Background Adipokines, tumor necrosis factor α(TNFα)and its receptors, participate in the regulation of the immune system and inflammation in immune disease (1). The role and interactions between those cytokines and systemic lupus erythematosus (SLE) characteristics and treatment is poorly studied and understood.
Objectives To analyze the association of adipokines and TNFα and its receptors with clinical, laboratory and treatment-related manifestations of SLE, and to investigate the correlation between adipokines and the TNF system.
Methods A 136 women with SLE, aged >18 years old, were included in this cross-sectional study. Disease activity was measured by modified SLEDAI-2K and irreversible cumulative damage by SLICC-ACR damage index. Serum concentrations of TNFα, soluble TNFα receptors 1 (sTNFR1) and 2 (sTNFR2) and adipokines were analyzed by ELISA kits.
Results The median of age was 41.5 (33.0-49.7) years old and of disease duration was 11.3 (7.8-15.8) years. 105 (77.2%) participants were nonwhite and 67 (49.3%) were postmenopausal. The median of cumulative dose of prednisone was 36.5 (22.9-51.1) g, and of daily dose of prednisone was 5.0 (0.0-10.0) mg/day. The median of disease activity and of damage index scores were 0 (0-4) and 2 (1-3). Higher levels of sTNFR1 and sTNFR2 were associated with nephritis (p<0.001 for both), and concentrations of sTNFR1 and TNFα were positively associated with arthritis (p=0.025 and p=0.014). Higher sTNFR1 levels were found in participants that were not using antimalarial drugs (p=0.04). Independent correlation was found between sTNFR1 and sTNFR2 levels and disease activity (sTNFR1: β=0.253; p=0.003; sTNFR2: β=0.297; p<0.001) and damage index (sTNFR1: β=0.367; p<0.001; sTNFR2: β=0.335; p<0.001). Regarding serum concentrations of adipokines, creatinine clearance was inversely correlated with resistin levels (rs= -0.219; p=0.011) and higher leptin concentrations were associated with azathioprine use (not using: 1.71ng/ml versus using: 1.93mg/ml; p=0.013). Higher adiponectin levels were independent associated with nephritis (p=0.009) and use of antimalarial drugs (p=0.015). There was a positive correlation between leptin and sTNFR2 levels (rs=0.414; p=0.002) and between resistin levels and sTNFR1 (rs=0.489; p<0.001) and sTNFR2 (rs=0.298; p<0.001).
Conclusions TNFα, its receptors and adipokines were associated with arthritis and nephritis. Higher levels of sTNFR1 were correlated with lupus global activity and organ damage, suggesting that this could be used as a marker of disease activity and prognosis. Resistin and leptin were associated with higher TNF receptors concentrations. The correlation between adipokines and TNF system allows a better understanding of the role of adipokines in the inflammatory response in SLE patients.
Su DL, Lu ZM, Shen MN, Li X, Sun LY. Roles of pro-and anti-inflammatory cytokines in the pathogenesis of SLE. J Biomed Biotechnol 2012:347-141.
Disclosure of Interest None declared