Levels of VCAM-1 and ICAM-1 in serum of active and inactive Systemic Lupus Erythematosus patients as biochemical markers for risk of cardiovascular disease
DOI:
https://doi.org/10.32007/jfacmedbagdad.1952Keywords:
SLE, Atherosclerosis, VCAM, ICAM, CVD, Lipid profileAbstract
Background: Cardiovascular complications represent one of the consequences of chronic autoimmune diseases such as Systemic Lupus Erythematosus (SLE), which has significant rates of morbidity and mortality. Dyslipidemia can be brought on by steroid medications, which are frequently given to SLE patients and are considered to be one of the major risk factors for cardiovascular diseases.
Objectives: This study attempted to investigate a potential association between circulating vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1) as risk factors for atherosclerosis and their relationship to cardiovascular risk.
Patients and methods: A total of 100 patients and 50 apparently healthy controls were included in the study. All patients were from the Department of Rheumatology, Baghdad Hospital / Medical City during the period from 1 December 2021 to 1 March 2022 who were all treated with antimalarial drugs as immunosuppressants such as chloroquine (CQ) or hydroxychloroquine HCQ). They were divided according to the SLE disease activity index 2000 (SLEDAI-2K) into the active group (SLEDAI ≥ 10) and the inactive group (SLEDAI).
Results: Serum VCAM and ICAM were significantly high in all study groups of SLE patients. The VCAM mean ± SD were (271.9±63.90), (247.9±82.92) and (97.7±24.69) in the active, inactive controls respectively. The ICAM mean ± SD were (3.1±0.91), (2.7±0.79) and (1.8±0.22) in the active, inactive and controls respectively. The values have increased gradually with increasing disease activity. The area under curve (AUC) of ICAM and VCAM were (0.802), (0.776) in active SLE patients and (0.858), (0.674) in inactive SLE patients. However, the AUC of VCAM and ICAM in active group were the highest.
Conclusion: In SLE patients, VCAM-1 and ICAM-1 serum levels may operate as disease detection and severity differentiation indicators, and they may be linked to the number of coronary lesions in people at risk of developing CVD.
Received: Aug.,2022
Accepted: Sept., 2022
Published: April 2023
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References
Thanou A, Jupe E, Purushothaman M, Niewold TB, Munroe ME. Clinical disease activity and flare in SLE: Current concepts and novel biomarkers. Journal of Autoimmunity. 2021 May 1;119:102615. https://doi.org/10.1016/j.jaut.2021.102615
Fanouriakis A, Tziolos N, Bertsias G, Boumpas DT. Update οn the diagnosis and management of systemic lupus erythematosus. Annals of the rheumatic diseases. 2021 Jan 1;80(1):14-25. https://doi.org/10.1136/annrheumdis-2020-218272
Kostopoulou M, Nikolopoulos D, Parodis I, Bertsias G. Cardiovascular disease in systemic lupus erythematosus: recent data on epidemiology, risk factors and prevention. Current Vascular Pharmacology. 2020 Nov 1;18(6):549-65.
https://doi.org/10.2174/1570161118666191227101636
Justiz Vaillant AA, Goyal A, Bansal P, Varacallo M. Systemic lupus erythematosus (SLE). StatPearls. Treasure Island (FL): StatPearls Publishing Copyright. 2020.
Mok CC, Tse SM, Chan KL, Ho LY. Effect of immunosuppressive therapies on survival of systemic lupus erythematosus: a propensity score analysis of a longitudinal cohort. Lupus. 2018 Apr;27(5):722-7. https://doi.org/10.1177/0961203317739129
Ruan Y, Guo Y, Zheng Y, Huang Z, Sun S, Kowal P, et al. Cardiovascular disease (CVD) and associated risk factors among older adults in six low-and middle-income countries: results from SAGE Wave 1. BMC public health. 2018 Dec;18(1):1-3.
https://doi.org/10.1186/s12889-018-5653-9
Leone P, Cicco S, Prete M, Solimando AG, Susca N, Crudele L, et al. Early echocardiographic detection of left ventricular diastolic dysfunction in patients with systemic lupus erythematosus asymptomatic for cardiovascular disease. Clinical and experimental medicine. 2020 Feb;20(1):11-9. https://doi.org/10.1007/s10238-019-00600-8
Roldan PC, Greene ER, Qualls CR, Sibbitt WL Jr, Roldan CA. Progression of atherosclerosis versus arterial stiffness with age within and between arteries in systemic lupus erythematosus. Rheumatol Int. 2019;39(6):1027-36.
https://doi.org/10.1007/s00296-019-04267- y
Benagiano M, Borghi MO, Romagnoli J, Mahler M, Della Bella C, Grassi A, et al, 2019. Interleukin-17/Interleukin-21 and Interferon-γ producing T cells specific for β2 Glycoprotein I in atherosclerosis inflammation of systemic lupus erythematosus patients with antiphospholipid syndrome. Haematologica, 104(12), p.2519.
https://doi.org/10.3324/haematol.2018.209536
Atta AM, Silva JP, Santiago MB, Oliveira IS, Oliveira RC, Sousa Atta ML. Clinical and laboratory aspects of dyslipidemia in Brazilian women with systemic lupus erythematosus. Clinical Rheumatology. 2018 Jun;37(6):1539-46.
https://doi.org/10.1007/s10067-018-4051-0
Andersen CJ. Impact of Dietary Cholesterol on the Pathophysiology of Infectious and Autoimmune Disease. Nutrients. 2018;10(6):764. https://doi.org/10.3390/nu10060764
Frieri M, Stampfl H, Systemic lupus erythematosus and atherosclerosis: review of the literature, Autoimmun. Rev. 15 (2016) 16-21. https://doi.org/10.1016/j.autrev.2015.08.007
Huang H, Liu X, Chen D, Lu Y, Li J, Du F, et al Melatonin prevents endothelial dysfunction in SLE by activating the nuclear receptor retinoic acid-related orphan receptor-α, International Immunopharmacology,Volume 83,2020,106365,ISSN 1567-5769.
