Circulating S100 proteins effectively discriminate SLE patients from healthy controls: a cross-sectional study
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S100 proteins are currently being investigated as potential diagnostic and prognostic biomarkers of several cancers and inflammatory diseases. The aims of this study were to analyse the plasma levels of S100A4, S100A8/9 and S100A12 in patients with incomplete systemic lupus erythematosus (iSLE), in patients with established SLE and in healthy controls (HCs) and to investigate the potential utility of the S100 proteins as diagnostic or activity-specific biomarkers in SLE. Plasma levels were measured by ELISA in a cross-sectional cohort study of 44 patients with SLE, 8 patients with iSLE and 43 HCs. Disease activity was assessed using the SLEDAI-2K. The mean levels of all S100 proteins were significantly higher in SLE patients compared to HCs. In iSLE patients, the levels of S100A4 and S100A12 but not S100A8/9 were also significantly higher compared to HCs. There were no significant differences in S100 levels between the iSLE and SLE patients. Plasma S100 proteins levels effectively discriminated between SLE patients and HCs. The area under the curve (AUC) for S100A4, S100A8/9 and S100A12 plasma levels was 0.989 (95% CI 0.976–1.000), 0.678 (95% CI 0.563–0.792) and 0.807 (95% CI 0.715–0.899), respectively. S100 levels did not differentiate between patients with high and low disease activity. Only the S100A12 levels were significantly associated with SLEDAI-2K and with cSLEDAI-2K. S100 proteins were significantly higher in SLE patients compared HCs and particularly S100A4 could be proposed as a potential diagnostic biomarker for SLE.
KeywordsBiomarkers SLE S100 proteins Disease activity
Anti-double-stranded DNA antibody
British Isles Lupus Assessment Group disease activity index
- c-SLEDAI-2 K
Systemic lupus erythematosus Disease Activity Index 2000 clinical items
Damage-associated molecular patterns
Enzyme-linked immunosorbent assay
Receiver operating characteristic
Systemic lupus erythematosus
Systemic Lupus Erythematosus Disease Activity Index 2000
Systemic Lupus International Collaborating Clinics/American College of Rheumatology
The receptor for advanced glycation end product
We would like to thank Milada Lösterová for the excellent work as a study nurse in the management of the study.
Substantial contributions to the conception or design of the work: BS, MG, JZ, LS, LAC, KP, JV. Substantial contributions to the acquisition, analysis, or interpretation of data for the work: BS, HH, JZ, LS, LSz, LN, MU, LAC, JV. Drafting the work or revising it critically for important intellectual content: BS, HH, MG, LS, JZ, LSz, LN, MU, LAC, KP, JV. Final approval of the version to be published: BS, HH, MG, JZ, LS, LSz, LN, MU, LAC, KP, JV. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: BS, HH, MG, JZ, LS, LSz, LN, MU, LAC, KP, JV.
This study was supported by the project of the Ministry of Health of the Czech Republic for conceptual development of research organization [Grant no. 00023728].
Compliance with ethical standards
Conflict of interest
The authors declare no competing interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and bits later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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