title: Evaluation of Endothelial Cell Adhesion Molecules and Anti-C1q Antibody in Discriminating between Active and Non-Active Systemic Lupus Erythematosus.
abstract: BACKGROUND
  Detecting the active state of systemic lupus erythematosus (SLE) is important but challenging. This study aimed to determine the diagnostic accuracy of serum endothelial cell adhesion molecules (ICAM-1 and VCAM-1) and anti-C1q antibody in discriminating between active and non-active SLE.
  
  
  METHODS
  Using SELENA-SLE disease activity index (SLEDAI), 95 SLE patients (45 active and 50 non-active) were assessed. A score above five was considered indicative of active SLE. The blood samples were tested for serum ICAM-1, VCAM-1 and anti-C1q antibody using enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  The levels of serum VCAM-1 and anti-C1q antibody were significantly higher in active SLE patients. Both VCAM-1 and anti-C1q were able to discriminate between active and non-active SLE (p-value < 0.001 and 0.005, respectively). From the receiver operating characteristic curves (ROCs) constructed, the optimal cut-off values for VCAM-1 and anti-C1q antibody in discriminating between active and non-active SLE were 30.5 ng/mL (69.0% sensitivity, 60.0% specificity, PPV 58.5%, NPV 66.7%) and 7.86 U/mL (75.6% sensitivity, 80% specificity, PPV 77.3%, NPV 78.4%), respectively. However, serum ICAM-1 level was unable to discriminate between the two groups (p-value = 0.193).
  
  
  CONCLUSIONS
  Anti-C1q antibody demonstrated the best diagnostic accuracy in discriminating between active and non-active SLE patients.
authors.affiliation: Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
authors.forename: Hasni
authors.initials: H
authors.lastname: Mahayidin
authors.affiliation: Department of Immunology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Nurul Khaiza
authors.initials: NK
authors.lastname: Yahya
authors.affiliation: Department of Medicine, Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Wan Syamimee
authors.initials: WS
authors.lastname: Wan Ghazali
authors.affiliation: Department of Medicine, Hospital Raja Perempuan Zainab II, 15000 Kota Bharu, Kelantan, Malaysia.
authors.forename: Asmahan
authors.initials: A
authors.lastname: Mohd Ismail
authors.affiliation: Department of Immunology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Wan Zuraida
authors.initials: WZ
authors.lastname: Wan Ab Hamid
keywords: anti-C1q antibody; cell adhesion molecules; intercellular adhesion molecule-1 (ICAM-1); systemic lupus erythematosus; vascular cell adhesion molecule-1 (VCAM-1)