The assessment of serum-mediated phagocytosis of necrotic material by polymorphonuclear leukocytes to diagnose and predict the clinical features of systemic lupus erythematosus: an observational longitudinal study

Michele Compagno; Birgitta Gullstrand; Søren Jacobsen; Gro Ø Eilertsen; Jan Åke Nilsson; Christian Lood; Andreas Jönsen; Lennart Truedsson; Gunnar Sturfelt; Anders A Bengtsson

doi:10.1186/s13075-016-0941-1

The assessment of serum-mediated phagocytosis of necrotic material by polymorphonuclear leukocytes to diagnose and predict the clinical features of systemic lupus erythematosus: an observational longitudinal study

Michele Compagno, Birgitta Gullstrand, Søren Jacobsen, Gro Ø Eilertsen, Jan Åke Nilsson, Christian Lood, Andreas Jönsen, Lennart Truedsson, Gunnar Sturfelt, Anders A Bengtsson

Institut for Klinisk Medicin

5 Citationer (Scopus)

33 Downloads (Pure)

Abstract

BACKGROUND: Serum-mediated phagocytosis of antibody- and complement-opsonized necrotic cell material (NCM) by polymorphonuclear leukocytes can be quantified by using a flow cytometry-based assay. The phagocytosis of necrotic cell material (PNC) assay parallels the well-known lupus erythematosus cell test. In this study, we aimed to investigate the diagnostic accuracy of the assay and the relationship with clinical manifestations and disease activity in systemic lupus erythematosus (SLE).

METHODS: The diagnostic accuracy for SLE diagnosis of the PNC assay was studied by cross-sectional assessment of blood samples from 148 healthy control subjects and a multicenter rheumatic group (MRG) of 529 patients with different rheumatic symptoms. A cohort of 69 patients with an established SLE diagnosis (SLE cohort) underwent longitudinal clinical and laboratory follow-up for analysis of the temporal relationships between PNC positivity and specific clinical manifestations.

RESULTS: In 35 of 529 MRG patients, 13 of whom had SLE, the PNC assay result was positive. Combined positivity of the PNC assay and anti-double-stranded DNA antibodies increased specificity and positive predictive value for SLE diagnosis to 0.99 and 0.67, respectively. In the longitudinal study, 42 of 69 SLE cohort patients had positive results in the PNC assay at least once. PNC assay positivity was associated with current hematological manifestations and could predict mucocutaneous manifestations. When combined with hypocomplementemia, PNC positivity preceded increased Systemic Lupus Erythematosus Disease Activity Index 2000 score, glomerulonephritis, and alopecia.

CONCLUSIONS: Serum-mediated PNC by polymorphonuclear leukocytes is commonly but not exclusively seen in patients with SLE. The PNC assay may be used in follow-up of patients with SLE and, especially in combination with other routinely assessed laboratory tests, may help to predict flares and different clinical manifestations, including glomerulonephritis. Our results encourage further development of the PNC assay as a complementary laboratory tool in management of patients with SLE.

Originalsprog	Engelsk
Artikelnummer	44
Tidsskrift	Arthritis Research & Therapy
Vol/bind	18
Antal sider	11
ISSN	1478-6354
DOI	https://doi.org/10.1186/s13075-016-0941-1
Status	Udgivet - 10 feb. 2016

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Citationsformater

Compagno, M., Gullstrand, B., Jacobsen, S., Eilertsen, G. Ø., Nilsson, J. Å., Lood, C., Jönsen, A., Truedsson, L., Sturfelt, G., & Bengtsson, A. A. (2016). The assessment of serum-mediated phagocytosis of necrotic material by polymorphonuclear leukocytes to diagnose and predict the clinical features of systemic lupus erythematosus: an observational longitudinal study. Arthritis Research & Therapy, 18, [44]. https://doi.org/10.1186/s13075-016-0941-1

The assessment of serum-mediated phagocytosis of necrotic material by polymorphonuclear leukocytes to diagnose and predict the clinical features of systemic lupus erythematosus : an observational longitudinal study. / Compagno, Michele; Gullstrand, Birgitta; Jacobsen, Søren et al.

