Background/Purpose:

The clinical presentation may be different between adult-onset SLE (aSLE) and childhood-onset SLE (cSLE). The profile of cytokine may the clarify of SLE pathophysiology. The aim of this study was to determine the serum levels of Th1 (IL-12), Th2 (IL-6 e IL-10) longitudinally as well as its possible associations in aSLE and cSLE. 

Methods:

The included SLE patients were recruited from outpatient Rheumatology and Pediatric Rheumatology –State University of Campinas, matched for disease duration. Sera samples were obtained quarterly from all participants, in each routine visit we made a blood collection, totaling four different periods in all patients, in the absence of infections. We further assessed disease activity through of the SLE Disease Activity Index (SLEDAI) and damage through Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), mood and anxiety through Becks Depression (BDI) and Anxiety Inventory (BAI) and current drug exposures. Th1 (IL-12), Th2 (IL-6 and IL-10) cytokines levels were measured by ELISA using commercial kits. Data were compared by non-parametric tests.

Results:

We included 63 cSLE patients (mean age 19.7±4.3 and disease duration 7.35±4.22), 67 aSLE patients (mean age 39.9±11.8 and disease duration 7.73±3.18) and 40 healthy controls (mean age 29.6±10). In aSLE patients compared with healthy controls during the four periods evaluated, IL-6 levels were significantly increased in patients (p=0.03, p=0.003, p=0.002, p=0.002), IL-12 fluctuated during the period evaluated (p=0.75, p=0.50, p=0.01, p=0.001) and IL-10 It had no significant difference (p=0.32, p=0.13, p=0.99, p=0.08).  In cSLE patients compared with healthy controls, we observed a significantly increase of IL-12 (p=0.04, p=0.001, p=0.01, p=0.02), we did not observe significant difference in IL-10 (p=0.94, p=0.85, p=0.81, p=0.95) and IL-6 (p=0.66, p=0.14, p=0.25, p=0.21). Comparing the levels of cytokines between aSLE and cSLE, we observed that IL-12 fluctuated during the period evaluated (p=0.07, p=0.001, p=0.99, p=0.14) and had no significant difference in IL-6 (p=0.97, p=0.11, p=0.15, p=0.53) and IL-10 (p=0.09, p=0.29, p=0.59, p=0.25). We did not observe an association between disease activity and cytokines in any period (p>0.05). The aSLE patients had a significant decrease of disease activity indices during periods evaluated (p=0.021), There was no significant difference in disease activity among cSLE and aSLE patients (p>0.05). No significant difference in SDI scores between aSLE and cSLE (p=0.10). Regarding medication, we observed that aSLE (p=0.001) and cSLE (p=0.001) patients had a significant decrease of use of prednisone during the four periods. In disorders of mood and anxiety, during the four evaluated periods, no significant variation in BAI, cSLE (p=0.52) and aSLE (p=0.13), and BDI, cSLE (p=0.29) and aSLE (p=0.65) was observed. When comparing the patients we observed that aSLE have significantly higher scores of BDI (p≤0.002) and BAI (p≤0.006) than cSLE.

Conclusion:

Cytokines behave differently in aSLE and cSLE patients. The analyzed cytokines fluctuated throughout the study period, however were not associated with disease activity markers.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/longitudinal-assessment-of-th1-and-th2-cytokines-a-comparison-between-adult-onset-and-childhood-onset-systemic-lupus-erythematous/