AutoAbs (ANA, ds-DNA) and trace elements (Zn, Cu, AL) and essential element (Ca) serum levels in Iraqi patients with SLE
Keywords:
SLE, ANA, ds-DNA, zinc, Copper, Aluminum, CalciumAbstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, with a wide range of clinical symptoms. Numerous studies have indicated to the association between autoantibodies (ANA and ds-DNA), trace elements [Zinc (Zn), Copper (Cu), Aluminum (AL)], and essential element Calcium (Ca) serum levels and pathogenesis of SLE. The current study aims to evaluate the role of some autoantibodies (ANA, ds-DNA), Trace elements (Zn, Cu, AL), and essential element (Ca) in pathogenesis of early diagnosed SLE patients and treated patients. The study included 180 females diagnosed with SLE and a healthy individuals as control (60 females as early diagnosed SLE without treatment, 60 females as SLE patients under treatment with (prednisolone, hydroxychloroquine) and 60 females healthy as control group, with ages ranging from 20 to 45 years. The serum levels of autoantibodies (ANA and ds-DNA) were assessed by Enzyme linked immunosorbent assay (ELISA). Trace elements (Zn, Cu, Al) and essential element (Ca) were assessed using atomic absorption spectrophotometer (AAS). The results of ANA and ds-DNA showed that the serum level of ANA was significantly higher in early diagnosed group followed by treated group compared with control group (p<0.05). The ds-DNA serum level was significantly higher in both SLE patients groups (early diagnosed and treated) compared with control group (p<0.05). The results of trace elements and Ca showed that the serum levels of Zn and Ca were significantly lower in both SLE patients groups (early diagnosed and treated) compared with healthy control group (p<0.05). The Cu and AL serum levels were significantly higher in both SLE patients groups (early diagnosed and treated) compared with healthy control group (p<0.05). Based on these results, autoantibodies (ANA, ds-DNA), trace elements (Zn, Cu, Al), and essential element (Ca) may plays a role in the pathogenesis of SLE.
Downloads
References
Abbas AH, Melconian AK. and Ad'hiah AH (2019)
Autoantibody Profile in Systemic Lupus Erythematosus
Patients. J Phys Conf Ser1294 (6):062006). DOI:
https://doi:1Q.1088/1742-6596/1294/6/062006
Abd-Alrasool ZA, Gorial Fl. and Hashim MT. (2017)
Prevalence and severity of depression among Iraqi
patients with systemic lupus erythematosus: A
descriptive study. Mediterr J Rheumatol 28(3):142-146.
DOI: https://doi.orq/10.31138/mjr.28.3.142
Agmon-Levin N, Arango MT, Kivity S, Katzav A, Gilburd B,
et al. (2014) Immunization with hepatitis B vaccine
accelerates SLE-like disease in a murine model. J
Autoimmun 54:21-32. DOI:
https://doi.orq/10.1016/i.iaut.2014.06.0Q6
Ala S, Shokrzadeh M, Golpour M, Salehifar E, Alami M, and
Ahmadi A (2013) Zinc and copper levels in Iranian
patients with psoriasis: a case control study. Biol Trace
Elem Res 153: 22-27. DOI:
https://doi.org/1Q.1007/s12011-013-9643-6
Al-Abassi HM, Almohaidi AMS, and ALMusawi AAR (2018).
Determination of Integrin 2 (ITGA2), Progesterone,
prolactin, estradiol, zinc and Vitamin C in serum of
female Iraqi patients with breast cancer. Ibn alHaitham j pure appl sci (pp.73-86). URL:
https://www.iasi.net/iasi/download/7f9edOOa3af523fe
Al-Hasso IKO, Al-Derzi AR, Abbas AA, Gorial Fl. and
Alnuimi AS. (2020) The role of microRNAs (MiR-125a
and MiR-146a), RANTES, and IFN- in systemic lupus
erythematosus. Ann Trop Med Public Health 23(13):231-
DOI: http://doi.org/10.36295/ASRO.2020.231382
Al-Mughales JA (2022) Anti-Nuclear Antibodies Patterns in
Patients With Systemic Lupus Erythematosus and Their
Correlation With Other Diagnostic Immunological Parameters. Front immunol 13: 850759.
