Plasma Th1/Th2 Cytokine Profile With Infections In Systemic Lupus Eythematosus

ObjectivesTo determine the plasma levels of Th1?IL-2,IFN-?,TNF-??and Th2?IL-4,IL-6,IL-10?cytokines,and to investigate the clinical value of Th1/Th2 cytokine profile with infections in systemic lupus erythematosuspatients.MethodsA total of 118 individuals were selected to participate in the study.Fifty-six SLE patients were admitted to the Division of Rheumatology,the First Affiliated Hospital of Zhengzhou University.SLE was diagnosed using the American College of Rheumatology?ACR?2013 revised criteria^[31].Disease activity was determined by SLEDAI score^[32].Most SLE patients received hormone and immunosuppressive therapy.Thirty-three patients with non-autoimmune diseases and Twenty-nine healthy individuals were from other departments and physical examination departments of the First Affiliated Hospital of Zhengzhou University,respectively.Inclusion criteria were patients of both sex and aged from 18 to 65 years.Exclusion criteria include?1?coexistence of other autoimmune diseases such as rheumatoid arthritis,systemic sclerosis,and inflammatory myopathy;?2?coexistence of symptoms of hepatitis B virus infection,hepatitis,malignancies,hematopathies and posttransplant patients;and?3?pregnancy or lactation.Diagnostic criteria for infection?1?clinical manifestations,laboratory,etiology,and imaging examinations;and?2?the comprehensive judgment of the clinician.Among them,30 patients with SLE were diagnosed with concurrent infection after admission.Demographic and clinical data were collected.All the participants signed the informed consent forms.The study was approved by the Ethic Committee of Zhengzhou University[34-KY-2019].We evaluated T helper type 1?Th1?/T helper type 2?Th?lineage cytokines by flow fluorescence assay and calculated the Th1/Th2 ratio.ResultsCompared with the SLE patients without infections,the levels of TNF-?,IL-6 and IL-10 were significantly increased in the SLE patients with infections?p?0.0001,p?0.01 and p?0.01,respectively?.SLE patients with infections had a higher TNF-?/IL-4 ratio?p?0.022?than SLE patients without infections.TNF-?/IL-4 ratio was a reliable predictor for infection in SLE,with an adjusted OR of 4.88?95%CI1.149-20.800,p=0.032?.A level of TNF-?associated with infection in SLE patients,with an adjusted OR of 3.296?95%CI 1.551-7.005,p=0.002?.The optimal cutoff values of TNF-?,TNF-?/IL-4 ratio were 1.66pg/ml,0.97,with AUC=0.7513,0.719?p=0.013,p=0.005,respectively?.ConclusionsPlasma TNF-?levels and TNF-?/IL-4 ratio could be used as indicators of SLE patients with infections.