title: Elevated levels of endogenous IL-6 in systemic lupus erythematosus. A putative role in pathogenesis.
abstract: Elevated spontaneous IgG production is characteristic of SLE. To identify the factors that support it, IL-6, a cytokine with an important role in the differentiation of IgG-secreting cells, was studied in SLE patients. Higher than normal levels of IL-6 were found, by a B9 assay, in sera of 63 of 70 patients (p less than 0.05). IL-6 was detected in 36 of 37 active SLE sera in higher titers (p = 0.009) than those for inactive SLE (n = 33), which were higher (p less than 0.05) than healthy controls (n = 15). IL-6 mRNA was detected in freshly isolated PBMC of 11 of 11 patients but not in normal PBMC, whereas IL-1 mRNA was detected only in patients with active disease. IL-6 activity was recovered from PBMC of four SLE patients, but not from four normal donors. By immunoperoxidase, IL-6 was detected in the cytoplasm of SLE monocytes and lymphocytes. When SLE PBMC were grown in short term cultures with no deliberate stimulation, expression of the IL-6 gene declined rapidly. Accordingly, the spontaneous production of IgG by SLE PBMC could be enhanced by exogenous IL-6. Spontaneous IgG production was diminished by 20 to 65% in the presence of neutralizing antibodies to IL-6, TNF-alpha, or IL-1. In contrast, neutralization of endogenous IL-4 increased production by approximately 40%. Anti-TNF-alpha treatment decreased IL-6 content of PBMC cultures, whereas anti-IL-4 augmented it, and exogenous IL-6 reversed anti-TNF-alpha effects on IgG production. Therefore, it is possible that the neutralization of TNF-alpha and IL-4 affected IgG production by modulating the synthesis/activity of IL-6. These results support the concept that SLE B cell hyperactivity is promoted by dysregulation of endogenous cytokines and suggest that IL-6, in particular, has an important pathogenic role.
authors.affiliation: Department of Medicine, Cedars-Sinai Medical Center/University of California, Los Angeles School of Medicine 90048.
authors.forename: M
authors.initials: M
authors.lastname: Linker-Israeli
authors.forename: R J
authors.initials: RJ
authors.lastname: Deans
authors.forename: D J
authors.initials: DJ
authors.lastname: Wallace
authors.forename: J
authors.initials: J
authors.lastname: Prehn
authors.forename: T
authors.initials: T
authors.lastname: Ozeri-Chen
authors.forename: J R
authors.initials: JR
authors.lastname: Klinenberg
mesh_terms: D015152:Blotting, Northern; D002478:Cells, Cultured; D016207:Cytokines / Q000235:genetics; D005260:Female; D015870:Gene Expression; D006801:Humans; D007074:Immunoglobulin G / Q000096:biosynthesis; D066298:In Vitro Techniques; D015850:Interleukin-6 / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D008180:Lupus Erythematosus, Systemic / Q000378:metabolism*; D008214:Lymphocytes / Q000378:metabolism; D009000:Monocytes / Q000378:metabolism; D012333:RNA, Messenger / Q000235:genetics
chemical_list: D016207:Cytokines; D007074:Immunoglobulin G; D015850:Interleukin-6; D012333:RNA, Messenger