Evaluation of the relationship between IL-10, IL-17, IL-23 levels and disease activity of systemic lupus erythematosus and vitamin D status

Abstract

Systemic lupus erythematosus (SLE) is a multisystemic, autoimmune connective tissue disease with a variable course and prognosis. We intended to determine IL-10, IL-17 and IL-23 cytokines and vitamin D levels in SLE patients, which we think play role in the pathogenesis of the disease. Forty SLE patients and 20 healthy controls were included in our study. Levels of IL-10, IL-17 and IL-23 were measured by sandwich ELISA method. Quantitative data are expressed as mean ± Standard deviation and median range (maximum-minimum) values. The data were analyzed at 95% confidence interval, and cases where the p value was less than 0.05 were considered statistically significant. IL-10 and IL-17 levels of the control and patient groups were compared and no significant difference was found (p=0.333, p=0.99). IL-23 levels of the patient group were found to be higher than the control group and were found to be statistically significant (p<0.001). No significant relationship was found between disease duration or SLEDAI score and IL-23 levels(p=0.476). 25 (OH) vitamin D levels of the patient group were found to be lower than the control group and were statistically significant (p=0.003). No significant relationship was found between IL-10 and IL-17 levels and vitamin D. Significant relationship was found between IL-23 and vitamin D levels (p=0.019). In our study, there was no significant difference between the groups in terms of IL-10 or IL-17, while IL-23 levels were found to be significantly higher in SLE patients. Vitamin D levels were found to be lower in the patient group with SLE compared to the control group, and a negative correlation was found between the disease duration and IL-23. Specific blocking of the IL-23 immune pathway can be an effective and safe treatment option in the treatment of SLE

Keywords

• Systemic lupus erythematosus
• IL-10
• IL-17
• IL-23
• Vitamin D

References

1. HOCHBERG, M.C., SILMAN, A.J., SMOLEN, J.S., WEINBLATT, M.E., WEISMAN, M.H., eds., 2011, Rheumatology, Connective Tissues Disorders, 5th edition, Mosby Elsevier, Philadelphia, 1223-1334.
2. YAP, D.Y., LAI, K.N., 2013, The role of cytokines in the pathogenesis of systemic lupus erythematosus – from bench to bedside, Nephrology, 18 (4), 243-255.
3. LOURENÇO, E.V., LA CAVA, A., 2009, Cytokines in Systemic Lupus Erythematosus, Current Molecular Medicine, 9 (3), 242-254.
4. PENG, H., WANG, W., ZHOU, M., et al., 2013, Role of interleukin-10 and interleukin-10 receptor in systemic lupus erythematosus, Clinical Rheumatology, 32 (9), 1255-1266.
5. CHEN, S., SIMS, G.P., CHEN, X.X., et al., 2007, Modulatory effects of 1,25-dihydroxyvitamin D3 on human B cell differentiation, Journal of Immunology, 179 (3), 1634-1647.
6. BOONSTRA, A., BARRAT, F.J., CRAIN, C., et al., 2001, 1alpha,25-Dihydroxyvitamin d3 has a direct effect on naive CD4(+) T cells to enhance the development of Th2 cells, Journal of Immunology, 167 (9), 4974-4980.
7. HOCHBERG, M.C., 1997, Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus, Arthritis and Rheumatism, 40 (9), 1725.
8. BOMBARDIER, C., GLADMAN, D.D., UROWITZ, M.B., et al., 1992, The Committee on Prognosis Studies in SLE. Derivation of the SLEDAI: A disease activity index for lupus patients. Arthritis and Rheumatism, 35 (6), 630-640.

9. WASZCZYKOWSKA, E., ROBAK, E., WOZNİACKA, A., et al., 1999, Estimation of SLE activity based on the serum level of chosen cytokines and superoxide radical generation, Mediators of Inflammation, 8 (2), 93-100.
10. WONG, C.K., LIT, L.C., TAM, L.S., et al., 2008, Hyperproduction of IL-23 and IL-17 in patients with systemic lupus erythematosus: implications for Th17-mediated inflammation in auto-immunity, Clinical Immunology, 127 (3), 385-393.
11. VAN VOLLENHOVEN, R.F., HAHN, B.H., TSOKOS, G.C., et al., 2018, Efficacy and safety of ustekinumab, an IL-12 and IL-23 inhibitor, in patients with active systemic lupus erythematosus: results of a multicentre, double-blind, phase 2, randomised, controlled study, Lancet, 392 (10155), 1330-1339.
12. SHAHIN, D., EL-FARAHATY, R.M., HOUSSEN, M.E., et al., 2017, Serum 25-OH vitamin D level in treatment-naïve systemic lupus erythematosus patients: Relation to disease activity, IL-23 and IL-17, Lupus, 26 (9), 917-926.
13. ARICAN, O., ARAL, M., SASMAZ, S., et al., 2005, Serum levels of TNF alpha, IFN-gamma, IL-6, IL-8, IL-12, IL-17, and IL-18 in patients with active psoriasis and correlation with disease severity, Mediators of Inflammation, 2005 (5), 273-279.