Abstract:
Background. Nervous system involvement in systemic lupus erythematosus (SLE) is frequent and diverse. The causes and mechanisms underlying these manifestations remain poorly understood. Recently, the biomolecule endoglin, which is associated with certain neurological and autoimmune diseases, has garnered the attention of researchers; however, its role in the pathogenesis of neuropsychiatric systemic lupus erythematosus (NPSLE) remains unclear. The purpose was to investigate the serum level of soluble endoglin in patients with SLE, to evaluate its association with demographic parameters and inflammatory activity, and to determine its diagnostic value as a potential marker of NPSLE. Materials and methods. A total of 96 patients with SLE aged between 19 and 55 years were examined. The level of soluble endoglin in the blood serum was determined using an enzyme-linked immunosorbent assay. Results. In patients with SLE, the level of endoglin was significantly higher by 90.4 % (p < 0.001) compared to the control group. The increase in soluble endoglin concentration was associated with longer disease duration and higher disease activity, as measured by the SLEDAI-1 index. It was not related to sex factors, patient age, or glucocorticoid use. As the level of soluble endoglin increased, the proportion of patients with nervous system involvement also rose. Analysis of mental health indices in patients with SLE, depending on the quartile distribution of endoglin levels, showed that nearly all assessed mental health parameters significantly worsened from the 1st to the 4th quartile. In the Q4 group, the proportion of patients with confirmed anxiety disorders, depressive disorders, and cognitive dysfunction was statistically significantly higher by 2.4, 5.52, and 2.74 times, respectively (p < 0.05), compared to the Q1 group. A high frequency of memory and sleep disturbances was observed in all quartile groups, without statistically significant intergroup differences. Conclusion. The serum level of soluble endoglin in patients with SLE was 90.4 % higher than in healthy individuals. Elevated serum levels of soluble endoglin were associated with worsening mental health indices, specifically a significant increase in the proportion of individuals with pronounced anxiety, depressive and cognitive disorders, and insomnia.
