Predictive biological markers of systemic lupus erythematosus flares: a systematic literature review

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

The aim of this study was to identify the most reliable biomarkers in the literature that could be used as flare predictors in systemic lupus erythematosus (SLE).

Methods

A systematic review of the literature was performed using two databases (MEDLINE and EMBASE) through April 2015 and congress abstracts from the American College of Rheumatology and the European League Against Rheumatism were reviewed from 2010 to 2014. Two independent reviewers screened titles and abstracts and analysed selected papers in detail, using a specific questionnaire. Reports addressing the relationships between one or more defined biological test(s) and the occurrence of disease exacerbation were included in the systematic review.

Results

From all of the databases, 4668 records were retrieved, of which 69 studies or congress abstracts were selected for the systematic review. The performance of seven types of biomarkers performed routinely in clinical practice and nine types of novel biological markers was evaluated. Despite some encouraging results for anti-double-stranded DNA antibodies, anti-C1q antibodies, B-lymphocyte stimulator and tumour necrosis factor-like weak inducer of apoptosis, none of the biomarkers stood out from the others as a potential gold standard for flare prediction. The results were heterogeneous, and a lack of standardized data prevented us from identifying a powerful biomarker.

Conclusions

No powerful conclusions could be drawn from this systematic review due to a lack of standardized data. Efforts should be undertaken to optimize future research on potential SLE biomarkers to develop validated candidates. Thus, we propose a standardized pattern for future studies.

Electronic supplementary material

The online version of this article (doi:10.1186/s13075-017-1442-6) contains supplementary material, which is available to authorized users.

Related collections

Most cited references 64

Record: found
Abstract: found
Article: not found

Anti-DNA antibodies--quintessential biomarkers of SLE.

David S Pisetsky (2016)

Antibodies that recognize and bind to DNA (anti-DNA antibodies) are serological hallmarks of systemic lupus erythematosus (SLE) and key markers for diagnosis and disease activity. In addition to common use in the clinic, anti-DNA antibody testing now also determines eligibility for clinical trials, raising important questions about the nature of the antibody-antigen interaction. At present, no 'gold standard' for serological assessment exists, and anti-DNA antibody binding can be measured with a variety of assay formats, which differ in the nature of the DNA substrates and in the conditions for binding and detection of antibodies. A mechanism called monogamous bivalency--in which high avidity results from simultaneous interaction of IgG Fab sites with a single polynucleotide chain--determines anti-DNA antibody binding; this mechanism might affect antibody detection in different assay formats. Although anti-DNA antibodies can promote pathogenesis by depositing in the kidney or driving cytokine production, they are not all alike, pathologically, and anti-DNA antibody expression does not necessarily correlate with active disease. Levels of anti-DNA antibodies in patients with SLE can vary over time, distinguishing anti-DNA antibodies from other pathogenic antinuclear antibodies. Elucidation of the binding specificities and the pathogenic roles of anti-DNA antibodies in SLE should enable improvements in the design of informative assays for both clinical and research purposes.

0 comments Cited 99 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

Personalized Immunomonitoring Uncovers Molecular Networks that Stratify Lupus Patients.

Virginia Pascual, Romain Banchereau, Seunghee Hong … (2016)

0 comments Cited 68 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

The complex nature of serum C3 and C4 as biomarkers of lupus renal flare.

