The Relationship between Interleukin 6 (IL-6) Levels and Disease Activity (SLEDAI-2K) and Manifestations of Renal and Non-Renal Damage in Patients with Systemic Lupus Erythematosus
Research
DOI:
https://doi.org/10.55175/cdk.v53i01.1596Keywords:
Degree of disease activity, interleukin-6 levels, renal-non-renal damage, systemic lupus erythematosusAbstract
Introduction: Systemic lupus erythematosus (SLE) is a chronic, heterogeneous, and complex autoimmune disease. Several studies have linked IL-6 levels and SLE. This study sought to investigate the relationship between IL-6 levels and degree of disease activity and manifestations of renal-non-renal damage in SLE. Methods: A retrospective cross-sectional study of 67 SLE patients based on the SLICC 2012/ACR EULAR 2019 criteria for at least 6 months at the Rheumatology Polyclinic of AM General Hospital, Medan from June to August 2023 who met the inclusion and exclusion criteria. Assessment of renal-non-renal damage used the SLICC Damage
Index-SDI score and the degree of disease activity was measured with SLEDAI-2K. Results: The highest median IL-6 level of 87.32 pg/mL was found in the remission group, while the lowest median IL-6 level of 46.05 pg/mL was found in patients with mild disease. No significant relationship between IL-6 levels and the degree of SLE disease activity (p = 0.158). The median interleukin-6 value in the group of subjects with renal damage was 71.95 pg/mL, while in the group of subjects with non-renal damage it was 53.05 pg/mL. No correlation was found between IL-6 levels and disease activity (p = 0.158), but there was a significant correlation between IL-6 levels
and renal damage (p = 0.045). Conclusion: No relationship between IL-6 levels and the degree of disease activity (p = 0.158), but a significant relationship between IL-6 levels and renal damage (p = 0.045).
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Jordan N, D’Cruz D. Key issues in the management of patients with systemic lupus erythematosus: latest developments and clinical implications. Ther Adv Musculoskelet Dis. 2015;7(6):234–46. doi: 10.1177/1759720X15601805.
Barber MRW, Drenkard C, Falasinnu T, Hoi A, Mak A, Kow NY, et al. Global epidemiology of systemic lupus erythematosus. Nat Rev Rheumatol. 2021;17(9):515–32. doi: 10.1038/s41584-021-00668-1.
Zhu JL, Black SM, Chong BF. Role of biomarkers in the diagnosis and prognosis of patients with cutaneous lupus erythematosus. Ann Transl Med. 2021;9(5):429. doi: 10.21037/atm-20-5232.
Sachinidis A, Xanthopoulos K, Garyfallos A. Age-associated B cells (ABCs) in the prognosis, diagnosis and therapy of systemic lupus erythematosus (SLE). Mediterr J Rheumatol. 2020;31(3):311. doi: 10.31138/mjr.31.3.311.
Aringer M, Johnson SR. Classifying and diagnosing systemic lupus erythematosus in the 21st century. Rheumatology 2020;59(Suppl 5):v4–11. doi: 10.1093/rheumatology/keaa379.
Tian J, Zhang D, Yao X, Huang Y, Lu Q. Global epidemiology of systemic lupus erythematosus: a comprehensive systematic analysis and modelling study. Ann Rheum Dis. 2022;ard-2022-223035. doi: 10.1136/ard-2022-223035.
Tanaka T, Narazaki M, Kishimoto T. IL-6 in inflammation, immunity, and disease. Cold Spring Harb Perspect Biol. 2014;6(10):a016295–a016295. doi: 10.1101/cshperspect.a016295.
Ding J, Su S, You T, Xia T, Lin X, Chen Z, et al. Serum interleukin-6 level is correlated with the disease activity of systemic lupus erythematosus: a meta-analysis. Clinics. 2020;75:e1801. doi: 10.6061/clinics/2020/e1801.
Ghazali WSW, Daud SMM, Mohammad N, Wong KK. SLICC damage index score in systemic lupus erythematosus patients and its associated factors. Medicine (Baltimore). 2018;97(42):e12787. doi: 10.1097/MD.0000000000012787.
Familia AC, Yuliasih Y, Rahmawati LD. Correlation between serum IL-6 level and Th17/Treg ratio with systemic lupus erythematosus disease activity. Biomol Health Sci J. 2019;2(2):107. doi: 10.20473/bhsj.v2i2.15768.
