Increased serum soluble CD14, ICAM-1 and E-selectin correlate with disease activity and prognosis in systemic lupus erythematosus

Lupus. 2000;9(8):614-21. doi: 10.1191/096120300678828749.

Abstract

To improve monitoring of immunological and disease activity, we determined soluble markers of activity of the monocyte/macrophage system (sCD14) and the vascular endothelium (sE-selectin, sICAM-1) in patients with systemic lupus erythematosus (SLE) and primary Sjögren's syndrome (pSS) in comparison to patients with infections or sepsis. Concentrations of sCD14, sICAM-1 and sE-selectin (soluble CD14, ICAM-1 and E-selectin, respectively) were measured in serum samples from patients with SLE and pSS, patients with sepsis, different infectious diseases and healthy controls using ELISA systems. Elevated levels of sE-selectin and sICAM-1 were detected in patients with SLE as well as sepsis, in contrast to patients with a localized infection (SLE and sepsis, respectively, versus infection P<0.001; Kruskal-Wallis test). Levels of sCD14 were persistently elevated in sera from patients with SLE, whereas these values decreased rapidly after effective therapy in patients with sepsis or infection. A continuous elevation of all of these three parameters was associated with a fatal outcome in patients with sepsis as well as in patients with SLE. Combined elevation of sCD14, sICAM-1 and sE-selectin correlates with the prognosis in patients with active SLE and indicates a remarkable immune activation involving the monocyte/macrophage system and the endothelium comparable to an activation found only in patients with sepsis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bacterial Infections / blood
  • Bacterial Infections / immunology
  • Candidiasis / blood
  • Candidiasis / immunology
  • E-Selectin / blood*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Intercellular Adhesion Molecule-1 / blood*
  • Lipopolysaccharide Receptors / blood*
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / physiopathology*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Sepsis / blood
  • Sepsis / immunology
  • Sjogren's Syndrome / blood
  • Sjogren's Syndrome / physiopathology

Substances

  • E-Selectin
  • Lipopolysaccharide Receptors
  • Intercellular Adhesion Molecule-1