Association between levels of anti-double-stranded DNA and concurrent flares in systemic lupus erythematosus patients

Abstract EN

Objective : to determine the degree to which changes in anti-double-stranded DNA (anti-dsDNA), [as determined by enzyme-linked immunosorbent assays (ELISA)] were associated with changes in systemic lupus erythematous (SLE) activity.

Methods : disease activity and anti-ds DNA were measured monthly in 26 SLE patients who were followed-up for one year.

Lupus flare was defined as an increase in M-SLEDAI>3 within a one month period.

Flare rates were calculated for groups, which were defined by “previous” (1 month prior to the flare) or “concurrent” (at the time of the flare) changes in anti-ds DNA.

Logistic regression models were used to determine the significance of the association between recent changes in anti-ds DNA and flares.

Results : Flares occurred at 19 % of visits, based on M.SLEDAI measure of disease activity.

A concurrent decrease in anti-ds DNA (ELISA) was associated with significantly higher flare rates based on M.SLEDAI (14 of 45, 30 % ; p = 0.002).

Flare rates were also significantly higher after a previous increase in anti-ds DNA (13 of 45, 30 % ; p = 0.002).

Flare rates tended to be lowest when there was a concurrent increase in anti-ds DNA (ELISA).

Analysis of specific organ systems showed that a concurrent decrease in anti-ds DNA (ELISA) was significantly associated with increases in renal disease acitivity (11 of 44, 25 % ; p = 0.02) Conclusion: A previous increase in anti-ds DNA levels occurred before SLE flares as measured with the M-SLEDAI.

However, during lupus flares, including the subject of renal flares, anti-ds DNA levels frequently decreased.

We hypothesize that this decrease in anti-ds DNA represents disposition in tissue at the time of flare.