Pediatric rheumatology

Endotoxaemia in childhood-onset systemic lupus erythematosus induces low-density granulocytes and extracellular traps of innate immune cells

Lupus Sci MedPublished Cross-sectional study

Authors' conclusion

Endotoxaemia presented in both active and inactive lupus (possibly correlated with some bacterial groups in the gut) that caused ETs in the PBMC fraction and LDGs. However, elevated LDGs were most prominent in endotoxaemia with active lupus.

Study context

Population
Patients with childhood-onset SLE
Participants
46 patients
Exposure
Childhood-onset SLE categorised by endotoxaemia and lupus activity
  • Active lupus with endotoxaemian = 14
  • Inactive lupus with endotoxaemian = 10
  • Active lupus without endotoxaemian = 10
  • Inactive lupus without endotoxaemian = 12

Main finding

As reported in the abstract

  • Serum cytokines (tumour necrosis factor (TNF)-α, IL-6, IL-8, IL-10), serum citrullinated histone H3, cell-free DNA and bacterial-free DNA not different among groups
  • Extracellular traps in the peripheral blood mononuclear cell (PBMC) fraction (immunofluorescence of myeloperoxidase (MPO) and neutrophil elastase) elevated in endotoxaemia regardless of lupus disease activity
  • Low-density granulocytes elevated in active lupus regardless of endotoxaemia but higher with positive endotoxaemia
  • Blood microbiome: Burkholderia group the representative bacteria in active lupus with endotoxaemia
  • Incubation of LPS or bacterial-free DNA with healthy-control neutrophils altered regular-density neutrophils to low-density granulocytes (LDGs)

Observational data: associations, not effects.

Original publication

Endotoxaemia in childhood-onset systemic lupus erythematosus induces low-density granulocytes and extracellular traps of innate immune cells. Lupus Sci Med. Published 31 July 2025. doi:10.1136/lupus-2025-001663

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