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Apoptosis of keratinocytes and serum DN ase I activity in patients with cutaneous lupus erythematosus: relationship with clinical and immunoserological parameters
Author(s) -
Skiljevic D.,
BonaciNikolic B.,
Brasanac D.,
Nikolic M.
Publication year - 2017
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.13943
Subject(s) - medicine , apoptosis , inflammation , keratinocyte , autoimmunity , immunology , lupus erythematosus , antibody , pathology , gastroenterology , cell culture , biochemistry , biology , genetics , chemistry
Background Dysregulation of apoptosis has an important role in the induction of autoimmunity. Objective To evaluate the influence of keratinocyte apoptosis and deoxyribonuclease I ( DN ase I) activity on the clinical and immunoserological parameters of cutaneous lupus erythematosus ( CLE ). Methods We studied 69 CLE patients (39 with discoid LE ( DLE ), 12 with subacute CLE ( SCLE ), 12 with acute and 6 with intermittent CLE ). Thirty of sixty‐nine patients fulfilled criteria for systemic LE ( SLE ). Apoptotic index ( AI ) was evaluated immunohistochemically in lesional and non‐lesional, photoprotected skin. Serum DN ase I activity, antichromatin and anti‐ ENA antibodies were measured by ELISA . Disease activity was determined by SLEDAI ‐2K, SLICC / ACR , CLASI and RCLASI . Results AI in lesions was higher than in non‐lesional skin ( P < 0.001). There was no difference in AI between CLE and SLE patients. Patients with SCLE had higher lesional AI than patients with DLE ( P < 0.05). We found a positive correlation between the lesional AI with CLASI A ( P < 0.05) and RCLASI D ( P < 0.05). CLE and SLE patients had significantly lower DN ase I activity than healthy controls ( P < 0.001). Patients with normal DN ase I activity and low AI had significantly lower CLASI A than patients with decreased DN ase I activity and/or elevated AI ( P < 0.05). Conclusions Increased keratinocyte apoptosis characterizes lesions of all CLE forms, especially of SCLE . AI correlates with CLE markers of acute and chronic inflammation. Normal level of apoptosis and DN ase I activity simultaneously reduce the level of acute inflammation in CLE . Serum DN ase I activity and AI might be important biomarkers in the evaluation of CLE patients.