Methods To obtain information about the involvement of tumour necrosis factor-alpha (TNF-a) in the pathophysiology of SLE this cytokine was measured, by an enzyme linked immunosorbent assay, in sera from 109 patients (pts) with systemic lupus erythematosus (SLE) (44 men and 65 women). The results were compared with 20 healthy subjects. The mean level of TNF-alpha was 84,4+ 43,2 pg/ml in males (0–859 pg/ml) and 11+7,4 pg/ml in females (0–192,2 pg/ml). The difference between male and female cohorts was significant (p < 0,002). The mean level of TNF-alpha was 0,6+0,8 (0–8,5 pg/ml) in donors. Patients of both groups (males and females) had a significantly higher serum TNF-alpha than control subjects (p < 0,001).
Results TNF-alpha was found positive (more than 3s.d. above the mean in normal controls) in 17 females (26%), 36 males (81,8%) in pts with SLE compared to 1 person (5%) of normal controls (p < 0,05). Data differed statistically between patients in male and female groups and controls. The raised level of TNF-alpha was defined as low, moderate and high positive. We have found the low-positive TNF-alpha in 2 pts (3%), the moderate-positive in 8 pts (12%) and the high-positive in 7 pts (10%) in females. We found significant positive correlation between TNF-alpha and ESR (p < 0,02), arthritis (p < 0,01), capillaritis (p < 0,01), lymphadenopathy (p < 0,001); the negative correlation was observed with serum albumin (p < 0,02) in females. The level of TNF-alpha was the low-positive in 2 pts (4,5%), the moderate-positive in 8 pts (18,1%), the high-positive in 26 pts (59%) in males. There was a positive correlation between TNF-alpha and SLAM index (p < 0,01), SLEDAI (p < 0,06), antiphospholipid syndrome (p < 0,01), IgG-anticardiolipin antibodies (p < 0,03) in male group.
Conclusion There are differences between the level, the clinical value of TNF-alpha in male and female cohorts of pts with SLE. The measurement of TNF-alpha maybe a useful tool for monitoring disease activity, in the male cohort especially.
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