Koliadenko D. The value of inflammatory markers, interleukin-10 and specific autoantibodies for assessing the activity and predicting the course of systemic lupus erythematosus

The dissertation is devoted to improving the assessment of activity, diagnosis of organ involvement and prediction of response to treatment of systemic lupus erythematosus (SLE) based on a comprehensive study of traditional and additional markers of inflammation, interleukin-10 (IL-10) and a spectrum of specific autoantibodies, their relationship with clinical and laboratory features of the disease. The study consisted of retrospective and prospective parts. In the retrospective descriptive part (197 patients), the clinical significance of traditional laboratory parameters – inflammatory markers (erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)) and autoantibodies characteristic of SLE – was evaluated. The prospective study included the following stages: initial visit (138 patients) and follow-up visit (101 patients) in 2-12 months, where changes in SLE activity and achievement of the treatment goal were assessed. In addition, in 79 SLE patients and 17 healthy individuals of appropriate age and sex (to obtain normative values), serum levels of additional laboratory parameters of inflammatory syndrome were determined during the initial visit – high-sensitivity CRP (hsCRP), interleukin-6 (IL-6), IL-10, antibodies to CRP (anti-CRP), and also procalcitonin and presepsin. Among the total cohort of patients with SLE, there were significantly more women (88%). The age of the patients at the time of evaluation was 37 (26-49) years, at the time of SLE onset – 28 (20-40) years. Low SLE activity (SLEDAI-2K index ≤4 points) was observed in 21% of patients, moderate activity (SLEDAI-2K 5-10 points) – in 33%, high activity (SLEDAI-2K >10 points) – in 46% of patients. The median value of the SLEDAI- 2K index was 10 (6-16) points, and the SLICC/ACR DI damage index was 1 (0-2) point. The spectrum of the clinical presentation in the study cohort corresponded to the well- known manifestations of the disease. At the time of inclusion in the study, 60% of patients were treated with oral glucocorticoids (GC), 55% with aminoquinolines, and 10% with other immunosuppressive drugs. The average daily dose of oral prednisolone at the time of the examination was 10 (10-15) mg. According to clinical and laboratory characteristics, the groups of patients from the retrospective and prospective studies were mostly comparable.