الفهرس | Only 14 pages are availabe for public view |
Abstract ABSTRACT Background: In systemic lupus erythematosus (SLE), the increased rate of apoptosis combined with an inefficient clearance of apoptotic cells leads to accumulation of damage associated molecular pattern (DAMPs) and activation of NLRP3 inflammasome. NLRP3 overstimulation was involved in the pathogenesis of lupus nephritis (LN). Objective: to measure the peripheral expression of NLRP3 among pediatric patients with SLE and LN in correlation to markers of activity. Methods: This pilot, cross-sectional controlled study was conducted in the Pediatric Allergy, Immunology, Rheumatology Unit, Children’s Hospital, Ain Shams University, Cairo, Egypt, from Jan 2022 to Jan 2024. Fifty-six patients with confirmed SLE and active LN with or without other system activity were compared to age and sex matched 56 healthy controls as regards expression of NLRP3 protein in the peripheral blood using enzyme linked immunosorbent assay (ELISA) technique (Human NLRP3 ELISA Kit). Results: Peripheral expression of NLRP3 was significantly higher among patients with juvenile SLE than controls. NLRP3 protein was significantly higher among SLE patients in active LN than healthy control (p value <0.001). Other systemic activities were present within 27/56 patients, 11/56 (19.6%) patients had cardiac manifestations, and 16 patients (28.6%) had neurological manifestations related to SLE. SLE disease activity index (SLEDAI) was 32.4 (SD 7.6), ranged between 18 and 48 and it was significantly correlated to peripheral NLRP3. LN class, level of C3 consumption, proteinuria and kidney functions were not correlated to levels of NLRP3 protein. Conclusion: Expression of NLRP3 inflammasome in the peripheral blood was significantly elevated in juvenile SLE with LN compared to controls, with significant correlation to SLEDAI, but not to LN class or markers of activity. Comparing pediatric patients with SLE without LN to those with LN as regards peripheral expression of NLRP3, and comparing renal NLRP3 inflammasome to its peripheral expression in patients with LN are recommended. |