Title:Elevated Circulating Thrombomodulin Levels in Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis
Volume: 28
Issue: 4
Author(s): Yu-Qian Hu, Zhi-Xin Wang, Kun Xiang, Yi-Sheng He, Ya-Ting Feng, Zong-Wen Shuai*Hai-Feng Pan*
Affiliation:
- Department of Rheumatology and Immunology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui,China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui,China
Keywords:
Systemic lupus erythematosus, lupus nephritis, disease activity, thrombomodulin, blood clotting, endothelial injury.
Abstract: Objectives: Thrombomodulin (TM) is closely related to the pathogenesis of autoimmune diseases, including
systemic lupus erythematosus (SLE). However, current evidence on circulating TM levels in SLE patients
is contradictory. We conducted this meta-analysis to more accurately assess circulating TM levels in patients
with SLE and lupus nephritis (LN) and to analyze related influencing factors.
Methods: Systematic search of relevant documents was conducted in PubMed, Embase, and The Cochrane Library
databases (up to 28 February 2021). Studies on the comparison of circulating TM between SLE patients
and controls were screened and evaluated for inclusion. Random-effects model analysis was applied to calculate
the combined standardized mean difference (SMD) with a 95% confidence interval (CI). Heterogeneity
was estimated by Q statistics and I2.
Results: A total of 353 articles were identified, 14 provided adequate information for this study finally. The results
illustrated that SLE patients had higher TM levels than healthy controls (SMD=0.38, 95% CI: 0.02 to
0.74, p=0.04). Circulating TM levels were increased in patients with active SLE compared to inactive SLE patients
(SMD=1.12, 95% CI: 0.03 to 2.20, p=0.04). In addition, circulating TM levels of SLE patients with LN
were higher than those without LN (SMD=4.55, 95% CI: 1.97 to 7.12, p=0.001).
Conclusion: The circulating TM levels in SLE patients are enhanced. In addition, circulating TM levels may be
practical in reflecting the disease activity and nephritis involvement of SLE patients.
