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Effect of disease activity and corticosteroids on serum levels of soluble endothelial cell protein C receptor in patients with systemic lupus erythematosus

  • Original Article
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Modern Rheumatology

Abstract

To assess the effects of disease activity of systemic lupus erythematosus (SLE) and high-dose corticosteroids on endothelial injuries, the significance of soluble endothelial cell protein C receptor (sEPCR) and soluble thrombomodulin (sTM) was analyzed. Serum levels of sEPCR and sTM were measured by enzyme-linked immunosorbent assay (ELISA) cross-sectionally in 97 SLE patients, 49 patients with other rheumatic diseases and 22 normal subjects. The changes in these levels upon corticosteroid treatment were also analyzed in 41 patients. The levels of sEPCR and sTM were both higher in SLE and other rheumatic disease patients than in normal subjects. When low-dose corticosteroids were used, both the level of sEPCR and the ratio of positive tests for sEPCR were significantly higher in active SLE patients than in inactive patients [median 2.30 ng/ml (range 0.00–147.10 ng/ml) vs 0.00 ng/ml (0.00–58.90 ng/ml) and 53.5 vs 13.0%, respectively] (P < 0.005). Moreover, the ratio of positive tests for sEPCR was higher after corticosteroid treatment in 9 of 19 (47.3%) SLE patients compared to other rheumatic diseases (3/22; 13.6%). Although the mean level of sTM was significantly higher in active SLE patients than in inactive patients, the ratio of positive tests for sTM was not affected by disease activity or corticosteroids. In conclusion, the positive test for sEPCR is a more sensitive biomarker than that for sTM in reflecting endothelial injuries caused by active disease and often by corticosteroids in SLE.

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Acknowledgments

Syuichi Koarada is supported by a grant-in-aid for scientific research from the Ministry of Education, Science, Sports, and Culture, Japan (No. 19591170). We thank M. Fujisaki for her assistance with the research.

Conflict of interest statement

The authors have declared no conflict of interest.

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Authors and Affiliations

  1. Division of Rheumatology, Department of Internal Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan

    Syuichi Koarada, Yoshio Haruta, Yoshifumi Tada, Mio Mitamura, Hisako Inoue, Akihide Ohta & Kohei Nagasawa

  2. Department of Immunology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan

    Naoko Tsuneyoshi & Kenji Fukudome

Authors
  1. Syuichi Koarada
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  2. Naoko Tsuneyoshi
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  3. Yoshio Haruta
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  4. Yoshifumi Tada
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  9. Kohei Nagasawa
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Correspondence to Syuichi Koarada.

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Koarada, S., Tsuneyoshi, N., Haruta, Y. et al. Effect of disease activity and corticosteroids on serum levels of soluble endothelial cell protein C receptor in patients with systemic lupus erythematosus. Mod Rheumatol 19, 173–179 (2009). https://doi.org/10.1007/s10165-008-0143-z

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  • DOI: https://doi.org/10.1007/s10165-008-0143-z

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