Background Presepsin (soluble CD14 subtype) is a newly recognized biomarker of sepsis. Recently it has been reported that presepsin levels are elevated in patients with systemic lupus erythematosus (SLE) without infection, possibly due to phagocytosis of neutrophil extracellular traps by monocytes/macrophages [1]. However, the clinical significance of presepsin in SLE remains uncertain [2].

Objectives This study aims to evaluate the relation between serum presepsin levels and clinical manifestations, disease activity and laboratory parameters in SLE patients.

Methods A total of 78 SLE patients (aged 38.9±12.8 years; 87.2% females) and 16 age- and sex-matched healthy controls were enrolled. Patients with infections were not included in the study. Serum presepsin levels were determined by ELISA and were analyzed in relation to SLE organ and system involvement, routine laboratory tests, inflammatory markers, serum complement levels, autoantibody spectrum, and the overall disease activity assessed by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Mann-Whitney test, Spearman and Pearson correlation tests were used for statistical analysis.

Results The median serum presepsin level was significantly higher in patients with SLE than in healthy controls (137 (95-197) pg/ml vs 66 (62-77) pg/ml, p<0.001). SLE males had higher presepsin concentration compared with females (180 (140-156) pg/ml vs 130 (90-170) pg/ml, p=0.02). Presepsin levels were significantly lower in SLE patients with involvement of skin (124 (84-157) pg/ml) and musculoskeletal system (111 (87-153) pg/ml) compared to those without such manifestations (164 (110-210) pg/ml, p=0.032 and 145 (122-175) pg/ml, p=0.041, respectively). However, SLE patients with fever (215 (170-1606) pg/ml vs 130 (93-166) pg/ml, p=0.004), nephritis (145 (110-197) pg/ml vs 102 (82-146) pg/ml, p=0.011), anemia (170 (126-280) pg/ml vs 130 (92-280) pg/ml, p=0.04) and thrombocytopenia (198 (170-280) vs 130 (92-161) pg/ml, p=0.049) had higher presepsin levels than those without such symptoms. Significant correlation was found between presepsin concentration and estimated glomerular filtration rate (r=-0.440, p=0.017). Presepsin levels did not correlate with white blood cell count, C3, C4, C-reactive protein, erythrocyte sedimentation rate and procalcitonin levels. Presepsin levels in patients with lupus nephritis significantly correlated with SLEDAI score (r=0.461, p=0.008) and anti-dsDNA levels (r=0.545, p<0.01); no such associations were found in SLE patients without kidney involvement.

Conclusion Higher serum presepsin levels in SLE patients are associated with male gender, fever, kidney involvement, anemia and thrombocytopenia. Further research focused on clinical use of presepsin in SLE is warranted.

References

1. Ikegame A, et al. Presepsin production in monocyte/macrophage-mediated phagocytosis of neutrophil extracellular traps. Sci Rep 2022; 12:5978.
2. Tanimura C., et al. Clinical significance of plasma presepsin levels in patients with systemic lupus erythematosus. Mod Rheumatol. 2018; 28(5):865-871.

Disclosure of Interests None declared

Keywords: Biomarkers, Systemic lupus erythematosus

DOI: 10.1136/annrheumdis-2023-eular.5750