Ab1016 Serum CXCL-13 Levels Are Associated With Active Neurological Involvement in Patients With Systemic Lupus Erythematosus

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Background: Systemic lupus erythematosus is a significant autoimmune disease characterized by various system involvements. The central nervous system manifestations of systemic lupus erythematosus (NPSLE) exhibit a range of severity and hold an essential prognostic implication. The primary challenge in managing NPSLE is needing a practical diagnostic marker. CXCL13 is a B-cell chemokine which's role is implicated in SLE in many studies. Objectives: The study aimed to evaluate serum CXCL-13 levels in patients with NPSLE and compare them with SLE patients without neuropsychiatric involvement and healthy controls. Methods: The study group was dichotomized into three subgroups: 1. SLE patients with NPSLE (n=32), 2. SLE patients without NPSLE (n=71) 3. Healthy controls (n=22). Patients with NPSLE were divided into two subgroups: those with active neurological involvement (n=6) and those with previous neurological involvement currently in remission (n=26). Disease activity was calculated according to the Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLEDAI version of SLEDAI score (PMID: 1599520). Serum CXCL-13 levels were detected with human enzyme-linked immunosorbent assay (ELISA, double antibody sandwich method) kits according to the manufacturer's instructions (BT Human BLC (CXCL13) ELISA Kit, USA). SPSS 17.0 version (Chicago, USA) was used for the statistical data analysis. Results: A total of 125 participants were enrolled in the study with a mean age of 42.8 years (123 female (96.03 %)/5 male (3.97 %)). All clinical involvements and laboratory parameters associated with SLE diagnosis and activity between patient groups were compared in Table 1. When patients were grouped according to the existence of NPSLE without regarding activity, patients with NPSLE had higher serum CXCL-13 levels when compared to SLE patients without NPSLE (median (IQR); 263.2 (132.8) ng/mL vs 204.2 (123.7) ng/mL, p= 0.047) and healthy controls (median (IQR); 263.2 (132.8) ng/mL vs 143.0 (70.2) ng/mL, p<0.001, Figure 1). Also, patients who didn't have a history of NPSLE had significantly higher levels of serum CXCL-13 compared to controls (p<0.001). Also, patients with NPSLE had significantly higher levels of antidsDNA antibody (p=0.031) and lower levels of total C3 (p= 0.047) than those without NPSLE. Total C4 levels were similar between these groups (p=0.162). Conclusion: NPSLE represents a challenging clinical manifestation characterized by difficulties in both diagnosis and management. The necessity of prompt intervention poses clinicians in a problematic situation. The need for a specific diagnostic biomarker stems from this challenge. In this regard, serum levels of CXCL-13 appear promising in filling this diagnostic gap. Table 1. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.