Evaluation of B-cell activating factor in corticosteroid-treated systemic lupus erythematosus patients

Background B-cell activating factor (BAFF) is one of the key regulators of B-cell function. Overexpression of BAFF is a characteristic feature of systemic lupus erythematosus (SLE). The effect of low-dose long-term corticosteroid therapy on BAFF level and its relation to clinical and laboratory findings in SLE patients were not thoroughly investigated. Objective To evaluate the effect of low-dose long-term corticosteroid therapy on serum BAFF levels, and to relate the BAFF results with various clinical and laboratory features. Patients and methods This study included 40 Egyptian SLE patients receiving a low-dose corticosteroid regimen (20mg prednisone orally daily) for a period of 6 months together with 40 controls. Patients were evaluated both clinically and serologically. Blood samples taken from each patient and control were subjected to enzyme-linked immunosorbent assay for estimation of serum BAFF level. Results BAFF level was elevated in 75% of corticosteroid-treated SLE patients and its mean level (1.468 ±1.540 ng/ml) was significantly higher than its mean in controls (0.517 ± 0.175 ng/ml), with a P value less than 0.001. No statistically significant relationship was detected between elevated BAFF level and any of the clinical and laboratory features except for disease duration (P= 0.005). Conclusion Steroid doses of 20 mg/day are ineffective in lowering BAFF level to its normal level. No correlation between elevated BAFF level and any clinical or laboratory finding was detected in our treated SLE patients.