Assessment of immunocompetence and risk factors of infection in patients with systemic lupus erythematosus

• Grant number: 24/06707-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: July 01, 2024
• End date: June 30, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Paulo Louzada Junior
• Grantee: Lara Berlofa Scrócaro
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Associated research grant: 13/08216-2 - CRID - Center for Research in Inflammatory Diseases, AP.CEPID

Abstract

Introduction: Systemic lupus erythematosus (SLE) is an inflammatory chronic disease, of multifactorial etiology, with pleiomorphic andheterogeneous manifestations. In recent years, with the evolution of the knowledge ofpathophysiology of the disease and therapeutic possibilities, there was a significantincrease in survival of patients with SLE. Despite this, mortality is about 3 to 5 times higher than the general population. SLE patientsare more vulnerable to infections, which are responsible for 30-50% ofmorbidity and mortality, being one of the main causes of hospitalization. Thatpredisposition arises from changes in different components of the immune system. Furthermore, the use of glucocorticoids and immunosuppressive drugsconstitute an additional risk factor for infections. Objective: Assess theimmunocompetence in SLE patients at different stages of the disease andunder different treatments, as well as determining clinical andlaboratories risk factors for infection. Patients and methods: this is a case-control study, with convenience sampling. Will be recruited120 patients with SLE followed at the Rheumatology Outpatient Clinic ofHospital das Clínicas de Ribeirão Preto and 40 healthy control subjects.All patients must meet the ACR classification criteria, haveage between 18-60 years and not presenting comorbidities that could interferein immunocompetence. Clinical characterization will be carried out through reviewof medical records. To assess humoral immunity, the following tests will be performed:nitroblue tetrazolium (NBT) test, measurement of immunoglobulins (IgA, IgM and IgG), serumprotein electrophoresis, determination of the C3 and C4 components of the systemcomplement and quantification of cytokines. We will also evaluate the presence ofneutrophil extracellular traps (NETs) in serum. Patients will begrouped according to disease activity and immunosuppressive therapyinto 5 groups (recent diagnosis of untreated SLE; SLE in remissiononly with antimalarial; SLE in remission with immunosuppressive drugs;SLE active with immunosuppressive drugs; SLE patients undergoing a systemic infection).