DOI:https://doi.org/1Q.3389%2Ffimmu.2022.850759
Al Rawi ZS, Gorial Fl, Tawfiq RF, Mohammed AK, Al Naaimi
AS et al. (2014) Brief Report: A Novel Application of
Buccal Micronucleus Cytome Assay in Systemic Lupus
Erythematosus: A Case-Control Study. Arthritis
Rheumatol 66(10):2837-2841.DOI:
https://doi.org/10.1002/art.38764
Arbuckle MR, James JA, Kohlhase KF, Rubertone MV,
Dennis GJ et al. (2001) Development of anti dsDNA
autoantibodies prior to clinical diagnosis of systemic
lupus erythematosus. Scand j immunol 54(1 2):211-
DOI:https://doi.orq/10.1046/j.1365-
2001.00959.x
Arbuckle MR, McClain MT, Rubertone MV, Scofield RH,
Dennis GJ, et al. (2003) Development of autoantibodies
before the clinical onset of systemic lupus
erythematosus. N Engl J Med 349(16):1526-
DOI:https://doi.org/10.1Q56/nejmoa021933
Bai Y, Tong Y, Liu Y. and Hu H (2018). Self-dsDNA in the
pathogenesis of systemic lupus erythematosus. Clin
Exper Immunol 191(1):1-10. DOI:
https://doi.org/10.1111%2Fcei.13041
Brown AC (2000) Lupus erythematosus and nutrition: a
review of the literature. J Ren Nutr 10(4): 170-183. DOI:
http://dx.doi.orq/10.1053/iren.2000.16323
Buckley L, Guyatt G, Fink HA, et al. (2017) American College
of Rheumatology guideline for the prevention and
treatment of glucocorticoid-induced
osteoporosis. Arthritis Rheumatol 69(8):1521-1537. DOI:
https://doi.orq/10.1002/art.40137
Cannas D, Loi E, Serra M, Firinu D, Valera P et al. (2020)
Relevance of essential trace elements in nutrition and
drinking water for human health and autoimmune
disease risk. Nutrients12(7):2074. DOI:
https://doi.org/10.3390/nu12072074
Cozzani E, Drosera M, Gasparini G. and Parodi A (2014)
Serology of lupus erythematosus: correlation between
immunopathological features and clinical
aspects. Autoimmune
dis, 2014:321359.DQI:https://doi.org/10.1155/2014/321359
Craig WY. and Ledue TB (2011) The antinuclear antibody
assay: developing criteria for reflexive anti-dsDNA
antibody testing in a laboratory setting. Clin Chern Lab
Med 49:1205-1211. DOI:
https://doi.Org/1Q.1Q46/j.13653083.2001.0Q959.x
Czupryn M, Falchuk KH, Stankiewicz A, Vallee BL (1993) A
Euglena gracilis zinc endonuclease. Biochem 32(5):1204-
URL:https://pubs.acs.org/doi/pdf/10.1021/bi00056a00
Dahham ZM. and Haddad N1.(2023) Correlation Between Gene
Expression of Interferon Regulatory Factor-5 and Disease
Activity Index in Systemic Lupus Erythematosus Iraqi
Patients.Iraqi J Sci 64(2): 605-619.
DQI:https://doi.org/10.24996/ijs.2023.64.2.10
Du X, Zhao D, Wang Y, Sun Z, Yu 0, et al. (2022). Low serum
calcium concentration in patients with systemic lupus
erythematosus accompanied by the enhanced peripheral
cellular immunity. Front Immunol 10(13):901854.
DOI:https://doi.org/1Q.3389/fimmu.2022.901854
ELAMIR A M, FARID AA, AM ES, HASSAN H A, MAGED M M
et al. (2019) Anti-nuclear antibody (ANA) patterns in
egyptian systemic lupus erythematosus.
