Monitoring of Disease Biomarkers Activity and Immunophenotyping as Important Factors in SLE Clinical Management

The highly specific biomarkers for monitoring of SLE disease activity are not yetdefined up to date, due to existing of different clinical SLE phenotypes caused byindividual genetic variation. Basically, numerous clinical complications followSLE patients such as nephritis, atherosclerosis and cardial, CNS, gastrointestinal andophthalmological complications, as well. Their monitoring in clinical SLE managementcan be evaluated by analysing of specific biochemical parameters and requirepermanent clinical observation. The presence of ANAs and anti-ds-DNAs are usualdiagnostic SLE autoimmunity parameters, while SLE disease activity biomarkersare C3 and C4 level, anticardiolipin antibodies, anti-Sm/RNPs and, recently levelof CD4 and CD8 lymphocytes. However, the number of TCR molecules on the Tcellssurface at SLE patients is lower then in normal condition, and otherwise forthese receptors CD molecules make specific connection. On the other hand, theT lymphocytes can be also, therapeutical targets at SLE patients, beacause of theirclear direct involving in SLE pathogenesis. The SLE phenotypes are characterized bydouble CD negativity ( CD3+/-, CD4-) caused by abnormal level of IL-2 and IL-17.T-lymphocytes have usually alpha-beta and gamma-delta TCR receptors, but for SLEpatients is characteristic lower number gama-delta TCR molecules, detected in theperipheral blood specimens. Taking into account all of the facts, we investigated thelevel of specific usual SLE activity biomarkers (anti-ds-DNAs, C3, C4, anticardiolipinantibodies (beta-2-IgG, beta-2-IgM, ACA-G, ACA-M, CD4 and CD8 level) in serumspecimens of SLE patients who underwent to the corresponding chemotherapy incombination with other biochemical and clinical parameters. Once again proved tobe, that SLE biomarker monitoring, could be useful aproach for SLE activity diseaseand prediction organ damage, as well. In our investigation we used the followingmethods: immunofluorescence microscopy (IFA-ANA), and nephelometry, HycorELISA system and Flow cytometry, for precisely quantitative measurements. Wedetermined correlation between C3 and C4 complement components level, CD3(T-Ly), CD3+/HLA-DR and total HLA-DR with regard to SLE disease activity. Also,CD4 (Th), CD4:CD8 ratio, beta-2-G, beta-2-M not proved to be useful biomarkers inthis sense, despite some results specific for some special SLE phenotypes. Anti-Sm/RNPs proved to be better in SLE diagnostic process.