Impaired phagocytosis and susceptibility to infection in pediatric-onset systemic lupus erythematosus

• Published in: Lupus 2013-03, Vol.22 (3), p.279-288
• Main Authors: Wu, S-A, Yeh, K-W, Lee, W-I, Yao, T-C, Kuo, M-L, Huang, B, Huang, J-L
• Format: Article
• Language: English
• Subjects: Adolescent; Asthma; Bacterial infections; Bacterial Infections - immunology; Blood; Child; Disease Susceptibility; Female; Hospitals; Humans; Immunosuppressive agents; Immunosuppressive Agents - pharmacology; Immunosuppressive Agents - therapeutic use; Leukocytes; Lipopolysaccharides - immunology; Lupus; Lupus Erythematosus, Systemic - drug therapy; Lupus Erythematosus, Systemic - immunology; Male; Mortality; Neutrophils - drug effects; Neutrophils - immunology; Pediatrics; Phagocytosis - drug effects; Phagocytosis - immunology; Rheumatology; Salmonella; Salmonella - drug effects; Salmonella Infections - immunology; Sepsis; Streptococcus infections
• ISSN: 0961-2033; 1477-0962
• DOI: 10.1177/0961203312474704

Objectives Impaired function of polymorphonuclear cells (PMNs) in systemic lupus erythematosus (SLE) leads to severe gram-positive and gram-negative bacterial infection, and to major morbidity and mortality. Few studies have focused on the association of impaired function of PMNs and SLE patients’ susceptibility to infection. This study aimed to analyze function of PMNs in peroxidase production, chemotaxis, and phagocytosis in pediatric-onset SLE with severe infection. Methods This study compared function of PMNs among pediatric-onset SLE patients with and without histories of severe infection and in normal control subjects. Human peripheral blood PMNs were isolated from patients and controls. Function of PMNs was measured by analyzing peroxidase, chemotaxis, and phagocytic activities. Different disease activity and severity, and drug use in newly diagnosed SLE patients were also compared. Results In total, 34 SLE patients (12 patients with severe infection, 22 patients without infection) and 25 healthy controls were analyzed. There were no differences in function of PMNs between SLE patients with or without severe infection. Regardless of infection status, medication, and disease activity, SLE patients had impaired phagocytic ability against Salmonella-specific lipopolysaccharides (LPS) compared with normal controls (p