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Cytokines and Adhesion Molecules In Lupus Nephritis

1Shirin S. Metwally, 2Amira A. Nasr, 3Samir Sally and 4Sameh Bahgat

1Immunology Unit, Clinical Pathology Department, 2Internal Medicine, and 3Nephrology, Urology and Nephrology Center, Mansoura University and 4Department of Internal Medicine, Zagazig University, Egypt.

Serum levels of interleukin 6 (IL-6), interleukin 8 (IL-8), tumour necrosis factor-a (TNF- a) and the soluble adhesion molecules sICAM-1 and sVCAM-1 were measured using ELISA in 27 patients with lupus nephritis (L.N.), 13 patients with membranoproliferative glomerulonephritis (MPGN), 11 patients with focal segmental glomerulosclerosis (FSGS) and 23 healthy subjects. Patients with L.N. had significantly higher levels of cytokines and adhesion molecules compared to controls (p < 0.001). Serum level of sVCAM-1 was significantly higher in patients with L.N. compared to those with FSGS (Mean SEM 2518.5 165.7 vs 1827.3 196.6 ng/ml p < 0.05). Patients with proliferative L.N. (n=13) had significantly higher levels of sVCAM-1 than those with non proliferative L.N. (n=14), (Mean SEM 2953.9 246.4 vs 2114.3 166.4 ng/ml, p = 0.008). Significant positive correlations were found between serum sVCAM-1 and the duration of treatment, SLE disease activity index (SLEDAI), and chronicity index of lupus nephritic lesion (r=0.041, p 0.05, r = 0.61, p 0.01, r = 0.69 p 0.01 respectively), whereas a significant negative correlation was found between serum sVCAM-1 and complement3 (C3) levels in those patients (r= -0.58, p 0.01). We conclude that serum levels of IL-6, IL-8, TNF-a, sICAM-l and sVCAM-1 are elevated in patients with lupus nephritis. sVCAM-1 is much more elevated in patients with proliferative L.N. and it is positively correlated with SLEDAI and chronicity index of lupus nephritic lesions, therefore sVCAM-1 is thought to play an important role in the initiation, progression and chronicity of proliferative renal lesions in patients with lupus nephritis. Strategies to decrease the levels of cytokines and adhesion molecules most notably sVCAM-1, may constitute novel hopes for treatment of patients with active lupus nephritis.