Comparison of Plasma Cytokine Levels before and after Treatment with Rituximab in Patients with Rheumatoid Arthritis and Systemic Lupus Erythematosus-Associated Polyautoimmunity

Abstract

Introduction: Coexistence of more than one autoimmune disease (AD) in a single patient is known as polyautoimmunity, and may be seen in up to 35% of patients with ADs. The elimination of B-cells using Rituximab (RTX) improves clinical status in different ADs. The role of cytokine production by B-cells is unclear in systemic lupus erythematosus (SLE) and polyautoimmunity. Methods: As an exploratory study, plasma from 11 patients with either rheumatoid arthritis (RA) or SLE-associated polyautoimmunity was assessed prior and 6 months after therapy with RTX. Eight healthy individuals were used as controls. Cytokine levels were measured using ELISA (IFN-α and TGF-β1) or Cytometric Bead Array (TNF-α, IL-1β, IL-6, IL-8, IL-10, and IL-12p70). Results: Prior to RTX, IL-6 was only elevated in RA and IL-8 was elevated in both RA and SLE-associated polyautoimmunity, compared with controls. After RTX, significant decreases of IL-6 in RA and IL-8 in SLE-associated polyautoimmunity were observed. Levels of other cytokines measured were either similar (IFN-α, TGF β1) or below the detection limit (TNF-α, IL-1β, IL-10, IL-12p70) for both patients and controls. Conclusion:Our data highlight the importance of B-cell cytokine secretion in RA and SLE-associated polyautoimmunity, and suggest a differential role in each pathology. A significant increase of IL-8 prior to RTX in both groups, and a significant decrease after therapy only in SLE-associated polyautoimmunity support the potential of IL-8 as a therapeutic target. The heterogeneity of the polyautoimmunity patient population highlights the importance of the selection of specific subsets in future research.

The Comparison of Interleukin-17 and Interleukin-10 with Systemic Lupus Erythematosus Disease Activity

“…A study by Godsell et al involving 129 active SLE patients who underwent IL-10 examination at the first visit and continued 2 years later showed that serum IL-10 could be a predictive factor for the possibility of relapse in SLE patients. In the study, it was mentioned that patients with the highest quartile at the time of initial diagnosis of SLE had a 3.6-fold potential to experience active SLE in subsequent controls, and this result also correlated with SLE inflammatory markers such as erythrocyte sedimentation rate, anti-dsDNA, levels C3 and C4, and significant correlations were also obtained at the next SLE patient visit, so from this study it was seen that serum IL-10 levels might be a marker of disease activity in SLE patients [28], [29], [30].…”