J Egypt Soc Parasitol 49(2):451-454.DOI:
https://doi.org/10.21608/iesp.2019.68190
Exley C, Siesjd P, and Eriksson H (2010) The immunobiology
of aluminium adjuvants: how do they really
work?. Trends Immunol 31(3):1O3-1O9.
DOI:https://doi.org/10.1Q16/j.it.2009.12.009
Foster M, and Samman S (2012) Zinc and regulation of
inflammatory cytokines: implications for
cardiometabolic disease. Nutrients 4(7): 676-694. DOI:
https://doi.org/10.3390%2Fnu4070676
Gammoh NZ, and Rink L (2020) Zinc and the immune
system: Insights into the role of zinc in autoimmune
diseases. In Essential and Toxic Trace Elements and
Vitamins in Human Health (pp. 31-53). Academic Press.
DOI: https://doi.org/1Q.1Q16/B978-0-12-8Q5378-
OOQO3-6
Gheita T A, Abaza NM, Hammam N, Mohamed AAA, ElGazzar II et al. (2018) Anti-dsDNA titre in female
systemic lupus erythematosus patients: relation
to disease manifestations, damage and
antiphospholipid antibodies. Lupus 27(7):1081-1087.
DOI: https://doi.org/10.1177/09612033187602Q9
Hasan EJ (2017) Evaluation of Copper, zinc, manganese,
and magnesium levels in newborn jaundice in
Baghdad. Ibn al-Haitham j pure appl sci 24(3). URL:
https://jih.uobaghdad.edu.iq/index.php/j/article/view/8
/680
Hochberg MC (1997) Updating the American College of
Rheumatology revised criteria for the classification of
systemic lupus erythematosus. Arthritis
rheum, 40(9):1725-1725. DOI:
https://doi.org/10.1002/art.178040Q928
Islam MA, Khandker SS, Kotyla PJ, and Hassan R (2020)
Immunomodulatory effects of diet and nutrients in
systemic lupus erythematosus (SLE): a systematic
review. Front immunol 22(11):1477.
DOI:https://doi.org/10.3389/fimmu.2020.01477
Izquierdo JH, Bonilla-Abadia F, Canas CA. and Tobon GJ.
(2014). Calcium, channels, intracellular signaling and
autoimmunity. Reumatol Clin 10(1):43-47.
Kamen DL (2014) Environmental influences on systemic
lupus erythematosus expression. Rheum Dis Clin
(3):401-
DOI:https://doi.org/10.1Q16/j.rdc.2014.05.003
Kamil MA, Kadr ZHM and Alabassi HM (2022) Role of
CXCL9-CXCR3 AXIS, ANA & DS-DNA ABS in
Pathogenicity of SLE in Iraqi Patients. Pakistan J.
Medical Health Sci 16(04):398-398. DOI:
https://doi.org/10.53350/pimhs22164398
Klack K, Bonfa E, and Borba Neto EF (2012) Diet and
nutritional aspects in systemic lupus
erythematosus. Rev Bras Reumatol 52:395-408.URL:
https://www.scielo.br/i/rbr/a/GdDn9ciL4gLTYghMXYM
BjQn/?format=pdf&lang=en
Lam NC, Ghetu MV. and Bieniek ML (2016) Systemic lupus
erythematosus: primary care approach to diagnosis and
management. Am fam physician 94(4): 284-294.DOI:
http://doi.org/10.3389/fmed.2018.00161
Mezzaroba L, Alfieri DF, Simao ANC. and Reiche EMV
(2019) The role of zinc, copper,manganese and iron in
neurodegenerativediseases. Neurotoxicology74:230-
DOI: https://doi.Org/10.1016/j.neuro.2019.07.007
Mohammed RK. and Fezea SM (2017) Determination of
Some Trace Element Levels in Iraqi Male patients with
Colorectal Cancer. Ibn al-Haitham j pure appl sci 29(2): 254-261. URL:
https://jih.uobaqhdad.edu.iq/index.php/j/article/view/1
/98
Nossent J, Lester S, Rischmueller M, ond Zalewski P (2017)
No zinc deficiency but a putative immunosuppressive
role for labile Zn in patients with systemic autoimmune
disease. Cur Rheumatol Rev 13(1):59-64.
