|
|
Serum IL-6 and sTWEAK levels in patients with neuropsychiatric systemic lupus erythematosus and their clinical significance |
PANG Jie ZHANG Zongfang LI Yanxia TAO Ran YANG Wenwen XU Huaheng#br# |
Department of Rheumatology and Immunolog, Cangzhou Central Hospital, Hebei Province, Cangzhou 061000, China |
|
|
Abstract Objective To investigate the levels of serum interleukin (IL)-6 and soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) in patients with neuropsychiatric systemic lupus erythematosus (NPSLE) and their clinical significance. Methods A total of 165 patients with systemic lupus erythematosus admitted to Cangzhou Central Hospital in Hebei Province from February 2017 to September 2021 were selected and divided into NPSLE group (68 cases) and non-NPSLE group (97 cases) according to the occurrence of NPSLE. In addition, according to the systemic lupus erythematosus disease activity index (SLEDAI) score, the patients in the NPSLE group were divided into mild group (23 cases), moderate group (26 cases), and severe group (19 cases). Serum levels of IL-6 and sTWEAK were detected, and the related factors of NPSLE and the value of IL-6 and sTWEAK in the diagnosis of NPSLE were analyzed. Results The age of onset in the NPSLE group was lower than that in the non-NPSLE group, the disease duration was longer than that in the non-NPSLE group, and the SLEDAI score was higher than that in the non-NPSLE group, with statistically significant differences (P < 0.05). The serum levels of IL-6 and sTWEAK in the NPSLE group were higher than those in the non-NPSLE group, and the differences were statistically significant (P < 0.05). There were significant differences in serum IL-6 and sTWEAK levels in NPSLE patients with different SLEDAI scores (P < 0.05). Among them, those of the severe group were higher than those of the moderate group and the mild group, while those of the moderate group were higher than those of the mild group, and the differences were statistically significant (P < 0.05). Multivariate logistic regression analysis showed that SLEDAI score (OR = 1.872, 95%CI: 1.533-2.286, P < 0.001), IL-6 (OR = 1.370, 95%CI: 1.113-1.687, P = 0.002), sTWEAK (OR = 1.508, 95%CI: 1.185-1.920, P < 0.001) were risk factors for NPSLE. The areas under the curve of IL-6 and sTWEAK in the diagnosis of NPSLE were 0.698 and 0.692, and the area under the curve of combined IL-6 and sTWEAK in the diagnosis of NPSLE was 0.854, which was higher than that of IL-6 and sTWEAK alone (P < 0.05). Conclusion Serum levels of IL-6 and sTWEAK are increased in NPSLE patients, and are related to the occurrence and disease activity of NPSLE, which can be used as auxiliary biological indicators for the diagnosis of NPSLE.
|
|
|
|
|
[1] Mackay M,Tang CC,Vo A. Advanced neuroimaging in neuropsychiatric systemic lupus erythematosus [J]. Curr Opin Neurol,2020,33(3):353-361.
[2] Moore E,Huang MW,Putterman C. Advances in the diagnosis,pathogenesis and treatment of neuropsychiatric systemic lupus erythematosus [J]. Curr Opin Rheumatol,2020, 32(2):152-158.
[3] Tanaka T,Narazaki M,Kishimoto T. Interleukin (IL-6) Immunotherapy [J]. Cold Spring Harb Perspect Biol,2018,10(8):a028456.
[4] Tang Y,Tao H,Gong Y,et al. Changes of Serum IL-6,IL-17,and Complements in Systemic Lupus Erythematosus Patients [J]. J Interferon Cytokine Res,2019,39(7):410-415.
[5] Guo Y,Ren M,Ge L,et al. Increased Serum Concentrations of TNF-Like Weak Inducer of Apoptosis Predict Higher 28-Day Mortality in Patients with Sepsis [J]. Emerg Med Int,2019,2019:7238705.
[6] Salem MN,Taha HA,Abd El-Fattah El-Feqi M,et al. Urinary TNF-like weak inducer of apoptosis (TWEAK) as a biomarker of lupus nephritis [J]. Z Rheumatol,2018, 77(1):71-77.
[7] 中华医学会风湿病学分会.系统性红斑狼疮诊断及治疗指南[J].中华风湿病学杂志,2010,14(5):342-346.
