ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1636

Disease Phenotype Is Associated with TH1, TH2 and TH17 Cytokines in Childhood-Onset Systemic Lupus Erythematosus

Karina Oliveira Peliçari1, Mariana Postal2, Renata Brabosa3, Nailu A. Sinicato2, Fernando Augusto Peres2, Roberto Marini4 and Simone Appenzeller5, 1State University of Campinas, Campinas, Brazil, 2Medicine, State University of Campinas, Campinas, Brazil, 3Medicine, Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Campinas, Germany, 4Departament of Pediatrics, State University of Campinas, Campinas, Brazil, 5Medicine, Faculty of Medical Science, State University of Campinas Unicamp, São Paulo, Brazil

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment: Biomarker, Translational and Nephritis Studies

Session Type: Abstract Submissions (ACR)

Background/Purpose

Childhood-onset Systemic lupus erythematosus (cLES) is an autoimmune disease characterized by periods of activity and remission. There is a wide spectrum of manifestations, such as hematologic and immunologic, which are commonly found. The cytokine profile assists in the diagnosis, determination of disease activity and may predict future damage caused by the disease. To determine the serum levels of Th1 (IL-12 and TNF-α), Th2 (IL-6 and IL-10) and Th17 (IL-17) cytokines in cSLE and to evaluate their role in different disease phenotypes. 

Methods

We included 53 consecutive cSLE patients [median age 21 years (range 13-28)] and 51 age and sex-matched healthy controls [median age 20 years (8-33)]. A complete clinical, laboratory and neurological evaluation was performed in all subjects. Neurological manifestations were analyzed according to the ACR classification criteria. Mood and anxiety disorders were determined through Becks Depression and Becks Anxiety Inventory in all subjects. SLE patients were further assessed for clinical and laboratory SLE manifestations, disease activity [SLE Disease Activity Index (SLEDAI)], damage [Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)] and current drug exposures. Th1 (IL-12 and TNF-α), Th2 (IL-6 and IL-10) and Th17 (IL-17) cytokines levels were measured by ELISA using commercial kits.  Data were compared by non-parametric tests.

Results

Serum IL-6 (p=0.002), IL-10 (p=0.028), IL-17 (p=0.009) and TNF-α (p=0.04) levels were increased in cSLE patients when compared to healthy controls. TNF-α levels were significantly increased in patients with active disease (SLEDAI≥3) (p=0.004). IL-6 (p=0.006) and TNF-α (p=0.024) levels were significantly increased in patients with nephritis and IL-10 levels were increased in patients with elevated ESR (p=0.013). We observed that IL-17 was associated with migraine (p=0.040) and IL-6 with thrombocytopenia (p=0.022) and low complement (p=0.014). IL-12 (p=0.008) and IL-17 (p=0.005) were associate with anxiety. No association between cytokine levels and SDI scores or medication was observed.

Conclusion

Cytokines play a central role in cSLE and may be responsible for different disease phenotype. TNF-α is associated with SLEDAI and may be a biomarker of disease activity, Th1 and Th2 responses may play a role in lupus nephritis and Th1 and Th17 may play a role in neuropsychiatric symptoms in cSLE. Longitudinal studies are needed to determine if these cytokines may be used as biomarkers in cSLE.

Disclosure:

K. O. Peliçari,
None;

M. Postal,
None;

R. Brabosa,
None;

N. A. Sinicato,
None;

F. A. Peres,
None;

R. Marini,
None;

S. Appenzeller,
None.

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