title: Reduced expression of CD44 on monocytes and neutrophils in systemic lupus erythematosus: relations with apoptotic neutrophils and disease activity.
abstract: BACKGROUND
  Increased numbers of apoptotic neutrophils, and impaired monocyte/macrophage clearance of apoptotic cells, have been demonstrated in systemic lupus erythematosus (SLE). CD44 is implicated in the clearance of apoptotic neutrophils.
  
  
  OBJECTIVE
  To determine the expression of CD44 on peripheral blood monocytes and neutrophils in SLE, and examine the relations with disease activity and numbers of circulating apoptotic neutrophils.
  
  
  METHODS
  Peripheral blood was sampled from 31 patients with SLE, 19 healthy normal subjects, and 19 patients with rheumatoid arthritis (RA). Monocyte and neutrophil density of surface CD44 expression was determined by immunofluorescence labelling and flow cytometry, and results expressed as mean channel fluorescence (MCF) values. Neutrophil apoptosis was measured by morphology in 15 patients with SLE, nine with RA, and six normal subjects.
  
  
  RESULTS
  Monocyte CD44 expression was significantly lower in SLE (median MCF 4.71) than in healthy normal subjects (median MCF 5.61) and controls with RA (median MCF 5.39). Neutrophil CD44 expression was also significantly lower in SLE (median MCF 1.95) than in healthy normal subjects (median MCF 2.37) and controls with RA (median MCF 2.60). Monocyte, but not neutrophil, CD44 expression correlated negatively with the percentage of apoptotic neutrophils. There was no significant correlation of monocyte or neutrophil CD44 expression in SLE with disease activity or damage.
  
  
  CONCLUSIONS
  Monocyte and neutrophil CD44 expression is reduced in SLE, and this may contribute to the impaired recognition and clearance of apoptotic neutrophils by monocyte derived macrophages.
authors.affiliation: Queen's University Musculoskeletal Education and Research Unit, Department of Rheumatology, Musgrave Park Hospital, Belfast, Northern Ireland, UK. andrewcairns@hotmail.com
authors.forename: A P
authors.initials: AP
authors.lastname: Cairns
authors.forename: A D
authors.initials: AD
authors.lastname: Crockard
authors.forename: J R
authors.initials: JR
authors.lastname: McConnell
authors.forename: P A
authors.initials: PA
authors.lastname: Courtney
authors.forename: A L
authors.initials: AL
authors.lastname: Bell
mesh_terms: D017209:Apoptosis / Q000502:physiology*; D001172:Arthritis, Rheumatoid / Q000276:immunology / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D005434:Flow Cytometry; D005455:Fluorescent Antibody Technique; D006801:Humans; D018960:Hyaluronan Receptors / Q000378:metabolism*; D007963:Leukocytes, Mononuclear / Q000378:metabolism*; D008180:Lupus Erythematosus, Systemic / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000502:physiology*; D018709:Statistics, Nonparametric
chemical_list: D018960:Hyaluronan Receptors