Caffeine intake influences disease activity and clinical phenotype in systemic lupus erythematosus patients

Abstract

Objective Caffeine, one of the most widely consumed products in the world, seems to interact with multiple components of the immune system by acting as a non-specific phosphodiesterase inhibitor. In vitro dose-dependent treatment with caffeine down-regulates mRNA levels of key inflammation-related genes in peripheral blood mononuclear cells. So far, no robust data are available about the possible contribution of caffeine in systemic lupus erythematosus (SLE). The aim of this study was to evaluate the impact of caffeine consumption on SLE-related disease phenotype and activity, in terms of clinimetric assessment and cytokine serum levels. Methods We performed a cross-sectional study, enrolling consecutive patients and reporting their clinical and laboratory data. Disease activity was assessed by SLE Disease Activity Index 2000 (SLEDAI-2K). Caffeine intake was evaluated by a 7-day food frequency questionnaire, including all the main sources of caffeine. As previously reported, patients were divided into four groups according to the daily caffeine intake: <29.1 mg/day (group 1), 29.2–153.7 mg/day (group 2), 153.8–376.5 mg/day (group 3) and >376.6 mg/day (group 4). At the end of questionnaire filling, blood samples were collected from each patient to assess cytokine levels. These were assessed by using a panel by Bio-Plex assays to measure the levels of IL-6, IL-10, IL-17, IL-27, IFNγ, IFNα and BLyS. Results We enrolled 89 consecutive SLE patients. We observed a negative correlation between caffeine consumption and disease activity, measured with SLEDAI-2K. A significantly higher prevalence of lupus nephritis, neuropsychiatric involvement, haematological manifestations, hypocomplementaemia and anti-dsDNA positivity was observed in patients with a low intake of caffeine. Furthermore, patients with a low intake of caffeine were more frequently treated with glucocorticoids. Regarding cytokine analysis, a negative correlation between daily caffeine consumption and serum level of IFNγ was found ( p = 0.03, r = –0.2); furthermore, patients with a high intake of caffeine showed lower serum levels of IFNα ( p = 0.02), IL-17 ( p = 0.01) and IL-6 ( p = 0.003). Conclusions In this report we demonstrated the impact of caffeine on SLE disease activity status, as confirmed by the inverse correlation between its intake and both SLEDAI-2K values and cytokine levels. Moreover, patients with a low caffeine consumption seem to have a more severe disease phenotype.

Caffeine, Coffee, Tea and Risk of Rheumatoid Arthritis: Systematic Review and Dose-Response Meta-analysis of Prospective Cohort Studies

“…Our finding is in agreement with a previous systematic review on clinical trials indicating that caffeine has no definite role in short-term inflammatory responses and these pathways are not clearly understood ( 63 ). However, a cross-sectional study found a statistically significant reduction in disease activity and cytokine levels in systemic lupus erythematosus patients who had higher intakes of caffeine ( 64 ). It was shown that caffeine metabolites, such as xanthine and theobromine, have antioxidant activities and decrease hydroxyl radicals ( 65 ).…”

Metabolic profiling of patients with different idiopathic inflammatory myopathy subtypes reveals potential biomarkers in plasma

“…It affects the immune system by inhibiting the release of proinflammatory cytokines, influencing the activity of macrophages and natural killer cells, reducing the proliferation of T and B cells proliferation and ultimately producing antibodies [ 29 ]. Caffeine metabolism is associated with disease activity, severity, and constitutional symptoms of autoimmune diseases, such as systemic lupus erythematosus [ 30 ] and rheumatoid arthritis [ 31 ]. We also found that arachidonic acid metabolism is enriched in DM and ASS patients.…”