Background/Purpose: Low-dose interleukin 2 (Ld-IL2) is increasingly being explored as an immune-modulating treatment for autoimmune diseases which mainly affect T cell subsets. This study investigates the metabolic effects of Ld-IL2 therapy in patients with primary Sjögren’s disease (pSjD).

Methods: A total of 60 patients were recruited to conduct a double-blind, randomized clinical trial. Of these patients, 50% (30/60) received Ld-IL2 therapy along with standard treatment for 12 weeks, followed by 12 weeks of follow-up. The effectiveness was evaluated by Sjögren’s Tool for Assessing Response (STAR). An untargeted analysis was performed to profile hydrophilic metabolites.

Results: Metabolic profiling revealed significant alterations post-treatment, notably in metabolites like acetyl-CoA, ascorbic acid, and glutathione, which are beneficial in managing autoimmune diseases. In addition, the levels of metabolite accumulation were correlated with variations in immune cell subsets (p < 0.05), particularly Tregs. Moreover, patients exhibiting a specific metabolic profile, including lower serum levels of isoleucine, ADP, Thymidine 5'-triphosphate, and other metabolites, had a high response rate (91.7%-98.6%), as indicated by the receiver operating characteristic (ROC) curve.

Conclusion: These findings suggest that Ld-IL2 therapy influences metabolic pathways in pSjD, offering insights into the systemic effects of Ld-IL2 therapy beyond immune modulation.

Impact of Ld-IL2 on serum metabolites from pSjD patients.

Association between metabolites and CD4+T cells.

Metabolites Biomarker Identification for Ld-IL2 Treatment Response.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/metabolic-impact-of-low-dose-il%e2%80%902-therapy-for-primary-sjogrens-disease-in-a-double%e2%80%90blind-randomized-clinical-trial/