I: Arthritis Research & Therapy, Bind 18, 44, 10.02.2016.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Compagno, M, Gullstrand, B, Jacobsen, S, Eilertsen, GØ, Nilsson, JÅ, Lood, C, Jönsen, A, Truedsson, L, Sturfelt, G & Bengtsson, AA 2016, 'The assessment of serum-mediated phagocytosis of necrotic material by polymorphonuclear leukocytes to diagnose and predict the clinical features of systemic lupus erythematosus: an observational longitudinal study', Arthritis Research & Therapy, bind 18, 44. https://doi.org/10.1186/s13075-016-0941-1

Compagno M, Gullstrand B, Jacobsen S, Eilertsen GØ, Nilsson JÅ, Lood C et al. The assessment of serum-mediated phagocytosis of necrotic material by polymorphonuclear leukocytes to diagnose and predict the clinical features of systemic lupus erythematosus: an observational longitudinal study. Arthritis Research & Therapy. 2016 feb. 10;18:44. doi: 10.1186/s13075-016-0941-1

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abstract = "BACKGROUND: Serum-mediated phagocytosis of antibody- and complement-opsonized necrotic cell material (NCM) by polymorphonuclear leukocytes can be quantified by using a flow cytometry-based assay. The phagocytosis of necrotic cell material (PNC) assay parallels the well-known lupus erythematosus cell test. In this study, we aimed to investigate the diagnostic accuracy of the assay and the relationship with clinical manifestations and disease activity in systemic lupus erythematosus (SLE).METHODS: The diagnostic accuracy for SLE diagnosis of the PNC assay was studied by cross-sectional assessment of blood samples from 148 healthy control subjects and a multicenter rheumatic group (MRG) of 529 patients with different rheumatic symptoms. A cohort of 69 patients with an established SLE diagnosis (SLE cohort) underwent longitudinal clinical and laboratory follow-up for analysis of the temporal relationships between PNC positivity and specific clinical manifestations.RESULTS: In 35 of 529 MRG patients, 13 of whom had SLE, the PNC assay result was positive. Combined positivity of the PNC assay and anti-double-stranded DNA antibodies increased specificity and positive predictive value for SLE diagnosis to 0.99 and 0.67, respectively. In the longitudinal study, 42 of 69 SLE cohort patients had positive results in the PNC assay at least once. PNC assay positivity was associated with current hematological manifestations and could predict mucocutaneous manifestations. When combined with hypocomplementemia, PNC positivity preceded increased Systemic Lupus Erythematosus Disease Activity Index 2000 score, glomerulonephritis, and alopecia.CONCLUSIONS: Serum-mediated PNC by polymorphonuclear leukocytes is commonly but not exclusively seen in patients with SLE. The PNC assay may be used in follow-up of patients with SLE and, especially in combination with other routinely assessed laboratory tests, may help to predict flares and different clinical manifestations, including glomerulonephritis. Our results encourage further development of the PNC assay as a complementary laboratory tool in management of patients with SLE.",

keywords = "Adolescent, Adult, Aged, Biomarkers, Cohort Studies, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Longitudinal Studies, Lupus Erythematosus, Systemic, Male, Middle Aged, Necrosis, Neutrophils, Phagocytosis, Predictive Value of Tests, Young Adult, Journal Article, Observational Study",

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TY - JOUR

T1 - The assessment of serum-mediated phagocytosis of necrotic material by polymorphonuclear leukocytes to diagnose and predict the clinical features of systemic lupus erythematosus

