The association of cytokines with disease activity and damage scores in systemic lupus erythematosus patients

Rheumatology (Oxford). 2014 Sep;53(9):1586-94. doi: 10.1093/rheumatology/ket428. Epub 2014 Apr 4.


Objective: The aim of this study was to explore the role of cytokines in the pathogenesis of SLE in a genetically homogeneous Caucasian SLE patient population.

Methods: Serum levels of the following cytokines were determined by ELISA in SLE patients (diagnosed as per ACR diagnostic criteria): IL-1β, IL-10, IL-12p70 and TNF-α. Demographic data, disease activity as per the SLEDAI and damage scores (SLICC) at the 5-year follow-up were calculated.

Results: Enhanced production of TNF-α, IL-1 and IL-10 were observed in SLE patients compared with controls. A strong positive correlation was seen between levels of IL-12p70 and IL-10. In addition, IL-10, TNF-α and IL-1 demonstrated a significant relationship with disease activity. Interestingly, elevated levels of IL-10 were observed in SLE patients with CNS involvement while patients with elevated levels of TNF-α were more likely to have renal involvement and sustain damage over the follow-up period. Additionally, the ratio of all cytokines assayed to IL-12p70 levels were significantly higher in SLE patients when compared with controls, with an association seen between damage accrual and the IL-1β/IL-12p70 ratio (r = 0.431, P = 0.003), IL-10/IL-12p70 ratio (r = 0.351, P = 0.018) and TNF-α/IL-12p70 ratio (r = 0.33, P = 0.028). When the respective ratios were analysed for organ-specific disease, significant differences were observed for the IL-1β/IL-12p70 ratio (0.79 vs 0.47, P = 0.036), IL-10/IL-12p70 ratio (4.29 vs 1.87, P = 0.018) and TNF-α/IL-12p70 ratio (7.49 vs 5.21, P = 0.018) with respect to renal involvement.

Conclusion: Increased levels of a number of immunomodulatory cytokines relative to IL-12p70 in this Caucasian SLE patient population are seen in patients with renal involvement and are associated with increased accrual of damage at the 5-year follow-up.

Keywords: cytokines; damage accrual; disease activity; systemic lupus erythematosus.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Biomarkers / blood
  • Case-Control Studies
  • Cytokines / blood*
  • Female
  • Humans
  • Inflammation Mediators / metabolism
  • Interleukin-10 / biosynthesis
  • Interleukin-12 / blood
  • Lupus Erythematosus, Systemic / immunology*
  • Male
  • Middle Aged
  • Severity of Illness Index*
  • Tumor Necrosis Factor-alpha / biosynthesis


  • Biomarkers
  • Cytokines
  • Inflammation Mediators
  • Tumor Necrosis Factor-alpha
  • Interleukin-10
  • Interleukin-12