[8] Anomynous. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes [J]. Arthritis Rheum,1999,42(4):599-608.
[9] Gladman DD,Ibanez D,Urowitz MB. Systemic lupus erythematosus disease activity index 2000 [J]. J Rheumatol,2002,29(2):288-291.
[10] 中华医学会风湿病学分会,国家皮肤与免疫疾病临床医学研究中心,中国系统性红斑狼疮研究协作组.2020中国系统性红斑狼疮诊疗指南[J].中华内科杂志,2020, 59(3):172-185.
[11] 郭慧娟,田冰超,唐今扬,等.类风湿性关节炎、系统性红斑狼疮及原发性干燥综合征肾损伤与体液免疫的相关性研究[J].中国医药导报,2020,17(29):115-118.
[12] 张志丹,许勇芝,谢彤.妊娠合并系统性红斑狼疮围生期管理的研究进展[J].中国当代医药,2021,28(12):54-58.
[13] B?觍rbulescu AL,Sandu RE,Vreju AF,et al. Neuroinflammation in systemic lupus erythematosus-a review [J]. Rom J Morphol Embryol,2019,60(3):781-786.
[14] 王东轶,沈俊逸,蔡辉.神经精神性系统性红斑狼疮发病机制的研究进展[J].江苏医药,2019,45(2):179-182.
[15] Rose-John S. Interleukin-6 Family Cytokines [J]. Cold Spring Harb Perspect Biol,2018,10(2):a028415.
[16] Talaat RM,Mohamed SF,Bassyouni IH,et al. Th1/Th2/Th17/Treg cytokine imbalance in systemic lupus erythematosus (SLE) patients:Correlation with disease activity [J]. Cytokine,2015,72(2):146-153.
[17] Yuan S,Tang C,Chen D,et al. miR-98 Modulates Cytokine Production from Human PBMCs in Systemic Lupus Erythematosus by Targeting IL-6 mRNA [J]. J Immunol Res,2019,2019:9827574.
[18] Kondo-Ishikawa S,Fujii T,Ishigooka N,et al. Association of anti-NR2 and U1RNP antibodies with neurotoxic inflammatory mediators in cerebrospinal fluid from patients with neuropsychiatric systemic lupus erythematosus [J]. Lupus,2020,29(13):1673-1682.
[19] Duarte-Delgado NP,Vásquez G,Ortiz-Reyes BL. Blood-brain barrier disruption and neuroinflammation as pathophysiological mechanisms of the diffuse manifestations of neuropsychiatric systemic lupus erythematosus [J]. Autoimmun Rev,2019,18(4):426-432.
[20] Fujihara K,Bennett JL,de Seze J,et al. Interleukin-6 in neuromyelitis optica spectrum disorder pathophysiology [J]. Neurol Neuroimmunol Neuroinflamm,2020,7(5):e841.
[21] Anany MA,Kreckel J,Füllsack S,et al. Soluble TNF-like weak inducer of apoptosis (TWEAK) enhances poly(I:C)-induced RIPK1-mediated necroptosis [J]. Cell Death Dis,2018,9(11):1084.
[22] Mirioglu S,Cinar S,Yazici H,et al. Serum and urine TNF-like weak inducer of apoptosis,monocyte chemoattractant protein-1 and neutrophil gelatinase-associated lipocalin as biomarkers of disease activity in patients with systemic lupus erythematosus [J]. Lupus,2020,29(4):379-388.
[23] Ma HY,Chen S,Cao WD,et al. Diagnostic value of TWEAK for predicting active lupus nephritis in patients with systemic lupus erythematosus: a systematic review and meta-analysis [J]. Ren Fail,2021,43(1):20-31.
[24] Wen J,Doerner J,Weidenheim K,et al. TNF-like weak inducer of apoptosis promotes blood brain barrier disruption and increases neuronal cell death in MRL/lpr mice [J]. J Autoimmun,2015,60:40-50.
[25] Wen J,Chen CH,Stock A,et al. Intracerebroventricular administration of TNF-like weak inducer of apoptosis induces depression-like behavior and cognitive dysfunction in non-autoimmune mice [J]. Brain Behav Immun,2016,54:27-37. |
|
|
|