Serum and urine interleukin-17A levels as biomarkers of disease activity in systemic lupus erythematosus

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Abstract

Objectives: This study examined the correlations of both serum and urine interleukin-17A (IL-17A) levels with disease activity in systemic lupus erythematosus (SLE). This study was also aimed at determining their sensitivity and specificity as biomarkers of disease activity in SLE. Methods: A cross-sectional study was performed involving SLE patients (n = 120 patients) from Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Serum and urinary IL-17A levels were determined by immunoassay while disease activity was assessed using Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) and British Isles Lupus Assessment Group's 2004 index (BILAG 2004) scores. The correlations between serum and urinary IL-17A levels with total SLEDAI-2K and BILAG 2004 scores were determined using bivariate correlation analyses. Receiver operating characteristic curves were calculated to determine their sensitivity and specificity as disease activity biomarkers. Results: Both serum and urinary IL-17A levels correlated with total scores of BILAG 2004, BILAG renal, BILAG mucocutaneous, and SLEDAI-2K (P < 0.05). Urine IL-17A levels correlated positively with urine protein : creatinine index while serum IL-17 level correlated with the BILAG hematology score (all P < 0.05). The area under curve of serum IL-17A and urine IL-17A with BILAG and SLEDAI scores were low (<0.75). Conclusion: Despite positive correlations between serum and urine IL-17A with SLE disease activity, both were neither sensitive nor specific as biomarkers to predict active disease. Hence, IL-17 measurement has no role in SLE disease activity assessments and future studies are needed to search for other reliable activity biomarkers.

Original languageEnglish
JournalInternational Journal of Rheumatic Diseases
DOIs
Publication statusPublished - 1 Jan 2019

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Interleukin-17
Systemic Lupus Erythematosus
Biomarkers
Urine
Serum
Sensitivity and Specificity
Malaysia
Hematology
Immunoassay
ROC Curve
Area Under Curve
Creatinine
Cross-Sectional Studies
Kidney

Keywords

  • biomarkers
  • interleukin-17A
  • nephritis
  • systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology

Cite this

@article{c532595a250748c4b10e1feca2112327,
title = "Serum and urine interleukin-17A levels as biomarkers of disease activity in systemic lupus erythematosus",
abstract = "Objectives: This study examined the correlations of both serum and urine interleukin-17A (IL-17A) levels with disease activity in systemic lupus erythematosus (SLE). This study was also aimed at determining their sensitivity and specificity as biomarkers of disease activity in SLE. Methods: A cross-sectional study was performed involving SLE patients (n = 120 patients) from Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Serum and urinary IL-17A levels were determined by immunoassay while disease activity was assessed using Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) and British Isles Lupus Assessment Group's 2004 index (BILAG 2004) scores. The correlations between serum and urinary IL-17A levels with total SLEDAI-2K and BILAG 2004 scores were determined using bivariate correlation analyses. Receiver operating characteristic curves were calculated to determine their sensitivity and specificity as disease activity biomarkers. Results: Both serum and urinary IL-17A levels correlated with total scores of BILAG 2004, BILAG renal, BILAG mucocutaneous, and SLEDAI-2K (P < 0.05). Urine IL-17A levels correlated positively with urine protein : creatinine index while serum IL-17 level correlated with the BILAG hematology score (all P < 0.05). The area under curve of serum IL-17A and urine IL-17A with BILAG and SLEDAI scores were low (<0.75). Conclusion: Despite positive correlations between serum and urine IL-17A with SLE disease activity, both were neither sensitive nor specific as biomarkers to predict active disease. Hence, IL-17 measurement has no role in SLE disease activity assessments and future studies are needed to search for other reliable activity biomarkers.",
keywords = "biomarkers, interleukin-17A, nephritis, systemic lupus erythematosus",
author = "Fariz Nordin and Shaharir, {Syahrul Sazliyana} and {Abdul Wahab}, Asrul and Ruslinda Mustafar and {Abdul Gafor}, {Abdul Halim} and {Mohamed Said}, {Mohd Shahrir} and Sakthiswary Rajalingham and Shah, {Shamsul Azhar}",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/1756-185X.13615",
language = "English",
journal = "International Journal of Rheumatic Diseases",
issn = "1756-1841",
publisher = "Wiley-Blackwell",

