Clinical Rheumatology

, Volume 34, Issue 5, pp 891–896 | Cite as

Basophil count, a marker for disease activity in systemic lupus erythematosus

  • Peifen Liang
  • Ying Tang
  • Sha Fu
  • Jun Lv
  • Bo Liu
  • Min Feng
  • Jinggao Li
  • Deyuan Lai
  • Xia Wan
  • Anping Xu
Original Article


Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease, with frequent flares amid remissions. Basophils contribute to the immunopathogenesis of SLE. This retrospective clinical study evaluated blood basophil count as a potential marker of SLE activity. This study included 213 patients with SLE, 70 with non-SLE chronic kidney disease (CKD), and 100 healthy volunteers. SLE disease activity was scored using the SLE Disease Activity Index (SLEDAI). Baseline and post-immunosuppressant bioparameters were compared in patients with active SLE, with second samples taken at total SLEDAI ≤4. Blood basophil counts and other conventional biomarkers were compared among the groups. Among the 213 SLE patients (192 women, 21 men; mean age 33.0 ± 12.0 years), 149 had active disease. Basophil counts were significantly lower in patients with SLE than in patients with non-SLE CKD and healthy controls (0.009 ± 0.010 vs. 0.025 ± 0.015 vs. 0.022 ± 0.010 × 109/L, p <0.001), and lower in patients with active than inactive SLE (0.008 ± 0.009 vs. 0.014 ± 0.012 × 109/L, p <0.001). Basophil counts in SLE patients were significantly higher after than before immunosuppressive treatment (0.021 ± 0.017 vs. 0.008 ± 0.008 × 109/L, p <0.001) and correlated with total SLEDAI score (r = −0.30, p <0.001). Receiver operator curve analysis showed that basophil counts were similar to conventional markers (leukocytes, platelets, and double-stranded (ds) DNA IgG) in differentiating active from inactive SLE. These findings indicate that blood basophil counts may be a useful biomarker in evaluating SLE activity.


Basophil counts Disease activity Marker Systemic lupus erythematosus 



This study was supported by Guangdong Natural Science Funds (S2012010009667).


Peifen Liang, Ying Tang, Sha Fu, Jun Lv, Bo Liu, Min Feng, Jinggao Li, Deyuan Lai, Xia Wan, and Anping Xu have nothing to disclose.


