title: Levels of transforming growth factor-beta are low in systemic lupus erythematosus patients with active disease.
abstract: OBJECTIVE
  Cytokines are central regulators of the immune response but the workings of this complex network in systemic lupus erythematosus (SLE) are not fully understood. We investigated a range of inflammatory and immune-modulating cytokines to determine their value as biomarkers for disease subsets in SLE.
  
  
  METHODS
  This was a cross-sectional study in 102 patients with SLE (87% women, disease duration 10.6 yrs). Circulating concentrations of interleukin 1β (IL-1β), IL-4, IL-6, IL-10, IL-12, IL-17, monocyte chemotactic protein 1 (MCP-1), macrophage inflammatory protein 1 (MIP-1α), MIP-1β, interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), and total transforming growth factor-β1 (TGF-β1) were related to disease activity (SLE Disease Activity Index; SLEDAI), lymphocyte subsets, autoantibody levels, accrued damage (Systemic Lupus International Collaborating Clinics/ACR Damage Index; SDI), and concomitant treatment.
  
  
  RESULTS
  Patients with SLE had lower levels of TGF-β1 (p = 0.01) and IL-1β (p = 0.0004) compared to controls. TGF-β1 levels were lower in patients with SLEDAI scores 1-10 and SDI > 3; and were correlated with CD4+, CD8+, and natural killer cell counts; and were independent of steroid or cytotoxic drug use. Treatment with cardiovascular drugs was associated with lower IL-12 levels. No consistent disease associations existed for the other cytokines investigated.
  
  
  CONCLUSIONS
  Lower TGF-β1 was the most consistent cytokine abnormality in patients with SLE. The associations with disease activity, lymphocyte subsets, and damage suggest that TGF-β1 may be a therapeutic target of interest in SLE.
authors.affiliation: Department of Rheumatology, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
authors.forename: Andrea
authors.initials: A
authors.lastname: Becker-Merok
authors.forename: Gro Østli
authors.initials: GØ
authors.lastname: Eilertsen
authors.forename: Johannes C
authors.initials: JC
authors.lastname: Nossent
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D018932:Chemokine CCL2 / Q000097:blood / Q000276:immunology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood / Q000276:immunology; D007378:Interleukins / Q000097:blood / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000276:immunology / Q000503:physiopathology; D019402:Macrophage Inflammatory Proteins / Q000097:blood / Q000276:immunology; D008875:Middle Aged; D016212:Transforming Growth Factor beta / Q000097:blood* / Q000276:immunology*; D053773:Transforming Growth Factor beta1 / Q000097:blood / Q000276:immunology
chemical_list: D015415:Biomarkers; D018932:Chemokine CCL2; D007378:Interleukins; D019402:Macrophage Inflammatory Proteins; D016212:Transforming Growth Factor beta; D053773:Transforming Growth Factor beta1; D007371:Interferon-gamma