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THU0340 Cytokines’ study in patients with different subtypes of juvenile idiopathic arthritis
  1. Y. Boyko1,
  2. V. Chernyshov2
  1. 1General Pediatrics, Western Ukrainian Specialised Children’s Hospital, Lviv
  2. 2State Institution “Institute of Pediatrics, Midwifery and Gynaecology, National Academy of Science”, Kyiv, Ukraine

Abstract

Background Cytokines play a significant role in pathogenesis of different subtypes of Juvenile Idiopathic Arthritis (JIA). Cytokines’ profile investigation enables differentiation of these subtypes

Objectives To investigate cytokines, their receptors and agonists in patients with different subtypes of JIA

Methods Blood serum of 105 patients with active JIA was studied for IL-1β, IL-4, IL-6, IL-8, IL-10, IL-17andIFN-γcytokine levels, as well as their receptors and agonists – IL-1Ra, sCD25, sIL6R, sTNFR1. Patients were classified into following subtypes, according to the disease course: systemic – 16 patients, oligoarthritis – 38, polyarthritis with negative rheumatoid factor -19, enthesitis-arthritis – 27, polyarticular arthritis with positive rheumatoid factor – 2 (not included in study), psoriatic arthritis – 3 (not included)

Results In comparison with a control group, a statistically significant increase in TNF-α (p<0,05), sTNF 1R (p<0,001), IL-6 (p$<<$0,000001), IL-1Ra (p=0,01) levels was seen in patients with systemic JIA, together with a decrease in IL-10 level (p<0,05).

Cytokines’ analysis in patients with oligoarthritis revealed a significant increase in TNF-α (p<0,005), sTNF 1R (p<0,001), IL-6 (p<0,001), IFN-γ (p<0,05), IL-17 (p<0,05), sCD25 (p<0,05) levels, as well as a decrease in IL-10 level (p<0,005).

In comparison with control group, patients with polyarthritis with negative RF had a significant increase in TNF-α (p<0,005), sTNF 1R (p<0,001), IL-6 (p<0,001), IFN-γ (p<0,05), IL-17 (p<0,05) and sCD25 (p<0,05) levels, as well as a decrease in IL-10 level (p<0,005).

The group of patients with enthesitis-arthritis had a significant increase of TNF-α (p<0,005), sTNF 1R (p<0,005) cytokines levels, as well as a decrease in IL-10 level (p<0,05) in comparison with healthy children group.

In patients with systemic JIA, in comparison with patients with oligoarthritis, a significant increase in IL-6 (p<0,00005) and IL-1Ra (p<0,01) levels was seen, while in comparison with patients with polyarthritis – a significant increase in IL-6 (p<0,001), IL-1Ra (p=0,05) levels, and in comparison with enthesitis-arthritis patients – an increase in IL-6 level (p<0,00001)

Conclusions Systemic JIA is a typical auto-inflammatory disease with increase in IL-6 andIL-1Ra levels, which discriminates it from the other JIA subtypes. In patients with polyarticular JIA an increase in pro-inflammatory cytokines IFNγ/IL-17andTNF-α as well as a decrease in IL-10was revealed, which, probably, reflects a disbalance between Th1/Th17 andTregCells. An increase of blood serum IL-17in patients with polyarticular JIA may be considered as biomarker of this JIA subtype

Disclosure of Interest None Declared

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