Oxidative Stress Markers and Premature Atherosclerosis in Egyptian Systemic Lupus Erythematosus Patients

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease characterized by the presence of flare of autoantibodies, especially against nuclear components. Although it is believed that the etiology of SLE is multifactorial, including immune dysfunction, genetic, hormonal and environmental, the molecular mechanisms underlying this systemic autoimmune response remain largely unknown. A key issue in the pathogenesis of lupus is how intracellular antigens become exposed and targeted by the immune system (Shah et al., 2011) In this regard, excessive production of Reactive oxygen species (ROS) and altered redox state which may cause abnormal activation of apoptosis (Munoz et al., 2008) are considered as imperative factors involved in production, expansion of antibody flares and various clinical features in SLE (Shah et al., 2011). Oxidative stress biomarkers may have a role in the future to assist clinical decisions regarding the use of antioxidant therapies and their efficacy. (Shah et al., 2014). This study was conducted to evaluate the oxidative stress in SLE patients and its correlation with the disease activity and Damage Index and the presence of atheroscler in SLE patients. The study is a case control study, that included two groups of patients, Group I enrolled thirty SLE patients, non smoker, and satisfy the American College of Rheumatology (ACR) classification revised criteria (Petri et al., 2012). They were selected from the Rheumatology and Internal Medicine inpatient department and outpatient clinic of Ain Shams hospital, after excluding patients with diabetes mellitus (before the onset of SLE), hypertension (before the onset of SLE), Familial hyperlipidemia and Postmenopausal females. Group II enrolled thirty apparently healthy, non smoker volunteers matched with Group I, regarding age and sex. This study showed that in SLE patients there is a significant positive correlation between MDA level and atherosclerosis, there was a significant positive correlation between MDA level and ESR, cholesterol level, trigycerides level, LDL level fasting blood sugar, 2 hours postprandial blood sugar level, intimal and carotid thickness. In our study, MDA level was higher in patients with lupus nephritis compared to MDA level in patients without lupus nephritis.