title: Milk fat globule E-8 and interleukin 17 in systemic lupus erythematosus: partners in crime?
abstract: OBJECTIVE
  Systemic lupus erythematosus (SLE) is a multi-factorial, autoimmune disease with a wide array of manifestations. The pro-inflammatory cytokine interleukin (IL)-17 has been implicated in the inflammatory response and tissue damage in SLE; however, its correlation with disease activity is still questionable. Meanwhile, efficient clearance of apoptotic cells is required for immune tolerance. An abnormally low or high level of milk fat globule (MFG-E8) can result in impaired apoptotic cell clearance and the subsequent autoimmune response. In this study, we endeavoured to compare the levels of MFG-E8 and IL-17 in SLE patients and healthy controls and to reveal the alleged association of these levels with SLE disease activity.
  
  
  METHODS
  Serum samples from 57 SLE patients and 30 healthy control subjects were examined for quantitation of MFG-E8 and IL-17 levels using ELISA. Systemic lupus erythematosus disease activity was calculated using the SLE Disease Activity Index (SLEDAI). Clinical manifestations and laboratory findings of the patients were also recorded.
  
  
  RESULTS
  We report that serum MFG-E8 levels were significantly elevated in the sera of SLE patients compared to healthy controls (p-value = 0.019). Likewise, IL-17 levels were higher in SLE patients (p-value < 0.001). A positive correlation was revealed between MFG-E8 level and proteinuria. Surprisingly, there was a poor correlation between disease activity and the levels of either IL-17 or MFG-E8.
  
  
  CONCLUSIONS
  Although serum MFG-E8 and IL-17 levels were higher in SLE patients than in normal controls, our results indicate that they cannot accurately reflect the disease activity. Meanwhile, further studies are needed to assess MFG-E8 and IL-17 as potential therapeutic targets in SLE patients.
authors.affiliation: Faculty of Medicine, Cairo University, Egypt.
authors.forename: Lamiaa
authors.initials: L
authors.lastname: Madkour
authors.affiliation: Faculty of Medicine, Cairo University, Egypt.
authors.forename: Fatema
authors.initials: F
authors.lastname: Elgengehy
authors.affiliation: Faculty of Medicine, Cairo University, Egypt.
authors.forename: Marwa
authors.initials: M
authors.lastname: Niazy
authors.affiliation: Faculty of Medicine, Cairo University, Egypt.
authors.forename: Shada
authors.initials: S
authors.lastname: Ghoneim
keywords: MFG-E8; apoptosis; autoimmune diseases; systemic lupus erythematosus