Interleukin-18 in systemic lupus erythematosus: link with clinical symptoms and vascular atherosclerosis

Abstract


Aim. To examine correlation between IL-18 concentration, SLE manifestations and atherosclerotic vascular affection. Material and methods. We examined 162 SLE female patients (age 26-43 years, mean age 35 years, duration of SLE 28-204 months, mean duration 96.0 months) and 64 healthy controls (women aged 30.0-45.0 years, mean age 35.5 years). We analysed correlation between IL-18 concentration, SLE symptoms, classic risk factors for cardiovascular diseases, subclinical and clinical signs of atherosclerosis. Results. IL-18 in blood serum of SLE patients was much higher than in the control group (p < 0.00001). A positive correlation exists between IL-concentration and the disease activity by scale SLEDAI-2K, the level of antibodies to IgG cardiolipin, ESR, SLE, titers of antibodies to double-chain DNA, concentration of creatinin, urine, glucocorticoids dose taken by the patients at examination. In SLE patients with stomatitis, hematological, immunological disorders, a positive test for antinuclear factor, IL-18 was much higher than in patients without the above signs. No significant correlation was seen between IL-18 concentration, subclinical and clinical signs of atherosclerosis, of risk factors, there was a negative correlation between total cholesterol concentration, LDLP and HDLP cholesterol. Conclusion. In SLE patients a high IL-18 level reflects activity of the basic disease and is not related with vascular atherosclerosis.

Full Text

Интерлейкин-18 при системной красной волчанке: связь с клиническими проявлениями заболевания и атеросклеротическим поражением сосудов. - Цель исследования. Оценить связь концентрации интерлейкина (ИЛ) 18 с проявлениями системной красной волчанки (СКВ) и атеросклеротическим поражением сосудов. Материалы и методы. Обследованы 162 пациентки с СКВ в возрасте 35 (26-43) лет, продолжительность заболевания 96 (28-204) мес, и 64 условно здоровые женщины в возрасте 35,5 (30-45), которые составили контрольную группу. Анализировали взаимосвязь концентрации ИЛ-18 с проявлениями СКВ, классическими факторами риска развития сердечно-сосудистых заболеваний, субклиническими и клиническими признаками атеросклероза. Результаты. Уровень ИЛ-18 в сыворотке крови у больных СКВ был значительно выше, чем в контрольной группе (р < 0,00001). Выявлена положительная корреляция между концентрацией ИЛ-18 и активностью болезни по шкале SLEDAI-2K, уровнем антител к кардиолипину изотипа IgG, СОЭ, титрами антител к двуспиральной ДНК, концентрацией креатинина, мочевины, дозой глюкокортикоидов, принимаемой больными на момент обследования. У больных СКВ, имеющих на момент обследования стоматит, гематологические, иммунные нарушения и положительный тест на антинуклеарный фактор, концентрация ИЛ-18 была значительно выше, чем у пациентов без указанных признаков. Статистически значимой связи между концентрацией ИЛ-18, субклиническими и клиническими проявлениями атеросклероза не выявлено. Среди факторов риска обнаружена отрицательная корреляция с концентрацией общего холестерина, холестерина липопротеидов низкой и высокой плотности. Заключение. У пациентов с СКВ повышенный уровень ИЛ-18 отражает активность основного заболевания и не связан с атеросклеротическим поражением сосудов.

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