Could Skin Autofluorescence Be a Useful Biomarker in Systemic Lupus Erythematosus? A Systematic Review

Area of Science:

• Rheumatology and Immunology
• Biomarker Discovery
• Oxidative Stress Research

Background:

• Systemic lupus erythematosus (SLE) is a complex autoimmune disease with varied organ involvement.
• Reliable biomarkers for SLE severity and activity are still under investigation.
• Advanced glycation end products (AGEs) and their receptor (RAGE) are implicated in chronic inflammatory conditions.

Purpose of the Study:

• To systematically review the utility of skin autofluorescence (SAF) as a biomarker in SLE.
• To assess SAF's correlation with disease severity, activity, and impact in SLE patients.
• To evaluate the role of the AGEs-RAGE axis in SLE pathophysiology.

Main Methods:

• Systematic review conducted following PRISMA guidelines.
• Analysis of six studies evaluating SAF, circulating AGEs, and soluble RAGE (sRAGE) in SLE patients.
• Comparison of biomarker levels and correlations with clinical features between SLE patients and healthy controls.

Main Results:

• Elevated AGE levels were consistently found in SLE patients compared to controls.
• Higher SAF and AGE levels correlated with increased SLE disease activity (SLEDAI scores), organ involvement, and damage indices.
• Lower sRAGE levels were observed in SLE patients, potentially due to consumption by AGEs.

Conclusions:

• The AGEs-RAGE axis, particularly SAF, shows promise as a non-invasive biomarker for SLE.
• SAF may help assess disease severity and activity in SLE patients.
• Further large-scale longitudinal studies are required to validate the clinical utility of SAF in SLE management.