title: Cytokine profile in childhood-onset systemic lupus erythematosus: a cross-sectional and longitudinal study.
abstract: Childhood-onset systemic lupus erythematosus (cSLE) exhibits an aggressive clinical phenotype and severe complications. This could be due to a pro-inflammatory cytokine milieu. Therefore, we determined plasma levels of Th1 (IL-2, IFN-γ, TNF), Th2 (IL-4), Th17 (IL-17A, IL-6), and Treg (IL-10) cytokines in a cohort of cSLE patients and healthy controls, and we evaluated the association between these cytokines and disease activity. We conducted a cross-sectional study with 51 cSLE patients from two pediatric rheumatology services. Ten cSLE patients participated in a longitudinal follow-up study. Blood samples were collected from the same patient during active and inactive disease. Disease activity was evaluated according to SLE Disease Activity Index 2000 (SLEDAI-2K). Cytokines levels were measured by cytometric bead array technique. cSLE patients had higher IL-6 (P<0.001) and IL-10 (P<0.001) levels than healthy controls. Patients with active disease had higher IL-6 and IL-10 levels than patients with inactive disease (P=0.001 and P=0.014, respectively) and the control group (both P<0.001). IL-6 (P=0.022), IL-10 (P=0.013), and IL-17A (P=0.041) levels were significantly higher during active than inactive disease. Linear regression analysis revealed IL-6 (P=0.002, 95%CI=0.006-0.025) and IL-10 (P=0.01 95%CI=0.021-0.150) as independent factors for increased SLEDAI-2K. IL-6, IL-10, and IL-17A are candidate biomarkers for disease activity in cSLE patients. This is the first longitudinal study to support their pivotal role in the pathogenesis of the disease.
authors.affiliation: Unidade de Reumatologia, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, PE, Brasil.|Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors.forename: A
authors.initials: A
authors.lastname: Cavalcanti
authors.affiliation: Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors.forename: R
authors.initials: R
authors.lastname: Santos
authors.affiliation: Unidade de Reumatologia Pediátrica, Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brasil.
authors.forename: Z
authors.initials: Z
authors.lastname: Mesquita
authors.affiliation: Unidade de Reumatologia, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, PE, Brasil.
authors.forename: A L B P
authors.initials: AL
authors.lastname: Duarte
authors.affiliation: Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.|Unidade de Oncologia Pediátrica, Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brasil.
authors.forename: N
authors.initials: N
authors.lastname: Lucena-Silva
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000473:pathology; D008297:Male; D015999:Multivariate Analysis; D012016:Reference Values; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016207:Cytokines