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 t SEM 2518.5 t 165.7 vs 1827.3
t 196.6 ng/m1 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 t SEM 2953.9 t 246.4 vs 2114.3 t 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 5 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 5 0.01). We conclude that serum levels of
IL-6, IL-8, TNF-a, sICAM-I 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. |