DOI:https://doi.orq/1Q.2174/157339711166615102622350
Oliveira CB, Lima CAD, Vajgel G, and Sandrin-Garcia P
(2021) The role of NLRP3 inflammasome in lupus
nephritis. Int J Mol Sci 22(22):12476.DOI:
https://doi.orq/10.3390%2Fijms222212476
Olsen NJ and Karp DR (2014) Autoantibodies and SLE—the
threshold for disease. NatRev Rheumatol 10(3):181-
DOI:https://doi.orq/10.1038/nrrheum.2013.184
Orbach H, Agmon-Levin N, and Zandman-Goddard G
(2010) Vaccines and autoimmune diseases of the
adult. Discov Med 9(45):90-97. URL:
https://pubmed.ncbi.nlm.nih.gov/2O193633/
Panday K, Gona A, and Humphrey MB (2014) Medicationinduced osteoporosis: screening and treatment
strategies. Ther Adv Musculoskelet Dis6(5):185-
DOI: https://doi.org/10.1177%2F1759720X14546350
Park YJ, Yoo SA, Kim M. and Kim WU (2020) The role of
calcium-calcineurin-NFAT signaling pathway in health
and autoimmune diseases. Fron Immunol11:195.
DOI:https://doi.orq/1Q.3389%2Ffimmu.2020.00195
Pascoe K, Lobosco S, Bell D, Hoskin B, Chang DJ, Pobiner B.
and Ramachandran, S. (2017) Patient- and Physicianreported Satisfaction With Systemic Lupus
Erythematosus Treatment in US Clinical Practice. Clin
Ther 39(9):1811-1826. DOI:
https://doi.orq/10.1016/j.clinthera.2017.07.039
Pedro EM, da Rosa Franchi Santos LF, Scavuzzi BM, Iriyoda
TMV, Peixe TS. Et al. (2019) Trace elements associated
with systemic lupus erythematosus and insulin
resistance. Biol Trace Elem Res191(1):34-44.
DOI: https://doi.org/10.1007/s12011-018-1592-7
Pfeil DL (1993) Atomic Absorption Spectrometry: Theory,
Design and Application. Edited by SJ Haswell, Elsevier,
Amsterdam,1991, 529:$179.00.
Pisetsky DS. and Lipsky PE (2020) New insights into the
role of antinuclear antibodies in systemic lupus
erythematosus. Nat Rev Rheumatol 16(10): 565-579.
DOI: http://dx.doi.org/10.1038/s41584-020-0480-7
Pravina P, Sayaji D, and Avinash M (2013) Calcium and its
role in human body. Int j res pharm biomed sci 4(2):659-
URL:
https://www.researchgate.net/publication/274708965
Calcium and its Role in Human Body
Refai RH, Barghout MF, Abou-Raya AN, and Abdou MH
(2022) Environmental Risk Factors of Systemic Lupus
Erythematosus: A Case Control Study. Sci rep,(Under
review). URL:
https://assets.researchsquare.com/files/rs-
/v1/9aef7280-a016-4a1a-80a0-
a488ee9374.pdf?c=1643818829
Rekvig OP, 2015. Anti-dsDNA antibodies as a classification
criterion and a diagnostic marker for systemic lupus
erythematosus: critical remarks. Clin Expe
Immunol179(1):5-10. DOI:
https://doi.org/10.1111/cei.12296
Relle M, Weinmann-Menke J, Scorletti E, Cavagna L, and
Schwarting A (2015) Genetics and novel aspects of
therapies in systemic lupus erythematosus. Autoimmun
Rev 14(11):1005-1018.DGI:
https://doi.orq/10.1016/j.autrev.2015.07.003
Ruiz JT, Lujan L, Blank M, and Shoenfeld Y (2017)
Adjuvants-and vaccines-induced autoimmunity: animal
models. Immunol Res 65(1):55-65.
