الفهرس | Only 14 pages are availabe for public view |
Abstract In this study, we were concerned to measure serum levels of NO and MDA as indicators of oxidative stress in known patients with pediatric SLE to study their relationship to the disease activity. We conducted this study on 20 children with pediatric onset SLE attending the Pediatric Allergy and Immunology Clinic, Children Hospital, Ain Shams University. Clinical evaluation of SLE patients with assessment of the disease activity using SLEDAI was done with special emphasis on age at onset of SLE, duration of the disease, medications given, body organs affected and other associated co-morbidities. Clinical examination included assessment of blood pressure and edema and physical examination of different systems . Laboratory investigations included CBC, ESR, immunological markers (anti-dsDNA, C3, lupus anticoagulant and anticardiolipin Abs), kidney function tests (serum creatinine, creatinine clearance and 24 hours’ urinary proteins) and lipid profile (T. Cholesterol, TG, HDL and LDL).Serum NO and MDA levels were measured by ELISA in pediatric SLE patients. The present study revealed that serum NO (Mean 249.31, ± SD 35.93) and MDA (Mean 14.64, ± SD 3.74) levels were significantly higher among SLE children in comparison to controls (serum NO (Mean 97.85± SD 12.87),serum MDA (Mean 2.16± SD 0.59)) There was a significant positive correlation between SLEDAI grades and serum NO & MDA levels. There was a significant positive correlation between number of exacerbations and NO serum levels. Children with associated comorbidities (hypertension) had significantly higher levels of serum MDA. Children with abnormal lipid profile (high LDL cholesterol and low HDL cholesterol) had significantly higher NO & MDA serum levels. Children with proteinuria had significantly higher levels of serum NO. Patients with high serum antibodies (Anti DNA antibody and Anticardiolipin IgM & IgG) had higher levels of serum NO.Patients with high serum anticardiolipin IgM & IgG had higher levels of serum MDA. Diet control had a significant impact on serum NO & MDA levels. Children without diet control had significant higher NO & MDA serum levels. Immunosuppressive therapy had no significant impact on serum NO & MDA expression.In conclusion, elevated serum NO &MDA levels in children with SLE suggested that systemic NO&MDA upregulation were induced by lupus disease activity. Further studies on a wider scale are needed to strengthen the findings of this study, to validate the usefulness of those biomarkers as markers of lupus activity and for better understanding of their role as predictors of disease severity and outcome. |