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Steroid Resistance Associated with High MIF and P-gp Serum Levels in SLE Patients

Alberto Beltrán-Ramírez1,2, José Francisco Muñoz-Valle2, Jorge I Gamez-Nava3

  • 1Doctorado en Farmacología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico.

Molecules (Basel, Switzerland)
|October 14, 2022
PubMed

Insights

Steroid resistance in systemic lupus erythematosus (SLE) is linked to higher serum levels of macrophage migration inhibition factor (MIF) and P-glycoprotein (P-gp). High P-gp is the primary risk factor for steroid resistance in SLE patients.

Area of Science:

  • Immunology
  • Rheumatology
  • Biochemistry

Background:

  • Systemic lupus erythematosus (SLE) affects approximately 30% of patients with steroid resistance (SR).
  • Macrophage migration inhibition factor (MIF) and P-glycoprotein (P-gp) are potential factors implicated in SR.
  • Understanding the relationship between MIF, P-gp, and SR in SLE is crucial for developing targeted therapies.

Purpose of the Study:

  • To investigate the association between serum levels of MIF and P-gp in patients with SR SLE.
  • To identify potential biomarkers for predicting steroid resistance in SLE.

Main Methods:

  • A case-control study involving 188 SLE patients (90 SR, 98 steroid-sensitive) and 35 healthy controls.
  • Serum levels of MIF and P-gp were quantified using ELISA.
  • Multivariable logistic regression and Chi-squared automatic interaction detection (CHAID) were employed to analyze risk factors.

Main Results:

  • Patients with SR SLE exhibited significantly higher serum levels of MIF and P-gp compared to steroid-sensitive patients and healthy controls (p < 0.001).
  • A positive correlation was observed between MIF and P-gp serum levels (rho = 0.41, p < 0.001).
  • Elevated MIF (≥15.75 ng/mL) and P-gp (≥15.22 ng/mL) were identified as risk factors for SR (OR = 2.29, OR = 5.27, respectively).

Conclusions:

  • Serum MIF and P-gp levels are associated with steroid resistance in SLE.
  • High P-gp levels (≥15.22 ng/mL) emerged as the primary risk factor for SR in SLE.
  • Further research is warranted to validate these findings and explore their clinical implications.
Keywords:
CHAIDMIFP-gpinteractionsteroid-resistancesystemic lupus erythematosus

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