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Increased serum soluble CD14, ICAM-1 and E-selectin correlate with disease activity and prognosis in systemic lupus erythematosus

Department of Rheumatology and Clinical Immunology, Charité University Hospital, Humboldt University of Berlin, Berlin, Germany;

E Feist

Department of Rheumatology and Clinical Immunology, Charité University Hospital, Humboldt University of Berlin, Berlin, Germany; Department of Rheumatology and Clinical Immunology, Charité University Hospital, Schumannstraûe 20=21, D-10117 Berlin, Germany

U Rohr

Department of Anesthesiology and Critical Care Medicine, Charité University Hospital, Humboldt University of Berlin, Berlin, Germany

A Pruss

Institute of Transfusion Medicine, Charité and University Hospital, Humboldt University of Berlin, Berlin, Germany

G-R Burmester

T Dörner

Department of Rheumatology and Clinical Immunology, Charité University Hospital, Humboldt University of Berlin, Berlin, Germany;

To improve monitoring of immunological and disease activity, we determined soluble markers of activity of the monocyte/macrophage system (sCD14) and the vascular endothelium (sE-selectin, sICAM-1) in patients with systemic lupus erythematosus (SLE) and primary Sjögren' syndrome (pSS) in comparison to patients with infections or sepsis.

Concentrations of sCD14, sICAM-1 and sE-selectin (soluble CD14, ICAM-1 and E-selectin, respectively) were measured in serum samples from patients with SLE and pSS, patients with sepsis, different infectious diseases and healthy controls using ELISA systems.

Elevated levels of sE-selectin and sICAM-1 were detected in patients with SLE as well as sepsis, in contrast to patients with a localized infection (SLE and sepsis, respectively, versus infection P < 0.001; Kruskal–Wallis test). Levels of sCD14 were persistently elevated in sera from patients with SLE, whereas these values decreased rapidly after effective therapy in patients with sepsis or infection. A continuous elevation of all of these three parameters was associated with a fatal outcome in patients with sepsis as well as in patients with SLE.

Combined elevation of sCD14, sICAM-1 and sE-selectin correlates with the prognosis in patients with active SLE and indicates a remarkable immune activation involving the monocyte/macrophage system and the endothelium comparable to an activation found only in patients with sepsis.

Key Words: SLE • sepsis • endotoxin • sCD 14 • adhesion molecules

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