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Ann Rheum Dis. 1999 May; 58(5): 309–314.
PMCID: PMC1752888

Increased apoptotic peripheral blood neutrophils in systemic lupus erythematosus: relations with disease activity, antibodies to double stranded DNA, and neutropenia


OBJECTIVE—To quantify the percentage of apoptotic peripheral blood neutrophils in systemic lupus erythematosus (SLE) and to determine the relations with disease activity and neutropenia.
METHODS—Neutrophil apoptosis in SLE patients (n =50) was assessed by flow cytometry using annexin V binding and fluorescent labelled anti-fas. Rheumatoid arthritis (RA, n =20) and inflammatory bowel disease patients (IBD, n =20) were studied as disease controls.
RESULTS—The percentage of apoptotic neutrophils, determined by annexin V binding, was increased in peripheral blood of SLE patients (median = 3.25%) compared with normal healthy donors (n =20, median = 1.20%) and disease controls (RA: median = 1.15%) (IBD: median = 1.15%). SLE neutrophil apoptosis correlated positively with lupus disease activity measured by SLAM score. SLE patients with increased antibodies to dsDNA (>10 mg/ml) had increased apoptotic neutrophils. Eight of 14 neutropenic SLE patients had increased apoptotic neutrophils. Increased neutrophil fas expression compared with normal controls was observed in SLE, RA, and IBD.
CONCLUSION—Neutrophil fas expression is increased non-specifically in inflammatory disease. Increased circulating apoptotic neutrophils in SLE correlate positively with disease activity (SLAM) and may contribute to autoantigen excess including dsDNA.

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Selected References

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Figures and Tables

Figure 1
Flow cytometric histograms showing: (A) separated neutrophils from an SLE patient defined by forward angle (FS) and side scatter (SSC) light properties. (B) CD15 positivity (96%) (shaded area) of the gated neutrophil population and isotype control profile ...
Figure 2
Percentage annexin V positive neutrophils in normal controls, SLE patients, RA patients and IBD patients. Each point represents one patient, and the median for each group is shown.
Figure 3
Percentage neutrophil fas expression in normal controls, SLE patients, RA patients, and IBD patients. Each point represents an individual patient and the median for each group is shown.
Figure 4
Scatter plot demonstrating positive correlation between percentage annexin V positive neutrophils and SLAM (r =0.50, p=0.001). Each point represents an individual SLE patient.
Figure 5
Percentage annexin V expression in SLE patients stratified according to the concentration of antibodies to double stranded DNA (mg/ml). The 5-10 group includes concentrations greater than 5.0 and less than or equal to 10.0. Each point ...

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