Expression And Clinical Significance Of Serum PGRN And FSTL1 In Patients With Systemic Lupus Erythematosus

Objective:To investigate the role of Progranulin and Follostatin-like-protein1 in the pathogenesis of patients with Systemic Lupus Erythematosus, the serum levels of progranulin and follistatin-like-protein1 were detected by Enzyme Linked Immunosorbent Assay(ELISA) in patients,then to study the correlation between them and disease activity.Methods :72 cases of SLE patients were recruited from Longyan First Hospital Attached Fujian Medical University June 2014 to December 2015 in this study.All of the patients met the American College of Rheumatology revised criteria in 1997 for the classification of SLE.SLE patients were divided into active group(SLEDAI?10) for 37 cases and inactive group(SLEDAI<10) for 35 cases.The control group included 36 sex and age-matched healthy volunteers from the same hospital. Then we collected the general information and clinical manifestations of patients,assessed the SLE disease activity index(SLEDAI), and detected relevant clinical laboratory parameters.The serum concentration of progranulin and follistatin-like-protein 1 in SLE and health controls were measured by Enzyme Linked Immunosorbent Assay according to the manufacturer's instruction.The serum level of TNF-? and IL10 was detected by Luminex liquidchip in 30 patients with SLE.The correlation of PGRN and FSTL1 with SLE disease activity,laboratory parameters and cytokines was analysed,as well as clinical significance.Statistical analysis was performed using SPSS 17.0.The differences between two groups were analyzed by using Non-parametric test(Mann.Whitney U-test).The relations between PGRN or FSTL1 and other variables were analyzed by using the Spearman rank correlation.A value of p< 0.05 was considered statistically significant.Results :(1)The levels of serum PGRN and FSTL1 were elevated in patients with SLE compared to the health groups(p<0.05);the levels of serum PGRN and FSTL1 in active group with SLE patients were higher than inactive group(p<0.05).(2)The levels of serum PGRN and FSTL1 in SLE patients were both positively correlated with anti-double-stranded DNA antibody titers(r=0.275 and 0.303,p=0.019 and 0.01),SLE Disease Activity Index(r=0.341 and 0.397,p=0.003 and 0.001),TNF-?(r=0.411 and 0.442,p=0.024 and 0.014)and IL10(r=0.452 and 0.438,p=0.012 and 0.016),and inversely with serum level of C3(r=-0.429 and-0.264,p = 0.000 and p=0.025).(3)After treatment, there were significant downregulation in the serum levels of PGRN and FSTL1(Pp< 0.05); the levels of which were also higher than the normal controls(p< 0.05).Conclusion :The levels of serum PGRN and FSTL1 in SLE patients were up-regulated significantly compared to the normal control.The levels of serum PGRN and FSTL1 were correlated with SLEDAI, anti-double-stranded DNA antibody titers,TNF-? and IL10.The levels of serum PGRN and FSTL1 decreased after administration of glucocorticoids and immunosuppressive drugs for three months.The present study demonstrated that PGRN and FSTL1 may play a critical role in the pathogenesis of SLE, of which dynamic monitoring can be used as a reference index of disease activity,thus contributing to guide treatment and prognosis of disease,and lead to more therapeutics for this disease.