OX40/OX40L in systemic lupus erythematosus: association with disease activity and lupus nephritis.
OBJECTIVE
OX40-OX40L interaction is implicated in the pathogenesis of systemic lupus erythematosus (SLE). We evaluated the role of OX40/OX40L as markers of disease activity and nephritis in SLE patients.


METHODS
Case-control study conducted in 2009 on SLE patients attending the outpatient clinics of Ain Shams University Hospital, Egypt.


METHODS
We assessed the percentage of CD4+ T-lymphocytes expressing OX40 by flowcytometry, and serum OX40 ligand (OX40L) levels in 40 patients with SLE (20 with lupus nephritis and 20 without) and in 20 healthy controls. Disease activity was assessed by the University of Toronto SLE disease activity index (SLEDAI).


RESULTS
The percentage of CD4+ T-lymphocytes expressing OX40 was significantly higher in SLE patients than in controls, and in patients with lupus nephritis than in those without. OX40 expression correlated positively with both serum creatinine levels and SLEDAI. OX40 expression was the highest in patients with class V lupus nephritis and lowest in class II. Serum OX40L levels were significantly higher in SLE patients than in controls, and in patients with nephritis than in those without. Serum OX40L levels correlated with serum creatinine levels but not with SLEDAI. OX40 expression on CD4+ T-cells had a higher sensitivity and specificity in diagnosing lupus nephritis than both OX40L and anti-double-stranded DNA levels.


CONCLUSIONS
OX40-OX40L interaction plays a role in the pathogenesis of SLE. The expression of OX40 on CD4+ T-lymphocytes and the serum level of OX40L may act as markers of lupus nephritis. Measurements of percentages of CD4+ T-lymphocytes expressing OX40 may serve as an indicator of disease activity in SLE.
Department of Internal Medicine, Allergy and Clinical Immunology, Ain Shams University, Cairo, Egypt.
Mohamed N
MN
Farres
Dina S
DS
Al-Zifzaf
Alaa A
AA
Aly
Nermine M
NM
Abd Raboh
D000293:Adolescent; D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009393:Nephritis / Q000097:blood* / Q000175:diagnosis; D053278:OX40 Ligand / Q000097:blood*; D012372:ROC Curve; D053262:Receptors, OX40 / Q000097:blood*; D012720:Severity of Illness Index; D055815:Young Adult
D000974:Antibodies, Antinuclear; D015415:Biomarkers; D053278:OX40 Ligand; D053262:Receptors, OX40
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