Olfactory Function And Related Factors In Systemic Lupus Erythematosus

Background and ObjectivesSystemic lupus erythematosus (SLE) is a kind of autoimmune diseases involving multiple organs and systems all over the body.In recent years, researches have shown that autoimmune diseases damage the skin mucous membrane, the kidney, the respiratory system, digestive system, blood system. In addition, olfactory system may also be affected. Anti-ribonsome P protein antibody (ARPA) is one of lupus autoantibodies. Recently, studies have proved that ARPA can lead to hyposmia in lupus mice. To investigate the olfactory function in patients with systemic lupus erythematosus (SLE) and to further study the influencing factors, this study tested the olfactory function in patients with SLE, and discusses the relationship between the olfactory function, ARPA, age and the course of the disease.Materials and methodsThere are sixty-five patients in SLE group, including seven men and fifty-eight women. All of them met the American College of Rheumatology revised criteria in1997for the classification of SLE. Using SLE diseases activity index (SLEDAI) to evaluate the disease activity of SLE patients.The control group included fifty sex-and age-matched healthy volunteers. It is important to exclude any underlying illness that may affect the sense of smell. All subjects signed informed consent forms. The Connecticut Chemosensory Clinical Research Center (CCCRC) test was carried out in SLE patients and healthy controls for olfaction function testing. ELISA method was used to detect anti-ribosomal P protein antibody in serum. Statistical analysis was performed using SPSS20.0.The statistical methods used in this study including ANOVA, t-test, Pearson correlation analysis, multiple linear regression analysis, and χ2test.ResultsComparison of CCCRC scores in SLE patients and controlsThe CCCRC scores of the active, inactive group and healthy controls were compared, the difference has statistical significance (F=26.52, P<0.01).CCCRC score in active SLE group (62.4±15.8) was lower than inactive group (79.7±13.0) and normal control group (83.4±11.7)(P<0.01), while there was no statistics difference between the inactive group and the normal controls(P=0.226).ARPA level in the serum of SLE patients and controlsThe level of ARPA in SLE patients (32.5±70.0) was higher than the normal controls (2.4±1.4)(t=2.704,P=0.008). Among them,16cases of SLE group were ARPA positive(positive rate24.6%), and the healthy controls were all negative (χ2=14.297,P=0.000)Comparison of CCCRC scores in-ARPA positive and negative groupCCCRC score was lower in sixteen ARPA positive SLE patients (61.3±16.7) than forty-nine negative patients (61.3±16.7),(t=2.681, P=0.009).Correlations of CCCRC scores with ARPA, age and the course of the diseaseCCCRC scores showed a negative correlation with ARPA serum concentration (r=-0.327, P=0.008). There was no significant correlation between CCCRC score and disease course (r=0.141,P>0.05)Multiple linear regression analysisMultiple linear regression analysis further hints the relationship between CCCRC score (Y) and age (X1)、ARPA(X2), The linear regression equation is: Y=90.808-0.529X1-0.185X2,(F=9.696, P=0.000) ConclusionsActive SLE patients existed olfactory dysfunction;the dysfunction was correlated with age and ARPA. We tested the olfactory function of SLE patients and healthy controls, and discussed the factors that affect CCCRC score. Our present study showed that active SLE patients exist hyposmia. Age and ARPA were correlated with smell disorders.