of serum
calprotectin was higher in patients with active SLE compared to patients in remission (1.6
(1.1-3.0) vs. 0.8 (0.2-1.4), P= 0.02). Moreover, the value of serum calprotectin in patients
with SLE who were in remission was not statistically significantly different from the value of
serum calprotectin in healthy subjects (0.85 (0.4-1.4) vs. 0.7 (0.38-0 .93), P=0.330). We also
proved that the values of serum calprotectin in the group of patients who had a history of
vascular incident as part of SLE were higher compared to those patients who had no history
of such events (1.7 (1.15-3) according to 1 (0.225-1.375), P=0.015). We also showed that
there was a statistically significantly positive correlation between SLEDAI values and serum
calprotectin in all SLE patients (ρ=0.532, P=0.0043), even more pronounced in active
patients (ρ=0.673, P=0.0017) . We showed that there was no statistically significantly
correlation between SLEDAI values and serum calprotectin in patients in remission
(ρ=0.0678, P=0.818).
Conclusion: Our research, although limited due to the small number of subjects and testing
patients of one Clinical Center, proved that serum calprotectin values are higher in patients
with SLE compared to healthy subjects and that patients with a more active disease,
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objectively measured using SLEDAI, had higher serum calprotectin values compared to
patients in remission (SLEDAI <6). We also proved that there is a connection between
antiphospholipid syndrome and neuropsychiatric lupus, the most common vascular
manifestations of SLE, and the value of serum calprotectin, because the patients with a higher
values were precisely those who had a clinically evident vascular incident in their medical
records. We also showed that there was a positive correlation between SLEDAI values and
serum calprotectin in all SLE patients, especially in those with active disease. There was no
correlation between SLEDAI values and serum calprotectin in patients in remission. Future
research should confirm these hypotheses on a larger number of subjects. |
