title: Up regulation of serum tumor necrosis factor-related apoptosis inducing ligand in juvenile-onset systemic lupus erythematosus: relations with disease activity, antibodies to double -stranded DNA, nephritis and neutropenia.
abstract: OBJECTIVE
  Apoptosis is induced by binding of death receptor ligands, members of the tumor necrosis factor (TNF) superfamily, to their cognate receptors. It is suggested that TNF-related apoptosis inducing ligand (TRAIL) is involved in pathogenesis of juvenile-onset systemic lupus erythematosus (JSLE). This study aimed to assess TRAIL concentrations in sera of JSLE children and to determine their potential relationship with disease activity, anti-double-stranded DNA (anti-dsDNA) levels, neutropenia and renal involvement.
  
  
  METHODS
  Circulating levels of TRAIL were measured by enzyme-linked immunosorbent assay (ELISA) in serum samples obtained from 40 JSLE patients (20 with active and 20 with inactive disease) and 20 controls.
  
  
  RESULTS
  The mean (SEM) serum TRAIL concentration in JSLE was 1750.7 (440.2) pg/mL. Serum TRAIL concentrations in patients were higher than those in controls (P < 0.01). Serum TRAIL concentrations for children with inactive disease (1854.8 [485.4] pg/mL) and those with activity (1646.6 [390.6] pg/mL) were statistically comparable. JSLE children with positive anti-dsDNA antibodies had significantly higher TRAIL levels (mean = 1846 [456] vs. 1455 [325] pg/mL; P < 0.05). Serum TRAIL concentrations were significantly higher in classes III and IV nephritis compared to classes I and II nephritis (1970 [512] vs. 1330 [331] pg/mL; P < 0.01). Serum TRAIL concentrations in patients with neutropenia were higher than those without neutropenia (1805 [505] vs. 1516 [400] pg/mL; P = 0.042) and in controls (P = 0.024).
  
  
  CONCLUSIONS
  Our data indicate that an increased level of TRAIL is a feature of JSLE that correlates with disease activity, anti-dsDNA titers neutropenia and lupus nephritis.
authors: Pediatric Rheumatology Unit, Children's Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Mohamed H M
authors: MH
authors: Ezzat
authors: Tarek M A
authors: TM
authors: El-Gammasy
authors: Kareem Y A
authors: KY
authors: Shaheen
authors: Ramzi A M
authors: RA
authors: El-Mezdawi
authors: Mervat S M
authors: MS
authors: Youssef
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D000974:Antibodies, Antinuclear / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D004247:DNA / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D008181:Lupus Nephritis / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D008297:Male; D009503:Neutropenia / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D053221:TNF-Related Apoptosis-Inducing Ligand / Q000097:blood*; D015854:Up-Regulation
chemical_list: D000974:Antibodies, Antinuclear; D015415:Biomarkers; D053221:TNF-Related Apoptosis-Inducing Ligand; C505653:TNFSF10 protein, human; D004247:DNA
keywords: TNF‐related apoptosis inducing ligand; TRAIL, tumor necrosis factor receptor family; apoptosis; juvenile‐onset systemic lupus erythematosus; nephritis; neutropenia