AB0498 CONCENTRATIONS OF ADVANCED GLYCATION END PRODUCTS (AGEs) CORRELATE WITH INDEXES OF ACTIVITY AND DAMAGE ACCRUAL IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (SLE).

Abstract

BackgroundIt has been postulated that AGES could have a relevant role as inducers in the chronic inflammatory pathway present in various diseases1; among them, in immune-mediated diseases such as SLE, as well as that its concentration could be related to some parameters of the disease such as activity 2 or accumulated damage 3, showing studies discrepant results to date.ObjectivesTo describe correlations between the concentrations of AGEs measured by cutaneous autofluorescence and various parameters related to the disease in a population of SLE patients.MethodsAGE concentrations were measured by skin autofluorescence (Age Reader Mu Connect from Diagnoptics Technologies BV) in 66 SLE Caucasian patients and correlations with demographic and clinical data were analyzed, after adjusting for age, smoking and corticosteroids as possible confounding factors, according to previous data. Previous validation studies have shown that skin autofluorescence is strongly related to AGE levels in skin biopsies4. The indices were analyzed both as quantitative and categorized variables according to previously established categories or to medians/tertiles/quartiles depending on the distribution of the variable in our population.ResultsTable 1 shows some descriptive characteristics of our cohort. There were clinically and statistically significant differences in the values of AGEs according to the patient’s SLEDAI and SLICC. Specifically, it was observed that AGEs’ values in the population with severe activity according to SLEDAI was 0.61 (95% CI 0.85-2.046; p=0.045) points > than in those in remission (p=0.045); as well as AGEs‘ values in patients with SLICC ≥1 was 1.23 (95% CI 0.49-1.98; p=0.030) points > than in the group without cumulative damage. In all the models, the values of AGEs increased significantly with age, smoking and current treatment with corticosteroids, except for the model including the SLICC variable. Interactions in said model were explored, and it was observed that the concentration of AGES depended on the interaction between the value of SLICC and the intake of corticosteroids, so that differences were only observed between SLICC groups in those who took corticosteroids.Table 1.Descriptive characteristics of the cohort. c: categorized.AverageSD%Age5415BMI25.364.68SmokerNo68.2Yes31.8AGEs2.60.7Disease duration (years)1611DAS282.221.16cDAS28remission71.2low9.1moderate15.2high4.5SLEDAI54cSLEDAIremission21.2low16.7moderate51.5high10.6SLICC11cSLICC00.0148.5>130.3321.2FACIT Fatigue Scale1810Patient global assessment (PGA)3.02.4cPGA0-131.82-328.8>339.4Physician global assessment1.71.3cPhysician global assessment0-147.0>153.0Visual Analogue Scale (VAS)3.13.1cVAS034.81-430.3>434.8Health Assessment Questionnaire (HAQ)0.5270.551cHAQ033.30-0.7536.4>0.7530.3CorticoidsYes27.3No72.7ConclusionA correlation with elevated values of AGEs was observed in those SLE patients with higher scores in the indexes of activity (SLEDAI) and damage accrual (SLICC). The fact that the differences in SLICC are only observed in those patients treated with corticosteroids suggests that, maybe, only the accumulated damage related to taking corticosteroids could be mediated by AGEs.References[1]Medzhitov R. Origin and physiological roles of inflammation. Nature 2008;454:428–435.[2]Vytášek R, Šedová L, Vilím V. Increased concentration of two different advanced glycation end-products detected by enzyme immunoassays with new monoclonal antibodies in sera of patients with rheumatoid arthritis. BMC Musculoskelet Disord 2010;11:83.[3]leeuw K de, Graaff R, Vries R de, Dullaart RP, Smit AJ, Kallenberg CG, Bijl M. Accumulation of advanced glycation endproducts in patients with systemic lupus erythematosus. Rheumatology 2007;46:1551–1556.[4]Meerwaldt R, Links T, Graaff R, Thorpe SR, Baynes JW, Hartog J, Gans R, Smit A. Simple noninvasive measurement of skin autofluorescence. Ann N Y Acad Sci 2005;1043:290-298.Disclosure of InterestsNone declared