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TY - JOUR

T1 - Serum and urine interleukin-17A levels as biomarkers of disease activity in systemic lupus erythematosus

AU - Nordin, Fariz

AU - Shaharir, Syahrul Sazliyana

AU - Abdul Wahab, Asrul

AU - Mustafar, Ruslinda

AU - Abdul Gafor, Abdul Halim

AU - Mohamed Said, Mohd Shahrir

AU - Rajalingham, Sakthiswary

AU - Shah, Shamsul Azhar

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: This study examined the correlations of both serum and urine interleukin-17A (IL-17A) levels with disease activity in systemic lupus erythematosus (SLE). This study was also aimed at determining their sensitivity and specificity as biomarkers of disease activity in SLE. Methods: A cross-sectional study was performed involving SLE patients (n = 120 patients) from Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Serum and urinary IL-17A levels were determined by immunoassay while disease activity was assessed using Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) and British Isles Lupus Assessment Group's 2004 index (BILAG 2004) scores. The correlations between serum and urinary IL-17A levels with total SLEDAI-2K and BILAG 2004 scores were determined using bivariate correlation analyses. Receiver operating characteristic curves were calculated to determine their sensitivity and specificity as disease activity biomarkers. Results: Both serum and urinary IL-17A levels correlated with total scores of BILAG 2004, BILAG renal, BILAG mucocutaneous, and SLEDAI-2K (P < 0.05). Urine IL-17A levels correlated positively with urine protein : creatinine index while serum IL-17 level correlated with the BILAG hematology score (all P < 0.05). The area under curve of serum IL-17A and urine IL-17A with BILAG and SLEDAI scores were low (<0.75). Conclusion: Despite positive correlations between serum and urine IL-17A with SLE disease activity, both were neither sensitive nor specific as biomarkers to predict active disease. Hence, IL-17 measurement has no role in SLE disease activity assessments and future studies are needed to search for other reliable activity biomarkers.

AB - Objectives: This study examined the correlations of both serum and urine interleukin-17A (IL-17A) levels with disease activity in systemic lupus erythematosus (SLE). This study was also aimed at determining their sensitivity and specificity as biomarkers of disease activity in SLE. Methods: A cross-sectional study was performed involving SLE patients (n = 120 patients) from Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Serum and urinary IL-17A levels were determined by immunoassay while disease activity was assessed using Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) and British Isles Lupus Assessment Group's 2004 index (BILAG 2004) scores. The correlations between serum and urinary IL-17A levels with total SLEDAI-2K and BILAG 2004 scores were determined using bivariate correlation analyses. Receiver operating characteristic curves were calculated to determine their sensitivity and specificity as disease activity biomarkers. Results: Both serum and urinary IL-17A levels correlated with total scores of BILAG 2004, BILAG renal, BILAG mucocutaneous, and SLEDAI-2K (P < 0.05). Urine IL-17A levels correlated positively with urine protein : creatinine index while serum IL-17 level correlated with the BILAG hematology score (all P < 0.05). The area under curve of serum IL-17A and urine IL-17A with BILAG and SLEDAI scores were low (<0.75). Conclusion: Despite positive correlations between serum and urine IL-17A with SLE disease activity, both were neither sensitive nor specific as biomarkers to predict active disease. Hence, IL-17 measurement has no role in SLE disease activity assessments and future studies are needed to search for other reliable activity biomarkers.

KW - biomarkers

KW - interleukin-17A

KW - nephritis

KW - systemic lupus erythematosus

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U2 - 10.1111/1756-185X.13615

DO - 10.1111/1756-185X.13615

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JO - International Journal of Rheumatic Diseases

JF - International Journal of Rheumatic Diseases

SN - 1756-1841

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