Combination of Serum NSE, S100B Can Measure Activity in SLE, Study Finds

Levels of the 2 markers appeared to indicate both the presence of SLE and disease activity levels.

A small study of patients with systemic lupus erythematosus (SLE) suggests that serum neuron-specific enolase (NSE) combined with serum S100B protein can be an effective means to track damage to the central nervous system (CNS), but the authors of a new report say research with a larger data set will be needed before the results can be used as a prognostic tool.

The report was published in Contrast Media & Molecular Imaging.

The authors of the 980th Hospital of People’s Liberation Army Joint Logistics Support Force, in China, wrote that existing measures of SLE disease activity, such as the SLE Disease Activity Index (SLEDAI), can be valuable tools. However, they also suffer from untimeliness, instability, and human error. On the other hand, biochemical markers can provide a fast and accurate picture of patients’ conditions, they said.

Two meaningful serum markers in SLE are NSE and S100B protein, the investigators argued. Previous research has associated NSE levels with advanced disease and poor histological types, but they said the specificity of serum NSE in SLE diagnosis is lower than the sensitivity. On the other hand, the specificity of S100B protein is higher than the sensitivity.

“Therefore, the diagnostic criteria of SLE should be combined with S100B protein,” the authors said. “However, the sensitivity and specificity of these 2 markers in SLE are rarely studied.”

The investigators recruited 60 patients with SLE and divided them into 3 groups of 20 patients each based on mild, moderate, or severe disease activity level. In addition, 60 healthy controls who underwent physical examinations at the same hospital were included. There were no significant differences in sex, age, marital status, or education level between the SLE and control groups nor between the 3 SLE activity groups.

The authors found that levels of S100B protein and NSE were higher in the SLE group compared with the control group. Furthermore, they found S100B and NSE levels increased in patients with SLE as disease severity increased.

“With the increase of SLE activity, serum S100B and NSE levels gradually increased, and the data difference was statistically significant,” the authors said.

The investigators next used a receiver operating characteristic (ROC) curve to evaluate the diagnostic value of the 2 markers. They found the markers were most effective when used in combination, rather than individually.

“The levels of serum S100B protein and NSE had a certain value in the diagnosis of SLE, while the combined diagnosis was of higher value, sensitivity, and specificity in the diagnosis of SLE,” they wrote.

The authors said their data suggest the 2 metrics, in combination, are “very sensitive indicators” to judge CNS damage, but they said their study alone is insufficient to create a tool for clinical use. They noted, for instance, that there are as many as 19 classifications for neuropsychiatric SLE (NPSLE), and their study included just 60 patients total.

“[S]o the relationship between S100B protein, NSE levels, and various NPSLE and their exact application value in diagnosing the disease and judging the prognosis needs to be confirmed by expanding the number of cases,” they concluded.

Reference

Chen J, Yan Cheng, Zhang X, Wang F, Chuai X. Clinical value of serum neuron-specific enolase combined with serum S100B protein in the diagnosis of systemic lupus erythematosus. Contrast Media Mol Imaging. Published online May 9, 2022. doi:10.1155/2022/9390991