APRIL levels strongly correlate with IL-17 in systemic lupus erythematosus

作者：Eilertsen G O^*; Nossent J C

来源：Lupus, 2014, 23(13): 1383-1391.

DOI：10.1177/0961203314543914

• B-lymphocyte activating factor
• a proliferation-inducing ligand
• systemic lupus erythematosus
• interleukin-17
• cytokines
• autoantibodies

Introduction Activated self-reactive B cells play an important part in systemic lupus erythematosus (SLE). A proliferation-inducing ligand (APRIL) and B cell-activating factor (BAFF) are B-cell specific stimulators, but activate B cells through different receptors. We investigated the reciprocal association between serum APRIL (s-APRIL), serum BAFF (s-BAFF) and immunological and clinical findings in SLE patients.
Methods A cross-sectional case-control study was performed in 100 SLE patients (87% female, age 49 years, disease duration 12 years). APRIL and BAFF levels were measured by sandwich ELISA, compared with healthy controls and correlated with autoantibody, cytokine (IL-6 and IL-17) and clinical findings through nonparametric and multivariate regression analyses.
Results Both median s-APRIL (478 vs. 0 pg/ml, p=0.01) and s-BAFF (1720 vs. 0.9 pg/ml, p<0.001) were higher in SLE patients than controls. Increased s-BAFF was observed in 86% of patients, while s-APRIL was increased only in 17% (p<0.01). S-APRIL correlated with s-BAFF in controls (p=0.04), but not in SLE (p=0.8). Increased s-APRIL was strongly and independently associated with IL-17 activation (p<0.001), while increased s-BAFF levels were associated with anti-nucleosome antibody presence (p=0.001). Disease activity and organ damage were associated with s-BAFF but not s-APRIL.
Conclusions While both s-BAFF and s-APRIL levels are elevated in SLE patients, they reflect different immunologic and clinical pathways. The strong association between s-APRIL and IL-17 activation supports a role for Th17 helper cells in B cell activation in SLE.

• 出版日期2014-11