Date: Monday, November 6, 2017
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Evidence supports the existence of different sub-phenotypes and the pivotal role of cytokines and autoantibodies in systemic lupus erythematosus (SLE). Cytokines interact in a highly complex network. Thus, understanding how these complex non-linear processes are connected and observed in real-life settings is a major challenge. Cluster approaches may assist in the identification of these sub-phenotypes, which represent such a phenomenon and may contribute to the development of personalized medicine. Therefore, we analyzed the relationship between autoantibodies and cytokine clusters in SLE.
This was an exploratory study in which 70 consecutive women with established SLE (ACR 1997) were assessed. Clinical characteristics, including disease activity (by SLAQ), a 14-autoantibody profile (by IFI and ELISA), and a panel of 15 serum cytokines (by cytometric bead array) were measured simultaneously. Mixed-cluster methodology was used to define autoantibody and cytokine clusters. Bivariate and multivariate analyses, including a heteroscedastic regression model, were done to identify associations between clusters and related variables.
Three clusters of autoantibodies were defined (Figure 1): neutral, 2) aPL-dominant, and 3) ENA-dominant. Eight cytokines disclosed levels above the threshold (as compared to healthy controls), allowing to find 4 clusters (Figure 2): 1) neutral, 2) chemotactic, 3) IL-6/G-CSF dominant, and 4) IFNα /Pro-inflammatory. Further, the disease activity was associated with cytokine clusters (Figure 3A), which, in turn, were associated with autoantibody clusters (Figure 3B).
These results support the existence of SLE cytokine-driven sub-phenotypes. They provide insight for a new taxonomy, encourage the practice of personalized medicine, and support proof-of-principle studies.
Figure 1. Autoantibody clusters.
Figure 2. Cytokine clusters.
A. Disease activity by cytokine cluster.
B. Cytokine and autoantibody clusters interaction.
To cite this abstract in AMA style:Barahona-Correa J, Pacheco Y, Monsalve DM, Rojas M, Rodríguez Y, Saavedra J, Rodríguez-Jiménez M, Mantilla R, Ramírez-Santana C, Molano-González N, Anaya JM. Cytokines and Autoantibody Cluster-Interaction in Systemic Lupus Erythematosus. a Systems Medicine Approach [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/cytokines-and-autoantibody-cluster-interaction-in-systemic-lupus-erythematosus-a-systems-medicine-approach/. Accessed January 26, 2021.
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