Researchers Discover Link Between Platelet Volume, Systemic Lupus Erythematosus

With no single biomarker for systemic lupus erythematosus, investigators wanted to investigate whether there is a connection between mean platelet volume and the disease.

In a recent study, researchers described findings that illustrate how mean platelet volume (MPV) may serve as a biomarker of systemic lupus erythematosus (SLE).

There is no single biomarker for SLE, the researchers noted, and so they wanted to investigate whether there is a connection between MPV and the disease. Several studies have shown that MPV may be a sign of inflammation in some chronic diseases, so the intent of the study, published in the International Journal of Clinical Practice, was to determine whether there is a connection between MPV with SLE and inflammatory markers.

In a literature search, the authors found a few studies about MPV values with inflammatory markers in juvenile and adult patients with SLE.

Their case-control, retrospective study included 39 female patients with SLE and 45 controls. Measurements included erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) levels, and MPV levels. Clinical findings and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) were also evaluated.

The mean [SD] age of the patients with SLE was 37 [10.7] and in the control group it was 33.7 [5.1]. In the patient group, ESR level was 30.7 [29] and 16.7 [10]. CRP levels were also higher patients compared with controls (8.2 [13] versus 4.5 [4].

The researchers found a statistically significant positive link between MPV with arthritis, nephritis, central nervous system involvement, vasculitis, and SLEDAI.

High MPV values were independent of age, body mass index, ESR, and CRP, according to a multiple regression analysis.

The analysis also tested for specificity and sensitivity of MPV. The receiver operator characteristic (ROC) curve had an area under the curve of 0.79. At a value of 7.8 fL for MPV, the sensitivity and specificity were 69% and 42%, respectively (P <.001; 95%CI, 0.69-0.89). Using the cut-off value of 7.8 fL, MPV had maximum sensitivity and specificity, indicating that the probability of SLE increases remarkably at that level.

“We consider that MPV may be a new activation indicator for SLE,” they said.

A possible explanation for the increase in MPV may be activity of autoantibodies, thrombocyte activation, and the release of vasoactive and thrombogenic molecules, which occur in SLE disease. Larger platelets are activated more easily than smaller ones by adenosine diphosphate, collagen, and epinephrine, releasing greater amounts of thromboxane A2, platelet factor 4 and thromboglobulin.

However, more studies are needed on this issue, the authors wrote. They noted that the sample size was small and the study was retrospective.

“Further controlled prospective studies may provide more evidence about the prognostic and diagnostic utility of MPV in larger SLE populations,” they concluded.

Reference

Uzkeser H, Keskin H, et al. Is mean platelet volume related to disease activity in systemic lupus erythematosus? Int J Clin Pract. Published online August 7, 2021. doi: 10.1111/ijcp.14676.