Kambayana G, Pulcheria M, Widiana IGR. Correlation between serum interleukin-6 with glomerular filtration rate in systemic lupus erythematosus. J Penyakit Dalam Udayana. 2019;3(1):22–5. https://doi.org/10.36216/jpd.v3i1.65.
Bruce IN, Urowitz M, van Vollenhoven R, Aranow C, Fettiplace J, Oldham M, et al. Long-term organ damage accrual and safety in patients with SLE treated with belimumab plus standard of care. Lupus. 2016;25(7):699–709. doi: 10.1177/0961203315625119.
Fanouriakis A, Adamichou C, Koutsoviti S, Panopoulos S, Staveri C, Klagou A, et al. Low disease activity— irrespective of serologic status at baseline—associated with reduction of corticosteroid dose and number of flares in patients with systemic lupus erythematosus treated with belimumab: A real-life observational study Semin Arthritis Rheum. 2018 Dec;48(3):467-474. doi: 10.1016/j.semarthrit.2018.02.014.
Bakshi J, Segura BT, Wincup C, Rahman A. Unmet needs in the pathogenesis and treatment of systemic lupus erythematosus. Clin Rev Allerg Immunol. 2018;55(3):352–67. doi: 10.1007/s12016-017-8640-5.
Kono M, Nagafuchi Y, Shoda H, Fujio K. The impact of obesity and a high-fat diet on clinical and immunological features in systemic lupus erythematosus. Nutrients 2021;13(2):504. doi: 10.3390/nu13020504.
Shamekhi Z, Habibagahi Z, Ekramzadeh M, Ghadiri A, Namjoyan F, Saki Malehi A, et al. Body composition and basal metabolic rate in systemic lupus erythematosus patients. Egypt Rheumatol. 2017;39(2):99–102. https://doi.org/10.1016/j.ejr.2016.10.004.
Mathis KW, Venegas-Pont M, Flynn ER, Williams JM, Maric-Bilkan C, Dwyer TM, et al. Hypertension in an experimental model of systemic lupus erythematosus occurs independently of the renal nerves. Am J Physiol-Regul Integr Comp Physiol. 2013;305(7):R711–9. doi: 10.1152/ajpregu.00602.2012.
Zucchi D, Silvagni E, Elefante E, Signorini V, Cardelli C, Trentin F, et al. Systemic lupus erythematosus: one year in review 2023. Clin Exp Rheumatol 2023;41(5):997−1008. https://doi.org/10.55563/clinexprheumatol/4uc7e8.
Muller R. Systemic toxicity of chloroquine and hydroxychloroquine: prevalence, mechanisms, risk factors, prognostic and screening possibilities. Rheumatol Int. 2021;41(7):1189−202. doi: 10.1007/s00296-021-04868-6.
Gonzalez LA, Santamaría-Alza Y, Alarcon GS. Organ damage in systemic lupus erythematosus. Rev Colomb Reumatol. 2021;28:66–81. doi: 10.1016/j.rcreu.2021.01.008.
Fujieda Y. Diversity of neuropsychiatric
Arnaud L, Tektonidou MG. Long-term outcomes in systemic lupus erythematosus: trends over time and major contributors. Rheumatology. 2020;59(Suppl_5):v29–38. doi: 10.1093/rheumatology/keaa382.
Grebenciucova E, VanHaerents S. Interleukin 6: at the interface of human health and disease. Front Immunol. 2023;14:1255533. doi: 10.3389/fimmu.2023.1255533.
Jacob N, Stohl W. Cytokine disturbances in systemic lupus erythematosus. Arthritis Res Ther. 2011;13(4):228. doi: 10.1186/ar3349.
Mak A, Mok CC, Chu WP, To CH, Wong SN, Au TC. Renal damage in systemic lupus erythematosus: a comparative analysis of different age groups. Lupus. 2007;16(1):28–34. doi: 10.1177/0961203306074469.
Osio-Salido E, Manapat-Reyes H. Epidemiology of systemic lupus erythematosus in Asia. Lupus. 2010;19(12):1365–73. doi: 10.1177/0961203310374305.
Idborg H, Oke V. Cytokines as biomarkers in systemic lupus erythematosus: value for diagnosis and drug therapy. Int J Mol Sci. 2021;22(21):11327. doi: 10.3390/ijms222111327.
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