Abstract
Background
There are limited data on neutrophil function in pediatric-onset systemic lupus erythematosus (pSLE) patients. This study aimed to evaluate phagocytosis and oxidase activity of neutrophils in patients with pSLE.
Patients and methods
Eighty-seven patients with pSLE and 44 controls were enrolled. Phagocytic activity was assayed using pHrodoTMRed E. coli BioParticles Phagocytosis Kit by flow cytometry. Determination of NADPH oxidase activity was carried out by Dihyrdrorhodamine-123 (DHR-123) flow cytometry assay.
Results
Phagocytic activity of patients’ neutrophils (mean 76.59%) was lower than that in controls (91.30%) (p < 0.001). Median delta median fluorescence intensity (ΔMFI) and stimulation index (SI) in patients (ΔMFI: 0.09; SI: 2.79) were also decreased compared to controls (ΔMFI: 0.18; SI: 5.00) (p < 0.002; p < 0.001 respectively). Disease activity showed an inverse correlation with phagocytic activity. Oxidase activity was also significantly low (SI DHR < 40) in 16% of patients. No significant correlation was found between oxidative burst and disease activity.
Conclusion
Neutrophil function is impaired in patients with pSLE, as evidenced by the markedly reduced phagocytic activity. Phagocytic activity is also inversely correlated with disease activity. The oxidative activity was also reduced but not significantly.
Impact
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Neutrophil phagocytic function is impaired in pediatric-onset systemic lupus erythematosus (pSLE).
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There is an inverse correlation between disease activity in pSLE and phagocytic activity.
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NADPH oxidase activity in patients with pSLE did not show significant correlation with disease activity.
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Data availability
The data necessary for the findings of this paper are included in the manuscript, online supplementary data, and in our records. These data can be shared on request.
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Acknowledgements
The authors thankfully acknowledge Postgraduate Institute of Medical Education and Research, Chandigarh, India for funding vide Grant No (PGI/MERC/2017/351715). The funders had no role in study design, data collection and analysis, decision to publish, or manuscript preparation. This study was approved by the Institute Ethics Committee, Institute Thesis Committee and Departmental Review Board of Pediatrics at the Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India. We deeply thank patients and their parents for their cooperation.
Funding
We thankfully acknowledge Postgraduate Institute of Medical Education and Research, Chandigarh, India for granting Institutional Thesis Grant (PGI/MERC/2017/351715) for this work.
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R.K.P.: inception of idea, design of the research, performance of laboratory tests, data collection, patient management, data interpretation, writing of first draft, review of literature, editing of manuscript and critical revision of manuscript at all stages. A.R.: inception of idea, design of the research, standardization of flow cytometry tests, data interpretation, editing of manuscript, critical revision at all stages, and final approval of the manuscript. R.K.P., A.R., J.S., and K.A. standardized and performed the flow cytometry tests. R.K.P., A.R., J.S., K.A., A.G., B.S., M.S., G.K., and S.S. performed the research. R.K.P., A.R., K.A., and S.S. wrote the paper. A.R., A.G., B.S., and S.S. critically supervised the manuscript. All the authors read and approve the final manuscript.
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The study was approved by the Departmental Review Board, Institute Thesis Committee, and Institute Ethics Committee.
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A written, informed parental consent (for patients 8 years, as per our institutional guidelines) was obtained from the patient or one of the parents.
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Pilania, R.K., Rawat, A., Shandilya, J. et al. Pediatric systemic lupus erythematosus: phagocytic defect and oxidase activity of neutrophils. Pediatr Res 92, 1535–1542 (2022). https://doi.org/10.1038/s41390-022-02055-2
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DOI: https://doi.org/10.1038/s41390-022-02055-2
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