DOI: https://doi.org/10.1007/s12026-016-8819-5
Ruiz-lrastorza G, Egurbide MV, Olivares N, MartinezBerriotxoa A, and Aguirre C (2008) Vitamin D
deficiency in systemic lupus erythematosus: prevalence,
predictors and clinical consequences. Rheumatol
(6):920-923.
Sahebari M, Abrishami-Moghaddam M, Moezzi A, GhayourMobarhan M, Mirfeizi Z, et al. (2014) Association
between serum trace element concentrations and the
disease activity of systemic lupus erythematosus. Lupus
(8):793-8O1. DOI:
https://doi.org/10.1177/0961203314530792
Sahebari M, Rezaieyazdi Z. and Khodashahi M. (2019)
Selenium and autoimmune diseases: a review
article. Curr Rheumatol Rev 15(2): 123-134.
DOI:http://dx.doi.orq/1Q.2174/15733971146661810161123
Sanna A, Firinu D, Zavattari P, and Valera P, (2018) Zinc
status and autoimmunity: a systematic review and
meta-analysis. Nutrients 10(1):68.
DOI: https://doi.org/10.3390%2Fnu10010068
Sha Y, Rui Z, Dong Y, Wei X, Zhou Y, et al. (2020) Total serum
calcium level is negatively correlated with systemic lupus
erythematosus activity. Dose-response
(2):1559325820926764.
DOI:https://doi.orq/10.1177%2F155932582Q926764
Soybilgic A, Onel KB, Utset T, Alexander K, and WagnerWeiner L (2013) Safety and immunogenicity of the
quadrivalent HPV vaccine in female Systemic Lupus
Erythematosus patients aged 12 to 26 years. Pediatr
RheumatoL 11(1):1-7. DOI: https://doi.org/10.1186/1546-
-11-29
Strecker D, Mierzecki A, and Radomska K (2013) Copper
levels in patients with rheumatoid arthritis. Ann Agric
Environ Med 20(2): 312-316. URL:
https://www.aaem.pl/pdf-71934-
?filename=Copper%20levels%20in%20patients.pdf
Tapiero H, Townsend DA, and Tew KD (2003) Trace
elements in human physiology and pathology.
Copper. Biomed & pharmacother 57(9):386-398. DOI:
https://doi.orq/10.1016/s0753-3322(03)00012-x
Tedeschi SK, Kim SC, Guan H, Grossman JM. and
Costenbader KH (2019) Comparative Fracture Risks
among US Medicaid Enrollees with and without
Systemic Lupus Erythematosus. Arthritis Rheumatol
(7):1141-1146.
DOI: https://doi.orq/10.1002/art.40818
Veldurthy V, Wei R, Oz L, Dhawan P, Jeon YH, and
Christakos S (2016) Vitamin D, calcium homeostasis
and aging. Bone Res4(1):1-
DOI:https://doi.orq/10.1038%2Fboneres.2016.41
Watad A, Tiosano S, Azrielant S, Whitby A, Comaneshter D,
et al. (2017) Low levels of calcium or vitamin Dwhich is more important in systemic lupus
erythematosus patients? An extensive data
analysis. Clin Exp Rheumatol 35(1):108-112.URL:file:///C:/Users/AL%20ASEEL/Downloads/arti cle%20(4).pdf
Zhu Y, Hu C, Li X, et al (2012) Suppressive effects of aluminum trchloride on the T lymphocyte immune function of rats. Food Chern Toxicol 50:532-535.50 DOI: https://doi.Org/10.1016/i.fct.2011.12.007
Downloads
Published
Issue
Section
License
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
