title: IL-18 activity in systemic lupus erythematosus.
abstract: Interleukin-18 (IL-18) is an inflammation-related cytokine that plays a central role both in innate defense reactions and in Th1 activation and specific immune responses. Increased levels of IL-18 can be detected in biological fluids and organs of individuals affected by several autoimmune pathologies, as well as in autoimmune animal models. In this review, the role of IL-18 in systemic lupus erythematosus (SLE) is critically examined, including its possible role in the pathogenesis of disease. In SLE, increased levels of IL-18 have been found in serum/plasma of affected persons, which positively correlated with disease severity. The possibility that circulating IL-18 levels are predictive of renal damage has been proposed, suggesting that IL-18 may be a prognostic marker of renal involvement useful to identify patients at risk of renal failure. The evaluation of urinary levels of free active IL-18 indeed suggests a correlation with the degree of renal involvement. The possible pathogenic role of IL-18 in lupus has been studied in a mouse model of progressive disease, which makes possible the identification, at the level of the different affected organs, of IL-18 changes preceding disease development and those appearing after disease onset. It can be concluded that IL-18 has a multifaceted role in autoimmune lupus, being apparently involved both in the effector phases of the late organ damage and, in some organs, in the initial pathogenic events. Therapeutic strategies targeting IL-18 in autoimmunity are under development.
authors.affiliation: National Research Council, Institute of Biomedical Technologies, Pisa, Italy. flavia.favilli@itb.cnr.it
authors.forename: Flavia
authors.initials: F
authors.lastname: Favilli
authors.forename: Consuelo
authors.initials: C
authors.lastname: Anzilotti
authors.forename: Lucia
authors.initials: L
authors.lastname: Martinelli
authors.forename: Paola
authors.initials: P
authors.lastname: Quattroni
authors.forename: Salvatore
authors.initials: S
authors.lastname: De Martino
authors.forename: Federico
authors.initials: F
authors.lastname: Pratesi
authors.forename: Detlef
authors.initials: D
authors.lastname: Neumann
authors.forename: Silke
authors.initials: S
authors.lastname: Beermann
authors.forename: Daniela
authors.initials: D
authors.lastname: Novick
authors.forename: Charles A
authors.initials: CA
authors.lastname: Dinarello
authors.forename: Diana
authors.initials: D
authors.lastname: Boraschi
authors.forename: Paola
authors.initials: P
authors.lastname: Migliorini
mesh_terms: D000818:Animals; D020869:Gene Expression Profiling; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000235:genetics / Q000378:metabolism; D019410:Interleukin-16 / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D007668:Kidney / Q000378:metabolism; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D008198:Lymph Nodes / Q000378:metabolism; D051379:Mice; D019463:Mice, Inbred MRL lpr
chemical_list: D036341:Intercellular Signaling Peptides and Proteins; D019410:Interleukin-16; C118370:interleukin-18 binding protein