Suppression of inflammation reduces endothelial microparticles in active systemic lupus erythematosus

Ben Parker, Awal Al-Husain, Philip Pemberton, Allen P. Yates, Pauline Ho, Rachel Gorodkin, Lee Suan Teh, M. Yvonne Alexander, Ian N. Bruce

    Research output: Contribution to journalArticlepeer-review


    Background In a prospective observational study, we investigated whether patients with active systemic lupus erythematosus (SLE) had higher indices of endothelial damage and dysfunction than healthy controls and whether improved disease control was associated with improvement in these indices. Methods: Twenty-seven patients with active SLE (four or more American College of Rheumatology (ACR) criteria) and 22 age-matched controls were assessed. Endothelial microparticles (EMPs; CD31+/annexin V+/CD42b-) were quantified using flow cytometry. Brachial artery flow-mediated dilatation (FMD) was measured using automated edge-tracking software. Twenty-two patients had a second assessment at a median (IQR) of 20 (16, 22) weeks after initiating new immunosuppressive therapy. Results: SLE patients had a median (IQR) baseline global British Isles Lupus Assessment Group Disease Activity Index (BILAG-2004) score of 14 (12, 22). CD31+/annexin V+/CD42b- EMPs were higher (157 548/ml (59 906, 272 643) vs 41 025(30 179, 98 082); p=0.003) and endothelial-dependent FMD was lower (1.63% (-1.22, 5.32) vs 5.40% (3.02, 8.57); p=0.05) in SLE patients than controls. CD31+/annexin V+/CD42b- EMPs correlated inversely with FMD (%) (r2 -0.40; p=0.006). At follow-up, the median (IQR) change in global BILAG- 2004 score was -11 (-18, -3). CD31+/annexin V +/CD42b- EMP levels were reduced (166 982/ml (59 906, 278 775 vs 55 655(29 475, 188 659; p=0.02) and FMD had improved (0.33% (-2.31, 4.1) vs 3.19% (0.98, 5.09); p=0.1) at the second visit. Conclusions: Active SLE is associated with evidence of increased endothelial damage and endothelial dysfunction, which improved with suppression of inflammation. Better control of active inflammatory disease may contribute to improved cardiovascular risk in patients with SLE.
    Original languageEnglish
    Pages (from-to)1144-1150
    Number of pages6
    JournalAnnals of the rheumatic diseases
    Issue number6
    Early online date5 May 2013
    Publication statusPublished - 2014


    • Cardiovascular Disease
    • Disease Activity
    • Systemic Lupus Erythematosus


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