The Role of Survivin in Systemic Lupus Erythematosus: Its Relationship with Diagnosis and Disease Activity

Systemic Lupus Erythematosus (SLE) is a chronic connective tissue disease of unclear etiopathogenesis characterized by affecting multiple organs and systems. Survivin, an apoptosis inhibitor protein (IAP) family member is involved in apoptosis, cell division, development and differentiation. In the pathogenesis of SLE, increased apoptosis is thought to play a significant role. Therefore, this study aims to investigate the relationship between survivin levels and disease activity, etiopathogenesis, and biomarkers related to apoptosis and inflammation in patients with SLE. The study included 36 patients with SLE, 17 patients with Sjögren’s syndrome (SjS) and 29 healthy controls who applied to the department, met the eligibility criteria and were non-consecutively enrolled between September 2019 and March 2020. Blood and urine samples were collected and analyzed using enzyme-linked immunoassay (ELISA) method. SLE activity was assessed using SLE Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) criteria. SjS activity was assessed using EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI). Plasma survivin levels were significantly lower in SLE patients compared to healthy controls (p<0.001). A strong positive correlation was found between plasma survivin levels and apoptotic and inflammatory markers in SLE patients (p<0.001). No correlation was found between urinary survivin levels, plasma survivin levels and inflammatory, apoptotic markers in SLE (p>0.05). No significant correlation was found between SLEDAI scores and either plasma or urinary survivin levels (p > 0.05). This study shows that survivin holds significant potential in the diagnosis, disease monitoring, and pathophysiological understanding of SLE, providing foundational data for future research.