Lupus & antiphospholipid syndrome
Dysregulated soluble immune mediators and lupus-associated autoantibody specificities inform the development of immune indexes that characterise classified systemic lupus erythematosus (SLE) transition and SLE disease activity
Authors' conclusion
We have conceptualised two immune mediator-informed indexes, the LCRII that predicts SLE from months to years before clinical presentation, and the LDAII that analogously predicts active disease in SLE to distinguish patients who would benefit from early intervention.
Study context
- Population
- Military personnel who developed classified SLE, lupus blood relatives and SLE patients, with matched controls
- Comparison
- Immune indexes (Lupus Classification Risk Index (LCRII), Lupus Disease Activity Immune Index (LDAII)) from soluble immune mediators and SLE-associated autoantibodies: pre-SLE vs matched controls; active vs low SLE disease activity
- Pre-SLE military personneln = 84
- Relatives who developed SLEn = 56
- Unaffected relativesn = 154reference
- Unrelated controlsn = 77reference
- Active diseasen = 179
- Low diseasen = 132reference
- Matched controls (LDAII)n = 48reference
- Outcome
- Discrimination of pre-SLE individuals before classification (LCRII) and of active vs low SLE disease activity (LDAII)
Methodological detailsmatched controls, random forest modelling
- Matched controls
- Random forest modelling
Performance
As reported in the abstract
- AUC, LCRII differentiating pre-SLE individuals before reaching disease classification
- ≥0.79
- P
- p<0.0001
- Effect size
- ≥1.1
Further findings
LCRII differentiating pre-SLE individuals even before the appearance of clinical criteria
- AUC, LCRII differentiating pre-SLE individuals before clinical criteria
- ≥0.74
- P
- P < 0.0001
- Effect size
- ≥0.9
LCRII-32, LCRII-17 and select mediators (MCP-3/CCL7, TNFRII, stem cell factor (SCF), IL-1α, IP-10/CXCL10, TGF-β) differentiating renal and serositis classification criteria
- Differentiated renal and serositis classification criteria
- P < 0.05
LDAII (26 or 13 mediators) differentiating low (hSLEDAI <4) vs active (hSLEDAI ≥4) disease
- AUC
- >0.6
- P
- P ≤ 0.002
- Effect size
- ≥0.4
LDAII differentiating clinical/serologic active vs quiescent disease
- AUC
- ≥0.7
- P
- P < 0.0001
- Effect size
- ≥0.6
LDAII-26, LDAII-13 and select mediators (MCP-1/CCL2, TNFRII, SCF, IL-2Rα, IL-10, TGF-β) and renal and serositis manifestations
- Differentiated renal and serositis manifestations
Original publication
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