Inflammation associated anemia and ferritin as disease markers in SLEReport as inadecuate




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Arthritis Research and Therapy

, 14:R182

First Online: 07 August 2012Received: 13 December 2011Revised: 25 July 2012Accepted: 07 August 2012

Abstract

IntroductionIn a recent screening to detect biomarkers in systemic lupus erythematosus SLE, expression of the iron storage protein, ferritin, was increased. Given that proteins that regulate the storage, transfer and release of iron play an important role in inflammation, this study aims to determine the serum and urine levels of ferritin and of the iron transfer protein, transferrin, in lupus patients and to correlate these levels with disease activity, inflammatory cytokine levels and markers of anemia.

MethodsA protein array was utilized to measure ferritin expression in the urine and serum of SLE patients and healthy controls. To confirm these results as well as the role of the iron transfer pathway in SLE, ELISAs were performed to measure ferritin and transferrin levels in inactive or active SLE patients and healthy controls. The relationship between ferritin-transferrin levels and inflammatory markers and anemia was next analyzed.

ResultsProtein array results showed elevated ferritin levels in the serum and urine of lupus patients as compared to controls, which were further validated by ELISA. Increased ferritin levels correlated with measures of disease activity and anemia as well as inflammatory cytokine titers. Though active SLE patients had elevated urine transferrin, serum transferrin was reduced.

ConclusionUrine ferritin and transferrin levels are elevated significantly in SLE patients and correlate with disease activity, bolstering previous reports. Most importantly, these changes correlated with the inflammatory state of the patients and anemia of chronic disease. Taken together, altered iron handling, inflammation and anemia of chronic disease constitute an ominous triad in SLE.

AbbreviationsACRAmerican College of Rheumatology

AOSDadult onset Still-s disease

CADcoronary artery disease

Crcreatinine

DAS 28Disease Activity Score 28

IREiron responsive element

LNlupus nephritis

LPSlipopolysaccharide

MSmultiple sclerosis

NOnitric oxide

RArheumatoid arthritis

rSLEDAIrenal-related SLE disease activity index

SLEsystemic lupus erythematosus

SLEDAISLE disease activity index

TIBCtotal iron-binding capacity

TNFtumor necrosis factor.

Electronic supplementary materialThe online version of this article doi:10.1186-ar4012 contains supplementary material, which is available to authorized users.

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Author: Kamala Vanarsa - Yujin Ye - Jie Han - Chun Xie - Chandra Mohan - Tianfu Wu

Source: https://link.springer.com/



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