The Expression of Migration Inhibitory Factor mRNA in Peripheral Blood of Children with Systemic Lupus Erythematosus

Abstract

Aim: This study was aiming at evaluation of the importance and the change in the level of macrophage migration inhibitory factor (MIF) in serum studied by ELISA and in peripheral blood mononuclear cell (PMBC) through the expression of mRNA of MIF studied by reverse PCR and its correlation with disease activity index in patients with systemic lupus erythematosus (SLE). Also, the relationship of MIF with the treatment by corticosteroids and renal involvement was taken into consideration.Material and methods: For this purpose, twenty lupus patients, regularly attending the Pediatric Allergy and Immunology Clinic, Children Hospital, Ain Shams University and fulfilling the American Rheumatism Association Revised Criteria for diagnosis of SLE, were studied in comparison to thirty-five healthy subjects as normal controls. According to the presence or absence of clinical renal involvement, lupus patients were divided into two groups: Group Ia: included 10 patients with clinical renal involvement and Group Ib: comprised 10 patients without clinical renal involvement. Full history taking and clinical examination were done and the SLEDAI was assessed. Also, the following laboratory investigations were performed ESR, routine microscopic urine analysis, 24 hours urine proteins, serum ANA, C3, serum anti-DNA, serum creatinine, serum MIF by ELISA and MIF gene expression through the mRNA in PBMC by rPCR.Results: The results of the present study showed that the MIF in serum and in PBMC were significantly higher among lupus patients as compared to normal controls. In addition, both were significantly higher among lupus patients with clinically evident nephritis than those without. Serum MIF and MIF gene expression were both significantly higher among lupus patients who suffered from symptoms suggestive of lupus nephritis as edema, hematuria, hypertension and positive anti DNA levels than other patients who did not experience these symptoms. In our study, different correlation analysis were done with serum MIF and MIF gene expression and proved to be significantly positive with SLEDAI score, ESR, cumulative dose of steroids, serum creatinine, 24 hour urinary protein and duration of illness in all lupus patients.Conclusions: In conclusion, MIF both in the serum and MIF gene expression by reverse PCR in macrophages were significantly higher in all lupus patients in comparison to healthy controls being significantly higher in those lupus patients with clinically evident nephritis than those without. Also MIF had a significant positive correlation to SLEDAI score and ESR indicating its correlation with disease activity.