Sera levels of interferon alpha and tumor necrosis factor alpha in childhood-onset systemic lupus erythematosus patients: association with clinical manifestations

Author(s)

Mariana Postal

• Document type: Master's Dissertation
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2012-06-02

Examining board members

Simone Appenzeller; Manoel Barros Bértolo; Cláudio Arnaldo Len

• Advisor: Simone Appenzeller; Lilian Tereza Lavras Costallat

Abstract

Systemic lupus erythematosus (SLE) is a chronic, multisystemic, relapsing and remitting autoimmune disease. The interest in identifying biomarkers that correlate with the SLE systemic activity and that can predict a future organ involvement is growing. The present cross-sectional study aimed to assess the levels of interferon alpha (IFN-?) and tumor necrosis factor alpha (TNF-?) in pediatric SLE patients (disease onset ?16 years), first-degree relatives and healthy unrelated controls and to elucidate its association with the activity disease, laboratory data and treatment. We selected consecutive pediatric SLE patients followed at the Pediatric Rheumatology Unit of UNICAMP between 2009/2010. Clinical, laboratory, disease activity [SLE Disease Activity Index (SLEDAI)], cumulative damage [Systemic Lupus International Collaborating Clinics / American College of Rheumatology Damage Index (SDI)] and current drug exposure were evaluated. Mood disorders were determined through the Depression (BDI) and Anxiety (BAI) Becks Inventory. The measurement of cytokines was performed by ELISA (Enzyme Linked Immuno Sorbent Assay). Serum levels of INF-? and TNF-? were increased in pediatric SLE patients (p?0.05) when compared to first-degree relatives and unrelated healthy controls. Serum levels of INF-? and TNF-? were significantly higher in patients with active disease (p=0.031; p=0,014, respectively). INF-? (r=0.33; p=0.012) and TNF-? (r=0.39; p=0.002) correlated with SLEDAI. INF-? was significantly higher in patients with positive anti-dsDNA (p=0.011), patients with cutaneous vasculitis (p=0.001), patients with malar rash (p=0.032) and patients without medication (p=0.035). Serum levels of IFN-? correlated with C3 levels (r=0.34; p=0.032) and age (r=-0.17; p=0.025). Serum levels of TNF-? were significantly higher in patients with nephritis (p=0.009) and in patients with depression (p=0.001). According to our results, IFN-? and TNF-? were associated with disease activity and could be considered biomarkers to assess disease activity in pediatric SLE patients, however longitudinal studies are needed to determine if increase of these cytokines may predict flares in pediatric SLE patients (AU)

• FAPESP's process: 09/11076-2 - Levels of interferon alpha, gamma and TNF alpha in patients of SLE: association with clinical manifestations
• Grantee: Mariana Postal Zink de Souza
• Support Opportunities: Scholarships in Brazil - Master