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Effect of pregnancy on serum cytokines in SLE patients.doc

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Effect of pregnancy on serum cytokines in SLE patients

Doriaetal.ArthritisResearchTherapy2012,14:R66 /content/14/2/R66 RESEARCH ARTICLE OpenAccess EffectofpregnancyonserumcytokinesinSLE patients AndreaDoria1*,MaurizioCutolo2,AnnaGhirardello1,MargheritaZen1,DaniloVillalta3,AngelaTincani4, LeonardoPunzi1,LucaIaccarino1andMichellePetri5 Abstract Introduction:Theaimofthisstudywastoevaluateanextensivepanelofcytokinesinvolvedinimmune regulationduringpregnancyinpatientswithsystemiclupuserythematosus(SLE)andinhealthywomen. Methods:Atotalof47consecutivesuccessfulpregnanciesin46SLEpatientsand56pregnanciesin56matched healthysubjects,ascontrols,wereprospectivelystudied.Seruminterleukin(IL)-1-a,IL-1-b,IL-2,IL-6,IL-8,IL-10,IL- 12p70,interferon(INF)-gandtumornecrosisfactor(TNF)-aweredetectedinseraobtainedatthefirstandthird trimesterofpregnancybyahighlysensitive,multiplexedsandwichELISA. Results:Medians(pg/ml)ofserumlevelsofmosthelperT(Th)1-typecytokinesweresignificantlylowerinthethird trimestercomparedwiththoseobservedinthefirsttrimesterofpregnancyinhealthywomen:INF-g2.0vs3.4, TNF-a10.2vs11.5,IL-1-a0.9vs1.1,IL-1-b0.6vs1.0,IL-23.0vs3.5,andIL-12p704.9vs5.6(P-values0.02forall). Bycontrast,onlytheIL-1-aserumlevelswerelowerinthethirdtrimestercomparedwiththefirsttrimesterinSLE patients(P=0.006).IFN-g/IL-6andIFN-g/IL-10ratioswerehigherincontrolsthaninSLE(P=0.002,andP=0.001, respectively);moreover,theyweresignificantlyreducedinthethirdcomparedtothefirsttrimesterofpregnancyin healthywomen,butnotinSLE. Conclusions:InSLEpatients,Th1/Th2cytokineserumlevelratiodoesnotdecreaseduringpregnancyprogression asmuchasinhealthypregnantwomen.Thiscouldaccountfortheobservationofalowfrequencyofdisease flaresinthethirdtrimesterofgestation. Introduction profiles can also be produced by other immune cells. Cytokinesplayanimportantroleinthepathogenesisof Despite this caveat, the Th1/Th2 cytokine pattern systemic lupus erythematosus (SLE), and their balance remainsaneffective, althoughover-simplistic, modelof seemstoaffectdiseaseactivity[1]. representing