Risk of prognostic serious infections and unapparent immunodeficiency in systemic lupus erythematosus
Abstract
Systemic lupus erythermatosus (SLE) is a chronic inflammatory autoimmune disease with variable manifestation and course, incl. a risk of serious prognosis. In time of milenium, the overall standardized mortality ratio was in SLE 2.4, and the following up-years without evident progress.
Euro-lupus project expressed the most frequent risk of fatal prognosis as follows: disease activity, infections and thrombosis. Nationwide registers (USA, Sweden etc.) demonstrated that SLE with serious infections (espec. bacterial pneumonia and/or sepsis) is significantly more frequent reason for hospitalization in comparison to adjusted non-SLE population.
SLE patients are immunocompromised subjects in general, but especially in relation to disease activity (nephrotic syndrom in lupus nephritis etc.), comorbidities, post-OP state (splenectomy), and therapy (glucocorticoids, cytostatics, etc.), except antimalarials. In a large amount of B cell immunity disorders in SLE, an analysis of memory marginal-zone B cells was made more in detail.
A cohort of SLE was examined by means of flow cytometry with detection a significant deficiency of memory marginal-zone (CD 19+ CD27+ IgM+) B cells in absolute values (x106/L) of whole lymphocytes in peripheral blood (PB), incl. with persistence after a twelve-months control, always in lupus low disease activity state. Is supposed, that investigation of unapparent deficiency of memory marginal-zone B cells in PB should be useful in evaluation the risk of serious infections in SLE.