  1. 1.
    Mirzayan MJ, Schmidt RE, Witte T (2000) Prognostic parameters for flare in systemic lupus erythematosus. Rheumatology (Oxford) 39:1316–1319CrossRefGoogle Scholar
  2. 2.
    Griffiths B, Mosca M, Gordon C (2005) Assessment of patients with systemic lupus erythematosus and the use of lupus disease activity indices. Best Pract Res Clin Rheumatol 19:685–708CrossRefPubMedGoogle Scholar
  3. 3.
    Jolly M (2005) How does quality of life of patients with systemic lupus erythematosus compare with that of other common chronic illnesses? J Rheumatol 32:1706–1708PubMedGoogle Scholar
  4. 4.
    Gladman DD, Ibanez D, Urowitz MB (2002) Systemic lupus erythematosus disease activity index 2000. J Rheumatol 29:288–291PubMedGoogle Scholar
  5. 5.
    Marks SD, Pilkington C, Woo P, Dillon MJ (2004) The use of the British Isles Lupus Assessment Group (BILAG) index as a valid tool in assessing disease activity in childhood-onset systemic lupus erythematosus. Rheumatology (Oxford) 43:1186–1189CrossRefGoogle Scholar
  6. 6.
    Bae SC, Koh HK, Chang DK, Kim MH, Park JK, Kim SY (2001) Reliability and validity of systemic lupus activity measure-revised (SLAM-R) for measuring clinical disease activity in systemic lupus erythematosus. Lupus 10:405–409CrossRefPubMedGoogle Scholar
  7. 7.
    Romero-Diaz J, Isenberg D, Ramsey-Goldman R (2011) Measures of adult systemic lupus erythematosus: updated version of British Isles Lupus Assessment Group (BILAG 2004), European Consensus Lupus Activity Measurements (ECLAM), Systemic Lupus Activity Measure, Revised (SLAM-R), Systemic Lupus Activity Questionnaire for Population Studies (SLAQ), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Arthritis Care Res (Hoboken) 63:37–46CrossRefGoogle Scholar
  8. 8.
    Esdaile JM, Joseph L, Abrahamowicz M, Li Y, Danoff D, Clarke AE (1996) Routine immunologic tests in systemic lupus erythematosus: is there a need for more studies? J Rheumatol 23:1891–1896PubMedGoogle Scholar
  9. 9.
    Esdaile JM, Abrahamowicz M, Joseph L, MacKenzie T, Li Y, Danoff D (1996) Laboratory tests as predictors of disease exacerbations in systemic lupus erythematosus. Why some tests fail. Arthritis Rheum 39:370–378CrossRefPubMedGoogle Scholar
  10. 10.
    Ho A, Barr SG, Magder LS, Petri M (2001) A decrease in complement is associated with increased renal and hematologic activity in patients with systemic lupus erythematosus. Arthritis Rheum 44:2350–2357CrossRefPubMedGoogle Scholar
  11. 11.
    Ho A, Magder LS, Barr SG, Petri M (2001) Decreases in anti-double-stranded DNA levels are associated with concurrent flares in patients with systemic lupus erythematosus. Arthritis Rheum 44:2342–2349CrossRefPubMedGoogle Scholar
  12. 12.
    Mukai K, Matsuoka K, Taya C et al (2005) Basophils play a critical role in the development of IgE-mediated chronic allergic inflammation independently of T cells and mast cells. Immunity 23:191–202CrossRefPubMedGoogle Scholar
  13. 13.
    Larson D, Cooper PJ, Hübner MP, Reyes J, Vaca M, Chico M, Kong HH, Mitre E (2012) Helminth infection is associated with decreased basophil responsiveness in human beings. J Allergy Clin Immunol 130:270–272CrossRefPubMedCentralPubMedGoogle Scholar
  14. 14.
    Oh K, Shen T, Le Gros G, Min B (2007) Induction of Th2 type immunity in a mouse system reveals a novel immunoregulatory role of basophils. Blood 109:2921–2927PubMedGoogle Scholar
  15. 15.
    Sokol CL, Chu NQ, Yu S, Nish SA, Laufer TM, Medzhitov R (2009) Basophils function as antigen-presenting cells for an allergen-induced T helper type 2 response. Nat Immunol 10:713–720CrossRefPubMedCentralPubMedGoogle Scholar
  16. 16.
    Karasuyama H, Mukai K, Obata K, Tsujimura Y, Wada T (2011) Nonredundant roles of basophils in immunity. Annu Rev Immunol 29:45–69CrossRefPubMedGoogle Scholar
  17. 17.
    Charles N, Rivera J (2011) Basophils and autoreactive IgE in the pathogenesis of systemic lupus erythematosus. Curr Allergy Asthma Rep 11:378–387CrossRefPubMedCentralPubMedGoogle Scholar
  18. 18.
    Charles N, Hardwick D, Daugas E, Illei GG, Rivera J (2010) Basophils and the T helper 2 environment can promote the development of lupus nephritis. Nat Med 16:701–707CrossRefPubMedCentralPubMedGoogle Scholar
  19. 19.
    Permin H, Skov PS, Norn S, Juhl F (1978) Basophil histamine release by RNA, DNA and aggregated IgG examined in rheumatoid arthritis and systemic lupus erythematosus. Results compared with basophil counts and antinuclear antibodies. Allergy 33:15–23CrossRefPubMedGoogle Scholar
  20. 20.
    Egido J, Sánchez Crespo M, Lahoz C, García R, López-Trascasa M, Hernando L (1980) Evidence of an immediate hypersensitivity mechanism in systemic lupus erythematosus. Ann Rheum Dis 39:312–317CrossRefPubMedCentralPubMedGoogle Scholar
  21. 21.
    Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725–1732CrossRefPubMedGoogle Scholar
  22. 22.
    Levey AS, Coresh J, Green T et al (2006) Using standardized blood creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med 145:247–254CrossRefPubMedGoogle Scholar
  23. 23.
    Pitashny M, Schwartz N, Qing X et al (2007) Urinary lipocalin-2 is associated with renal disease activity in human lupus nephritis. Arthritis Rheum 56:1894–1903CrossRefPubMedGoogle Scholar
  24. 24.
    Yoshimura C, Miyamasu M, Nagase H, Iikura M, Yamaguchi M, Kawanami O, Morita Y, Iwata T, Yamamoto K, Hirai K (2001) Glucocorticoids induce basophil apoptosis. J Allergy Clin Immunol 108:215–220CrossRefPubMedGoogle Scholar
  25. 25.
    Dorner T, Jacobi AM, Lee J, Lipsky PE (2011) Abnormalities of B cell subsets in patients with systemic lupus erythematosus. J Immunol Methods 363:187–197CrossRefPubMedGoogle Scholar
  26. 26.
    Kyttaris VC, Katsiari CG, Juang YT, Tsokos GC (2005) New insights into the pathogenesis of systemic lupus erythematosus. Curr Rheumatol Rep 7:469–475CrossRefPubMedGoogle Scholar
  27. 27.
    Blanco P, Palucka AK, Gill M, Pascual V, Banchereau J (2001) Induction of dendritic cell differentiation by IFN-alpha in systemic lupus erythematosus. Science 294:1540–1543CrossRefPubMedGoogle Scholar
  28. 28.
    Byrne JC, Ní Gabhann J, Lazzari E, Mahony R, Smith S, Stacey K, Wynne C, Jefferies CA (2012) Genetics of SLE: functional relevance for monocytes/macrophages in disease. Clin Dev Immunol 2012:582352, 15 pagesCrossRefPubMedCentralPubMedGoogle Scholar
  29. 29.
    Chirumbolo S (2012) State-of-the-art review about basophil research in immunology and allergy: is the time right to treat these cells with the respect they deserve? Blood Transfus 10:148–164PubMedCentralPubMedGoogle Scholar
  30. 30.
    Amundsen EK, Henriksson CE, Holthe MR, Urdal P (2012) Is the blood basophil count sufficiently precise, accurate, and specific?: three automated hematology instruments and flow cytometry compared. Am J Clin Pathol 137:86–92CrossRefPubMedGoogle Scholar

Copyright information

© International League of Associations for Rheumatology (ILAR) 2014

Authors and Affiliations

  • Peifen Liang
    • 1
  • Ying Tang
    • 1
  • Sha Fu
    • 1
  • Jun Lv
    • 1
  • Bo Liu
    • 1
  • Min Feng
    • 1
  • Jinggao Li
    • 1
  • Deyuan Lai
    • 1
  • Xia Wan
    • 1
  • Anping Xu
    • 1
  1. 1.Department of Nephrology, Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhouChina

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