title: Th1/Th2 cytokine profile in childhood-onset systemic lupus erythematosus.
abstract: OBJECTIVE
  To determine the serum levels of Th1 (IL-12, IFN-γ,TNF-α) and Th2 (IL-5, IL-6 and IL-10) cytokines in childhood-onset SLE, first-degree relatives and healthy controls. To elucidate their association with disease activity, laboratory and treatment features.
  
  
  METHODS
  We included 60 consecutive childhood-onset SLE patients [median age 18 years (range 10-37)], 64 first-degree relatives [median 40 (range 28-52)] and 57 healthy [median age 19 years (range 6-30 years)] controls. Controls were age and sex-matched to SLE patients. SLE patients were assessed for clinical and laboratory SLE manifestations, disease activity (SLEDAI), damage (SDI) and current drug exposures. Mood and anxiety disorders were determined through Becks Depression (BDI) and Anxiety Inventory (BAI). Th1 (IL-12, IFN-γ,TNF-α) and Th2 (IL-5, IL-6 and IL-10) cytokines levels were measured by ELISA and compared by non-parametric tests.
  
  
  RESULTS
  Serum TNF-α (p=0.004), IL-6 (p=0.007) and IL-10 (p=0.03) levels were increased in childhood-onset SLE patients when compared to first-degree relatives and healthy controls. TNF-α levels were significantly increased in patients with active disease (p=0.014) and correlated directly with SLEDAI scores (r=0.39; p=0.002). IL-12 (p=0.042) and TNF-α (p=0.009) levels were significantly increased in patients with nephritis and TNF-α in patients with depression (p=0.001). No association between cytokine levels and SDI scores or medication was observed.
  
  
  CONCLUSIONS
  Th1 cytokines may play a role in the pathogenesis of neuropsychiatric and renal manifestations in childhood-onset SLE. The correlation with SLEDAI suggests that TNF-α may be a useful biomarker for disease activity in childhood-onset SLE, however longitudinal studies are necessary to determine if increase of this cytokine may predict flares in childhood-onset SLE.
authors: Department of Medicine, Rheumatology Unit, Faculty of Medical Science, State University of Campinas, Brazil.
authors: Mariana
authors: M
authors: Postal
authors: Karina Oliveira
authors: KO
authors: Peliçari
authors: Nailú Angélica
authors: NA
authors: Sinicato
authors: Roberto
authors: R
authors: Marini
authors: Lilian Tereza Lavras
authors: LT
authors: Costallat
authors: Simone
authors: S
authors: Appenzeller
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D016207:Cytokines / Q000097:blood*; D003710:Demography; D005260:Female; D006801:Humans; D007118:Immunoassay; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000453:epidemiology* / Q000276:immunology / Q000628:therapy; D008297:Male; D018417:Th1 Cells / Q000378:metabolism*; D018418:Th2 Cells / Q000378:metabolism*; D055815:Young Adult
chemical_list: D016207:Cytokines