T2 - an observational longitudinal study

AU - Compagno, Michele

AU - Gullstrand, Birgitta

AU - Jacobsen, Søren

AU - Eilertsen, Gro Ø

AU - Nilsson, Jan Åke

AU - Lood, Christian

AU - Jönsen, Andreas

AU - Truedsson, Lennart

AU - Sturfelt, Gunnar

AU - Bengtsson, Anders A

PY - 2016/2/10

Y1 - 2016/2/10

N2 - BACKGROUND: Serum-mediated phagocytosis of antibody- and complement-opsonized necrotic cell material (NCM) by polymorphonuclear leukocytes can be quantified by using a flow cytometry-based assay. The phagocytosis of necrotic cell material (PNC) assay parallels the well-known lupus erythematosus cell test. In this study, we aimed to investigate the diagnostic accuracy of the assay and the relationship with clinical manifestations and disease activity in systemic lupus erythematosus (SLE).METHODS: The diagnostic accuracy for SLE diagnosis of the PNC assay was studied by cross-sectional assessment of blood samples from 148 healthy control subjects and a multicenter rheumatic group (MRG) of 529 patients with different rheumatic symptoms. A cohort of 69 patients with an established SLE diagnosis (SLE cohort) underwent longitudinal clinical and laboratory follow-up for analysis of the temporal relationships between PNC positivity and specific clinical manifestations.RESULTS: In 35 of 529 MRG patients, 13 of whom had SLE, the PNC assay result was positive. Combined positivity of the PNC assay and anti-double-stranded DNA antibodies increased specificity and positive predictive value for SLE diagnosis to 0.99 and 0.67, respectively. In the longitudinal study, 42 of 69 SLE cohort patients had positive results in the PNC assay at least once. PNC assay positivity was associated with current hematological manifestations and could predict mucocutaneous manifestations. When combined with hypocomplementemia, PNC positivity preceded increased Systemic Lupus Erythematosus Disease Activity Index 2000 score, glomerulonephritis, and alopecia.CONCLUSIONS: Serum-mediated PNC by polymorphonuclear leukocytes is commonly but not exclusively seen in patients with SLE. The PNC assay may be used in follow-up of patients with SLE and, especially in combination with other routinely assessed laboratory tests, may help to predict flares and different clinical manifestations, including glomerulonephritis. Our results encourage further development of the PNC assay as a complementary laboratory tool in management of patients with SLE.

AB - BACKGROUND: Serum-mediated phagocytosis of antibody- and complement-opsonized necrotic cell material (NCM) by polymorphonuclear leukocytes can be quantified by using a flow cytometry-based assay. The phagocytosis of necrotic cell material (PNC) assay parallels the well-known lupus erythematosus cell test. In this study, we aimed to investigate the diagnostic accuracy of the assay and the relationship with clinical manifestations and disease activity in systemic lupus erythematosus (SLE).METHODS: The diagnostic accuracy for SLE diagnosis of the PNC assay was studied by cross-sectional assessment of blood samples from 148 healthy control subjects and a multicenter rheumatic group (MRG) of 529 patients with different rheumatic symptoms. A cohort of 69 patients with an established SLE diagnosis (SLE cohort) underwent longitudinal clinical and laboratory follow-up for analysis of the temporal relationships between PNC positivity and specific clinical manifestations.RESULTS: In 35 of 529 MRG patients, 13 of whom had SLE, the PNC assay result was positive. Combined positivity of the PNC assay and anti-double-stranded DNA antibodies increased specificity and positive predictive value for SLE diagnosis to 0.99 and 0.67, respectively. In the longitudinal study, 42 of 69 SLE cohort patients had positive results in the PNC assay at least once. PNC assay positivity was associated with current hematological manifestations and could predict mucocutaneous manifestations. When combined with hypocomplementemia, PNC positivity preceded increased Systemic Lupus Erythematosus Disease Activity Index 2000 score, glomerulonephritis, and alopecia.CONCLUSIONS: Serum-mediated PNC by polymorphonuclear leukocytes is commonly but not exclusively seen in patients with SLE. The PNC assay may be used in follow-up of patients with SLE and, especially in combination with other routinely assessed laboratory tests, may help to predict flares and different clinical manifestations, including glomerulonephritis. Our results encourage further development of the PNC assay as a complementary laboratory tool in management of patients with SLE.

KW - Adolescent

KW - Adult

KW - Aged

KW - Biomarkers

KW - Cohort Studies

KW - Cross-Sectional Studies

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Longitudinal Studies

KW - Lupus Erythematosus, Systemic

KW - Male

KW - Middle Aged

KW - Necrosis

KW - Neutrophils

KW - Phagocytosis

KW - Predictive Value of Tests

KW - Young Adult

KW - Journal Article

KW - Observational Study

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DO - 10.1186/s13075-016-0941-1

M3 - Journal article

C2 - 26860519

SN - 1478-6354

VL - 18

JO - Arthritis Research & Therapy

JF - Arthritis Research & Therapy

M1 - 44

ER -