https://doi.org/10.1016/j.intimp.2020.106365
Lewandowski LB, Kaplan MJ. Update on cardiovascular disease in lupus, Curr. Opin. Rheumatol. 28 (2016) 468-476. https://doi.org/10.1097/BOR.0000000000000307
Pober JS, Sessa WC. Evolving functions of endothelial cells in inflammation. Nat Rev Immunol 2007; 7: 803-815 https://doi.org/10.1038/nri2171
(16) Santos JCD, Cruz MS, Bortolin RH, Oliveira KMD, Araújo JNGD, Duarte, VHR, et al, 2018. Relationship between circulating VCAM-1, ICAM-1, E-selectin and MMP9 and the extent of coronary lesions. Clinics, 73. https://doi.org/10.6061/clinics/2018/e203
Yu KY, Yung S, Chau MK, Tang CS, Yap DY, Tang AH, et al. Clinico-pathological associations of serum VCAM-1 and ICAM-1 levels in patients with lupus nephritis. Lupus. 2021 Jun;30(7):1039-50. https://doi.org/10.1177/09612033211004727
Smith E, Corkhill R, Midgley A, Watson L, Jones C, Marks S, et al. Urinary VCAM-1 as a biomarker of lupus nephritis disease activity. Pediatric Rheumatology. 2014 Sep;12(1):1-2.
https://doi.org/10.1186/1546-0096-12-S1-P108
Gustafsson J, Gunnarsson I, Börjesson O, Pettersson S, Möller S, Fei GZ, et al., 2009. Predictors of the first cardiovascular event in patients with systemic lupus erythematosus-a prospective cohort study. Arthritis research & therapy, 11(6), pp.1-11.
https://doi.org/10.1186/ar2878
Guo Liu RN, Cheng QY, Zhou HY, Li BZ and Ye DQ. 2020. Elevated blood and urinary ICAM-1 is a biomarker for systemic lupus erythematosus: a systematic review and meta-analysis. Immunological Investigations, 49(1-2), pp.15-31.
https://doi.org/10.1080/08820139.2019.1624769
Wang D, Cai X. Smooth ROC curve estimation via Bernstein polynomials. PLoS One. 2021;16(5):e0251959. Published 2021 May 25.
https://doi.org/10.1371/journal.pone.0251959
Tan EM, Cohen AS, Fries JF, Masi AT, Mcshane DJ, Rothfield NF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 1982 Nov;25(11):1271-7.
https://doi.org/10.1002/art.1780251101
Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH, Austin A, et al. Derivation of the SLEDAI. A disease activity index for lupus patients. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 1992 Jun;35(6):630-40. https://doi.org/10.1002/art.1780350606
Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6):499-502. https://doi.org/10.1093/clinchem/18.6.499
Moradi S, Entezari MH, Mohammadi H, Jayedi A, Lazaridi AV, Kermani MA, et al. Ultra-processed food consumption and adult obesity risk: a systematic review and dose-response meta-analysis. Critical reviews in food science and nutrition. 2021 Jun 21:1-2. https://doi.org/10.1080/10408398.2021.1946005
Lecube A, Sánchez E, Monereo S, Medina-Gómez G, Bellido D, García-Almeida JM, et al. Factors Accounting for Obesity and Its Perception among the Adult Spanish Population: Data from 1,000 Computer-Assisted Telephone Interviews. Obes Facts 2020;13:322-332. doi: 10.1159/000508111. https://doi.org/10.1159/000508111
Santos MJ, Carmona-Fernandes D, Canhao H, Canas da Silva J, Fonseca JE, Gil V. Early vascular alterations in SLE and RA patients-a step towards understanding the associated cardiovascular risk.
Hoke M, Winter M, Wagner O, Exner M, Schillinger M, Arnold Z, et al. The impact of selectins on mortality in stable carotid atherosclerosis. Thromb Haemost. 2015;114(3):632-8, https://doi.org/10.1160/TH14-12-1014
Zhou B, Xia Y, She J. Dysregulated serum lipid profile and its correlation to disease activity in young female adults diagnosed with systemic lupus erythematosus: a cross-sectional study. Lipids in health and disease. 2020 Dec;19(1):1-6.
https://doi.org/10.1186/s12944-020-01232-8
Tselios K, Koumaras C, Gladman DD, Urowitz MB. Dyslipidemia in systemic lupus erythematosus: just another comorbidity?, Seminars in Arthritis and Rheumatism, Volume 45, Issue 5, 2016, Pages 604-610, ISSN 0049-0172.
https://doi.org/10.1016/j.semarthrit.2015.10.010
Szabo MZ, Szodoray P, Kiss E. Dyslipidemia in systemic lupus erythematosus. Immunol Res. 2017;65(2):543-550. https://doi.org/10.1007/s12026-016-8892-9
Atik N, Hayati RU, Hamijoyo L. Correlation Between Steroid Therapy and Lipid Profile in Systemic Lupus Erythematosus Patients. Open Access Rheumatology: Research and Reviews. 2020;12:41. https://doi.org/10.2147/OARRR.S245662
Tao CY, Shang J, Chen T, Yu D, Jiang YM, Liu D, Cheng GY, et al. 2019. Impact of antimalarial (AM) on serum lipids in systemic lupus erythematosus (SLE) patients: a systematic review and meta-analysis. Medicine, 98(14).
https://doi.org/10.1097/MD.0000000000015030
patients: a systematic review and meta-analysis. Medicine, 98(14).
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