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Elevation of proinflammatory cytokine (IL-18, IL-17, IL-12) and Th2 cytokine (IL-4) concentrations in patients with systemic lupus erythematosus

CY Y Ho

Department of Chemical Pathology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong

EK Li

Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong

CWK Lam

Department of Chemical Pathology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong. Tel: (+ 852) 2632 2332; Fax: (+ 852) 2636 5090; waikeilam{at}cuhk.edu.hk

Previous studies have indicated that the autoimmune phenomenon might be caused by an imbalance of T helper cell (Th) cytokines. We measured the plasma concentrations of three novel proinflammatory cytokines interleukin (IL)-17, IL-18, IL-12 and a key Th2 cytokine IL-4 in patients with systemic lupus erythematosus (SLE) and correlated the ratio of proin/Th2 cytokines with SLE disease activity index (SLEDAI). Plasma IL-12, IL-17, IL-18 and IL-4 concentrations of 36 SLE patients and 18 sex-and age-matched control subjects were measured by enzyme linked immunosorbent assay. All were significantly higher in SLE patients than control subjects (IL-12, mean± s.d. of 166.7± 84.5 vs 93.5± 39.2 pg/ml, P < 0.001; IL-17, 76.5± 45.7 vs 37.6± 35.3 pg/ml, P = 0.002; IL-18, 368.7± 199.5 vs 141.1± 47.1 pg/ml, P < 0.001; and IL-4, 27.1± 15.3 vs 17.3± 7.2 pg/ml, P < 0.05), and IL-18/IL-4 ratio correlated positively and significantly with SLEDAI score (r = 0.435, P = 0.006). We propose that SLE is characterized by an elevation of both Th1 and Th2 cytokines: the elevation of proinflammatory cytokine IL-12, IL-17 and IL-18 may trigger the inflammatory process in SLE and the elevation of IL-18/IL-4 ratio suggests an imbalance of cytokine profile to mediate the inflammatory response.

Key Words: systemic lupus erythematosus • proinflamma torycytokines • T helper cell cytokines

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