Article Text
Abstract
Objectives Previous studies demonstrated associations between reduced serum 25-hydroxyvitamin D (25OHD), inflammation and disease activity in paediatric systemic lupus erythematosus (pSLE). The goal of this study was to assess parathyroid hormone (PTH) in its relationship to vitamin D and inflammation, as well as to better understand the role of human cathelicidin (LL-37) in pSLE.
Methods Frozen serum samples collected at baseline of the Atherosclerosis Prevention in Paediatric Lupus Erythematosus (APPLE) study were assayed to determine 25OHD, PTH and LL-37 levels. Pearson’s correlations and Χ2 tests were used to evaluate the relationships between 25OHD, PTH, LL-37, inflammation, disease activity and infection using baseline values collected as part of the APPLE study.
Results 201/221 APPLE participants had serum available for analysis. Serum 25OHD was inversely associated with serum PTH, but not LL-37. Serum PTH was not associated with high sensitivity C-reactive protein, carotid intima media thickness or high-density lipoprotein (HDL) or low-density lipoprotein (LDL) cholesterol, but was negatively associated with lipoprotein(a) levels. Despite no association with serum 25OHD, LL-37 was negatively associated with total cholesterol, HDL and LDL cholesterol and positively associated with age. There was no significant difference in mean LL-37 levels in participants with reported infection as an adverse event during the 3-year APPLE study.
Conclusions Despite links to vitamin D levels in other studies, LL-37 levels were not associated with baseline serum 25OHD concentrations in paediatric patients with pSLE. Despite the lack of correlation with 25OHD, LL-37 levels in this study were associated with cholesterol levels. Some subjects with pSLE have significantly elevated levels of LL-37 of unknown significance. These exploratory results addressing the role of LL-37 levels in pSLE appear worthy of future study.
- systemic lupus erythematosus
- Childhood/paediatric lupus
- autoimmune diseases
- infections
- inflammation
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Footnotes
Presented at An abstract of this paper was presented at the ACR Annual Meeting for 2016.
Contributors The following participated in this study by enrolling patients at sites or by performing study procedures at sites: Esi Morgan Dewitt, C Egla Rabinovich, Janet Ellis, Janet Wootton (Duke University Medical Center, Durham, North Carolina, USA), Peter Chira, Joyce Hsu, Tzielan Lee, Jan Perea (Stanford University School of Medicine, Palo Alto, California, USA), Beth Gottlieb, Patricia Irigoyen, Jennifer Luftig, Shaz Siddiqi, Zhen Ni, Marilynn Orlando, Eileen Pagano (Cohen Children's Medical Center, New Hyde Park, New York, USA), Andrew Eichenfield, Deborah Levy, Philip Kahn, Candido Batres, Digna Cabral (Morgan Stanley Children's Hospital of New York–Presbyterian, New York, New York, USA), Kathleen A. Haines, Suzanne C Li, Jennifer Weiss, Mary Ellen Riordan, Beena Vaidya (Hackensack University Medical Center, Hackensack, New Jersey, USA), Michelle Mietus-Snyder (University of California at San Francisco Medical Center, San Francisco, California, USA), Lawrence Ng (Hospital for Sick Children, Toronto, Ontario, Canada, USA), Susan Ballinger, Thomas Klausmeier, Debra Hinchman, Andrea Hudgins (Indiana University School of Medicine, Indianapolis, Indiana, USA), Shirley Henry, Shuzen Zhang (Texas Scottish Rite Hospital for Children, Dallas, Texas, USA), Elizabeth B Brooks, Stacy Miner, Nancy Szabo, Lisabeth Scalzi (University Hospitals/Case Medical Center, Cleveland, Ohio), Libby Dorfeld, Sarajane Wilson, Jenna Tress (Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA), Tatiana Hernandez, Jyotsna Vitale (University of California Los Angeles Medical Center, Los Angeles, California, USA), Angela Kress, Nicole Lowe, Falguni Patel (Children's Memorial Hospital, Chicago, Illinois, USA), Stephanie Hamilton (Seattle Children's Hospital and Regional Medical Center, Seattle, Washington, USA), Katie Caldwell, Diane Kamen (Medical University of South Carolina, Charleston, South Carolina, USA), Becky Puplava, Atanas Lonchev (University of Chicago, Chicago, Illinois, USA), Monica Bacani (Nationwide Children's Hospital, Columbus, Ohio, USA), Cynthia Rutherford, Jamie Meyers-Eaton, Shannen Nelson, Alexei Grom (Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA), Teresa Conway, Lacey Frank, Lori Kuss (Creighton University Medical Center, Omaha, Nebraska, USA), Hazel Senz (University of Colorado, Aurora, Colorado, USA), Thomas Mason, Jane Jaquith, Diana E Paepke-Tollefsrud (Mayo Clinic, Rochester, Minnesota, USA).
Funding APPLE supported by the NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases contract N01-AR-2-2265), the Edna and Fred L Mandel Jr. Center for Hypertension and Atherosclerosis and Pfizer. Secondary analysis supported by the Rainbow Babies and Children’s Hospital Pediatrics Pilot Award and the NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases contract 5P30-AR-047363-12).
Disclaimer The views expressed in the stated article are those of the authors and are not an official position of the affiliated institutions or funders.
Competing interests None declared.
Patient consent Obtained.
Ethics approval CWRU IRB EM-17-19, approved through 5/14/2023.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement There is no additional unpublished data from the study.