Circulating endothelial cells as a marker of vascular dysfunction in patients with systemic lupus erythematosus by real-time polymerase chain reaction.
BACKGROUND
Systemic lupus erythematosus (SLE) is associated with an increased risk of atherosclerosis; endothelial dysfunction represents the first step in its pathogenesis.


OBJECTIVE
To assess endothelial dysfunction in SLE by circulating endothelial cells (CECs) and to characterize SLE-specific factors that contribute to its appearance.


METHODS
Case-control study was conducted on 60 subjects, divided into 2 groups: group A (30 patients with SLE) and group B (30 healthy sex- and age-matched controls). Total cholesterol, triglycerides, antinuclear antibodies, anti-double-stranded DNA antibodies, and C3 were determined in all patients. Systemic lupus erythematosus activity was assessed using the SLE Disease Activity Index. Endothelial function was assessed by means of flow-mediated dilation of the brachial artery using B-mode ultrasonography and relative quantification of CD 146 mRNA by real-time polymerase chain reaction.


RESULTS
The group of SLE patients was formed of 20 females and 10 males, with a mean age of 31.16 ± 9.69 years. The values of SLE-specific tests and SLE Disease Activity Index were represented by anti-double-stranded DNA antibodies 160 ± 40.5, C3 68.91 ± 11.91 mg/dL, total cholesterol 188.66 ± 49.63 mg/dL, triglycerides 143.41 ± 46.26 mg/dL, and SLE Disease Activity Index 12.66 ± 3.70. Values for flow-mediated dilation were 8.85% ± 2.02% (group A) and 20.33% ± 6.19% (group B), P < .001, and CECs were 300 ± 40.5 μL⁻¹ blood (group A) and 10 ± 2.5 μL⁻¹ blood (group B). The statistical analysis showed a strong inverse correlation between CECs and SLE Disease Activity Index, a strong correlation between CECs and C3, a strong correlation between CECs and anti-double-stranded DNA antibodies, and a moderate inverse correlation between CECs and total cholesterol.


CONCLUSIONS
Endothelial dysfunction is present in SLE patients even in the absence of traditional cardiovascular risk factors due to disease activity.
Department of Clinical Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Fadia M
FM
Attia
Ahmed
A
Maaty
Fawzy Attia
FA
Kalil
D000328:Adult; D050197:Atherosclerosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D016022:Case-Control Studies; D042783:Endothelial Cells / Q000502:physiology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000503:physiopathology*; D008297:Male; D060888:Real-Time Polymerase Chain Reaction