Notarnicola A, Lapadula G, Natuzzi D, Lundberg I E, Iannone F
DIM-Rheumatology Unit, Medical School, University of Bari , Italy.
Scand J Rheumatol. 2015 May;44(3):224-8. doi: 10.3109/03009742.2014.956141. Epub 2014 Nov 7.
To assess the serum levels of interleukin (IL)-15 and IL-17 in patients with idiopathic inflammatory myopathies (IIM) and correlate them with levels of IL-1 receptor antagonist (IL-1ra), IL-6, IL-10, interferon (IFN)-γ, monocyte chemoattractant protein (MCP)-1, macrophage inflammatory protein (MIP)-1α, and MIP-1β. Possible correlations with disease activity parameters were also evaluated.
Sera from 14 patients with new-onset polymyositis (PM), 10 with dermatomyositis (DM), seven with anti-synthetase syndrome (ASS) and 19 healthy controls (HC) were analysed by multiplex immunoassay. Sera from 19 patients were analysed after a median follow-up of 5 months. All patients underwent physical examination, manual muscle testing (MMT) using the five-point MMT scales, the Health Assessment Questionnaire (HAQ), and serum creatine kinase (CK) measurement. All patients received glucocorticoids, and 13 were taking immunosuppressive therapy.
At baseline, serum levels of IL-15, IL-17, MCP-1, and MIP-1β were significantly higher in IIM patients than in HC. IL-17 serum levels were directly correlated (r = 0.39, p = 0.02) with disease duration while a significant inverse correlation was detected between IL-17 levels and MMT scores (r = -0.4, p = 0.02). The highest IL-15 levels were present in DM patients (p = 0.02 vs. PM). The most striking finding was the strong correlation between IL-15 and IL-17 levels (r = 0.60, p = 0.0001), and this correlation was even stronger in DM patients (r = 0.82, p = 0.006).
The strong correlation between IL-15 and IL-17 in IIM patients, and especially in DM, suggests that there may be an interplay between the two cytokines in the pathogenesis of myositis. Further studies of larger patient cohorts and of muscle biopsies are needed to confirm these preliminary data.
评估特发性炎性肌病（IIM）患者血清白细胞介素（IL）-15和IL-17水平，并将其与IL-1受体拮抗剂（IL-1ra）、IL-6、IL-10、干扰素（IFN）-γ、单核细胞趋化蛋白（MCP）-1、巨噬细胞炎性蛋白（MIP）-1α和MIP-1β水平进行关联分析。同时评估其与疾病活动参数的可能相关性。
采用多重免疫分析法对14例新发多发性肌炎（PM）患者、10例皮肌炎（DM）患者、7例抗合成酶综合征（ASS）患者和19名健康对照者（HC）的血清进行分析。对19例患者在中位随访5个月后进行血清分析。所有患者均接受体格检查，使用五点式MMT量表进行徒手肌力测试（MMT）、健康评估问卷（HAQ）以及血清肌酸激酶（CK）测定。所有患者均接受糖皮质激素治疗，13例患者正在接受免疫抑制治疗。
基线时，IIM患者血清IL-15、IL-17、MCP-1和MIP-1β水平显著高于HC。IL-17血清水平与疾病持续时间呈正相关（r = 0.39，p = 0.02），而IL-17水平与MMT评分呈显著负相关（r = -0.4，p = 0.02）。DM患者的IL-15水平最高（与PM相比，p = 0.02）。最显著的发现是IL-15和IL-17水平之间存在强相关性（r = 0.60，p = 0.0001），且这种相关性在DM患者中更强（r = 0.82，p = 0.006）。
IIM患者尤其是DM患者中IL-15和IL-17之间的强相关性表明，这两种细胞因子在肌炎发病机制中可能存在相互作用。需要对更大的患者队列和肌肉活检进行进一步研究以证实这些初步数据。
