title: Cytokine Profile in Gout: Inflammation Driven by IL-6 and IL-18?
abstract: BACKGROUND
  Gout is considered to be an autoinflammatory disease and the presence of monosodium urate (MSU) crystals stimulates activation of NPRL3 inflammasome and subsequently caspase-1, generating production of active IL-1β and IL-18. However, the association between serum cytokines levels and clinical manifestations of the disease is not yet well understood. We evaluated the serum profile of proinflammatory cytokines (IL-1β, IL-6, IL-8, IL-17A, IL-18, IL-22, and IL-23) and described their relationship with clinical and laboratory data.
  
  
  METHODS
  Thirty-nine male patients with gout (GG) were assessed for clinical and laboratory variables and cytokine levels were measured by ELISA. For the purposes of comparison, 34 males with no previous history of arthritis were also included in the study (CG).
  
  
  RESULTS
  Seventeen participants (43%) exhibited active arthritis on evaluation. Levels of IL-18 were significantly higher in patients in relation to the CG (p = 0.0013). No statistically significant differences were found between the GG and CG for the other measured cytokines. There was a moderate correlation between IL-18 and ESR (R = 0.43, p = 0.0073), CRP (R = 0.47, p = 0.0025), and serum levels of IL-6 (R = 0.36, p = 0.023). An association was observed between serum levels of IL-6 and the presence of tophi (p = 0.005) and deformities (p = 0.0008), as well as a correlation between this cytokine and ESR (R = 0.41, p = 0.011) and CRP (R = 0.48, p = 0.02).
  
  
  CONCLUSIONS
  IL-18 is associated with inflammatory activity in gout, as well as with IL-6 levels, while IL-6 is associated with clinical and laboratory activity, the presence of tophi and articular deformities, and may be a prognostic marker of this pathology.
authors.affiliation: a Rheumatology Department , Hospital das Clínicas da Universidade Federal de Pernambuco (UFPE) , Recife , Brazil.
authors.forename: Nara Gualberto
authors.initials: NG
authors.lastname: Cavalcanti
authors.affiliation: a Rheumatology Department , Hospital das Clínicas da Universidade Federal de Pernambuco (UFPE) , Recife , Brazil.
authors.forename: Cláudia Diniz Lopes
authors.initials: CD
authors.lastname: Marques
authors.affiliation: b Laboratório de Imunomodulação e Novas Abordagens Terapêuticas (LINAT), Núcleo de Pesquisa em Inovação Suely Galdino (NUPIT-SG), Centro de Ciências Biológicas, Universidade Federal de Pernambuco , Recife , Brazil.
authors.forename: Thiago Ubiratan
authors.initials: TU
authors.lastname: Lins E Lins
authors.affiliation: b Laboratório de Imunomodulação e Novas Abordagens Terapêuticas (LINAT), Núcleo de Pesquisa em Inovação Suely Galdino (NUPIT-SG), Centro de Ciências Biológicas, Universidade Federal de Pernambuco , Recife , Brazil.
authors.forename: Michelly Cristiny
authors.initials: MC
authors.lastname: Pereira
authors.affiliation: b Laboratório de Imunomodulação e Novas Abordagens Terapêuticas (LINAT), Núcleo de Pesquisa em Inovação Suely Galdino (NUPIT-SG), Centro de Ciências Biológicas, Universidade Federal de Pernambuco , Recife , Brazil.
authors.forename: Moacyr Jesus Barreto de Melo
authors.initials: MJ
authors.lastname: Rêgo
authors.affiliation: a Rheumatology Department , Hospital das Clínicas da Universidade Federal de Pernambuco (UFPE) , Recife , Brazil.
authors.forename: Angela Luzia Branco Pinto
authors.initials: AL
authors.lastname: Duarte
authors.affiliation: b Laboratório de Imunomodulação e Novas Abordagens Terapêuticas (LINAT), Núcleo de Pesquisa em Inovação Suely Galdino (NUPIT-SG), Centro de Ciências Biológicas, Universidade Federal de Pernambuco , Recife , Brazil.
authors.forename: Ivan da Rocha
authors.initials: Ida R
authors.lastname: Pitta
authors.affiliation: b Laboratório de Imunomodulação e Novas Abordagens Terapêuticas (LINAT), Núcleo de Pesquisa em Inovação Suely Galdino (NUPIT-SG), Centro de Ciências Biológicas, Universidade Federal de Pernambuco , Recife , Brazil.
authors.forename: Maira Galdino da Rocha
authors.initials: MG
authors.lastname: Pitta
mesh_terms: D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D006073:Gout / Q000097:blood*; D006801:Humans; D020382:Interleukin-18 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; C000589760:IL18 protein, human; C508600:IL6 protein, human; D020382:Interleukin-18; D015850:Interleukin-6; D002097:C-Reactive Protein
keywords: Gout; prognostic marker; proinflammatory cytokines; tophi