Harry L. Hebert, Hong-Wu Lang, F Irshaid … (2010)

To assess the relationship between serum C3 or C4 levels and lupus renal flare, C3 and C4 levels were measured bimonthly in 71 lupus nephritis patients for a mean of 35 months, during which time 70 renal flares were identified. Comparing baseline, pre-flare, and at-flare values indicated that neither C3 nor C4 levels decreased pre-flare, but both decreased on average significantly at flare. However, sensitivity/specificity for C3 (75%/71%) and C4 (48%/71%) were low. To account for other influencing factors, multiple regression was performed that included bimonthly values of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and genotype data on C3 (S/F), CRP (1846G > A), and the complement regulator factor H (Y402H). This analysis revealed that reduced levels of C4, but not C3, were independently associated with the two-month pre-flare period. Conversely, reduced levels of C3, but not C4, were independently associated with the flare visit. Significant pro-flare interactions included low C3 levels with the factor H 402HH-encoding genotype, and low CRP levels with the C3 F allele. Together these data suggest that C4 activation is critical for initiating renal flare while C3 activation is involved in the actual tissue damage, and that these effects are influenced by genetic variability in complement activation and regulation.

0 comments Cited 58 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Noémie Gensous:

ORCID: http://orcid.org/0000-0002-8428-616X

noemie_gensous@hotmail.com

Aurélie Marti: aurelie.marti@ymail.com

Thomas Barnetche: thomas.barnetche@chu-bordeaux.fr

Patrick Blanco: patrick.blanco@chu-bordeaux.fr

Estibaliz Lazaro: estibaliz.lazaro@chu-bordeaux.fr

Julien Seneschal: julien.seneschal@chu-bordeaux.fr

Marie-Elise Truchetet: marie-elise.truchetet@chu-bordeaux.fr

Pierre Duffau: pierre.duffau@chu-bordeaux.fr

Christophe Richez: +33557820270 , christophe.richez@chu-bordeaux.fr

Journal

Journal ID (nlm-ta): Arthritis Res Ther

Journal ID (iso-abbrev): Arthritis Res. Ther

Title: Arthritis Research & Therapy

Publisher: BioMed Central (London )

ISSN (Print): 1478-6354

ISSN (Electronic): 1478-6362

Publication date (Electronic): 24 October 2017

Publication date PMC-release: 24 October 2017

Publication date (Print): 2017

Volume: 19

Electronic Location Identifier: 238

Affiliations

[1 ]ISNI 0000 0001 2106 639X, GRID grid.412041.2, ImmunoConcept, UMR CNRS 5164, , Université de Bordeaux, ; Bordeaux, France

[2 ]ISNI 0000 0001 2200 1651, GRID grid.414339.8, Department of Internal Medicine and Clinical Immunology, , Saint-Andre Hospital, ; Bordeaux, France

[3 ]ISNI 0000 0001 2200 1651, GRID grid.414339.8, Department of Dermatology, , Saint-Andre Hospital, ; Bordeaux, France

[4 ]GRID grid.414263.6, Department of Rheumatology, , Pellegrin Hospital, ; Place Amélie Raba Léon, 33076 Bordeaux, France

[5 ]Department of Internal Medicine and Infectious Diseases, Haut-Leveque Hospital, Pessac, France

Author information

Noémie Gensous http://orcid.org/0000-0002-8428-616X

Article

Publisher ID: 1442

DOI: 10.1186/s13075-017-1442-6

PMC ID: 5655881

PubMed ID: 29065901

SO-VID: 57f5d842-a212-4863-87a3-cbc9ccf7c183

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 27 April 2017

Date accepted : 25 September 2017

Custom metadata

ScienceOpen disciplines: Orthopedics

Keywords: systemic lupus erythematosus,biomarker,flare,exacerbation,systematic review

Data availability:

ScienceOpen disciplines: Orthopedics

Keywords: systemic lupus erythematosus, biomarker, flare, exacerbation, systematic review

Predictive biological markers of systemic lupus erythematosus flares: a systematic literature review

Read this article at

Abstract

Background

Methods

Results

Conclusions

Electronic supplementary material

Related collections

Orthopedics

Most cited references 64

Anti-DNA antibodies--quintessential biomarkers of SLE.

Personalized Immunomonitoring Uncovers Molecular Networks that Stratify Lupus Patients.

The complex nature of serum C3 and C4 as biomarkers of lupus renal flare.

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 604

Cited by 28

Most referenced authors 1,232