Elevated serum complement levels and higher gene copy number of complement C4B are associated with hypertension and effective response to statin therapy in childhood-onset systemic lupus erythematosus (SLE)

What is it about?

KEY MESSAGES

What is already known about this subject?
Lupus patients experience heart and blood vessel diseases 9 to 50 times more frequently than healthy people. Statins are being used in adults to reduce levels of cholesterol in blood and decrease the risk of cardiovascular diseases. However, the effects of statins on children with lupus are not clear.

What does this study add?
This study used patient information and specimens created by a clinical trial of 221 children lupus patients who were treated with atorvastatin or placebo (sugar pills) over a three-year period. The diversities of some key immune genes and proteins among these patients were studied.

1. Compared with patients without hypertension, children with lupus and high blood pressure consistently had higher levels of immune proteins known as complement C4 and C3. Lupus patients with hypertension also had more copies of complement C4B genes than others.

2. Children with lupus and high copy number of C4B genes appeared to benefit from atorvastatin treatment to reduce the risk of cardiovascular diseases.

How might this impact on clinical practice?
1. Identifying sub-groups of lupus patients with higher risk of developing cardiovascular disease is important for effective therapy and management.

2. While complement levels tend to fluctuate with lupus disease activities, lupus patients with hypertension tend to have higher complement levels that can mask active diseases, or cause misinterpretation of lupus disease severity.

3. It may be beneficial to segregate lupus patients based on the complement C4 genetic diversity for precision treatment.


Featured Image