Background/Purpose:

Lupus nephritis (LN) is a common and serious organ manifestation of SLE and is associated with substantial patient morbidity and mortality. The production of interleukin-2 (IL-2), a key cytokine that regulates the differentiation and activation of CD4+ T cell subsets, is impaired in LN patients. Previous studies have shown IL-2 can expand Treg cell numbers and reduce Tfh and Th17 effector CD4+ T cell subsets in SLE. However, the efficacy of low-dose IL-2 to refractory LN is still unclear.

Methods: We conducted a prospective, open-label study to evaluate the effects of low-dose rhIL-2 (recombinant human IL-2^Ser125, Beijing SL Pharma) in patients with refractory LN. Three cycles of rhIL-2 were administered subcutaneously at a dose of 1 million IU every other day for 2 weeks (a total of 7 doses), followed by a 2-week break. After the initiation of IL-2, no increase in any other treatments for SLE was permitted. Clinical and laboratory data were measured at baseline and every 4 weeks thereafter until week 12. Refractory disease was defined as no or incomplete response to conventional 2-drug immunosuppressive therapy. Ten patients with refractory LN were eligible in IL-2 group and 10 in Placebo Group.

Results:

Significant reductions of 24h proteinuria and urine erythrocyte (p＜0.05）in IL-2 group compared with placebo group.Serum albumin also demonstrated improvement. Both C3 and C4 increased significantly at week 12（P<0.01). In addition, anti-dsDNA and Anti-Nuclear Ab titter decreased significantly(P<0.01). Immunological analysis revealed that low-dose rhIL-2 administration was associated with selective expansion of Treg cells and conversely with reductions of Tfh and Th17 cells.

Conclusion:

Low-dose IL-2 therapy was effective in refractory LN.

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/low-dose-interleukin-2-treatment-of-refractory-lupus-nephritis/