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.