CXCL13 is an activity marker for systemic, but not cutaneous lupus erythematosus: a longitudinal cohort study
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Serum levels of the IFN-regulated cytokine CXCL13 have been found to correlate with SLEDAI and renal involvement in systemic lupus erythematosus. This study investigates whether CXCL13 can also be a marker of disease activity in patients with subacute cutaneous or chronic cutaneous lupus erythematosus (SCLE, CCLE). We analysed CXCL13 levels in 60 patients’ sera (18 SLE, 19 SCLE, 23 CCLE) at five time points within 1 year and correlated these levels with disease activity scores and laboratory markers. Clinical scores with no/mild, moderate or high/severe disease activity were categorized by SLEDAI in SLE, by CLASI in SCLE/CCLE. CXCL13 levels were significantly higher in SLE (median 122.5, IQR 88.0–239.0 pg/ml) than in CCLE patients (median 69.0, IQR 60.0–102.0 pg/ml) (p = 0.006). CXCL13 levels were elevated in 59% (41/70) of SLE patient visits with mild or no disease activity, but in 90% (9/10) with high disease activity. CXCL13 levels correlated with ECLAM, dsDNA-antibodies, and inversely with complement factors C3 and C4 in SLE, and with IgA and ESR in SCLE. In CCLE CXCL13 did not correlate with CLASI or laboratory markers. One SCLE and two CCLE patients with CXCL13 levels > 500 pg/ml had conversion to SLE or an underlying autoimmune disease. CXCL13 seems to be a useful marker of disease activity in SLE, but not in SCLE and CCLE. Conversion from normal to elevated CXCL13 may indicate a flare of SLE. Whether high CXCL13 levels in cutaneous LE indicate the development of SLE should be further investigated.
KeywordsCXCL13 Systemic lupus erythematosus Cutaneous lupus erythematosus Activity biomarker SLEDAI CLASI
We greatly acknowledge the laboratory work of Ingrid Krainberger and Monika Joch.
No funding was provided for this project.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval was given by the ethics commettee of the Medical University of Graz (Approval No. 19-338 ex 07/08).
All patients gave written consent to participate in the study.
- 2.Albrecht J, Taylor L, Berlin JA, Dulay S, Ang G, Fakharzadeh S, Kantor J, Kim E, Militello G, McGinnis K, Richardson S, Treat J, Vittorio C, Van Voorhees A, Werth VP (2005) The CLASI (Cutaneous Lupus Erythematosus Disease Area and Severity Index): an outcome instrument for cutaneous lupus erythematosus. J Invest Dermatol 125:889–894CrossRefPubMedPubMedCentralGoogle Scholar
- 6.Bauer JW, Petri M, Batliwalla FM, Koeuth T, Wilson J, Slattery C, Panoskaltsis-Mortari A, Gregersen PK, Behrens TW, Baechler EC (2009) Interferon-regulated chemokines as biomarkers of systemic lupus erythematosus disease activity: a validation study. Arthritis Rheum 60:3098–3107CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Greisen SR, Schelde KK, Rasmussen TK, Kragstrup TW, Stengaard-Pedersen K, Hetland ML, Horslev-Petersen K, Junker P, Ostergaard M, Deleuran B, Hvid M (2014) CXCL13 predicts disease activity in early rheumatoid arthritis and could be an indicator of the therapeutic ‘window of opportunity’. Arthritis Res Ther 16:434CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Kuhn A, Ruzicka T Classification of cutaneous lupus erythematosus. In: Kuhn A, Lehman P, Ruzicka T eds, (ed). Cutaneous lupus erythematosus: Springer, New York 2004:p 53Google Scholar
- 22.Lam GK, Petri M (2005) Assessment of systemic lupus erythematosus. Clin Exp Rheumatol 23:S120–132Google Scholar
- 26.Mullegger RR, Means TK, Shin JJ, Lee M, Jones KL, Glickstein LJ, Luster AD, Steere AC (2007) Chemokine signatures in the skin disorders of Lyme borreliosis in Europe: predominance of CXCL9 and CXCL10 in erythema migrans and acrodermatitis and CXCL13 in lymphocytoma. Infect Immun 75:4621–4628CrossRefPubMedPubMedCentralGoogle Scholar
- 34.Vitali C, Bencivelli W, Isenberg DA, Smolen JS, Snaith ML, Sciuto M, Neri R, Bombardieri S (1992) Disease activity in systemic lupus erythematosus: report of the Consensus Study Group of the European Workshop for Rheumatology Research. II. Identification of the variables indicative of disease activity and their use in the development of an activity score. The European Consensus Study Group for Disease Activity in SLE. Clin Exp Rheumatol 10:541–547PubMedGoogle Scholar