Hammad A, Osman E, Mosaad Y, Wahba M
1 Pediatric Nephrology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Egypt.
2 Pediatric Allergy and Clinical Immunology Unit, Faculty of Medicine, Mansoura University, Egypt.
Lupus. 2017 Apr;26(4):388-395. doi: 10.1177/0961203316665709. Epub 2016 Sep 28.
Objective Pulmonary involvement in paediatric systemic lupus erythematosus (pSLE) is not an uncommon finding; however, subclinical affection occurs more frequently. Many studies have reported that cytokine dysregulation as interleukin-17 (IL-17) over-expression plays a key role in the pathogenesis of systemic lupus erythematosus (SLE). We aim to assess serum levels of IL-17 A and their association with pulmonary involvement in children with SLE. Methods Serum IL-17A levels - determined by solid phase sandwich ELISA - were assessed in forty-two pSLE patients and compared to 45 age-matched healthy controls. All patients were subjected to pulmonary function tests to detect subclinical pulmonary affection. High-resolution CT (HRCT) chest scan was carried out in patients with abnormal pulmonary function tests (PFTs) and those with chronic respiratory symptoms. Results Abnormal PFTs were found in 73% of patients; of them, only 25% had abnormal findings in HRCT chest. Serum levels of IL-17 A were significantly elevated in pSLE patients as compared to healthy controls ( p < 0.001). The serum levels of IL-17 A had a highly significant positive correlation with SLEDAI ( r = 0.811 and p < 0.001) Strong negative correlation was found between serum levels of IL-17A with both FEV1 and FVC ( p < 0.05). Conclusions Serum IL-17A is elevated in pSLE patients, which correlates with disease activity. IL-17 seems to have a possible role in the pathogenesis of subclinical lung affection. Abnormal PFTS may be found in pSLE patients even with normal radiology.
目的 小儿系统性红斑狼疮（pSLE）合并肺部受累并不少见；然而，亚临床受累更为常见。许多研究报告称，细胞因子失调，如白细胞介素-17（IL-17）过表达，在系统性红斑狼疮（SLE）的发病机制中起关键作用。我们旨在评估SLE患儿血清IL-17 A水平及其与肺部受累的关系。方法 采用固相夹心ELISA法测定42例pSLE患者的血清IL-17A水平，并与45例年龄匹配的健康对照进行比较。所有患者均接受肺功能测试以检测亚临床肺部受累情况。对肺功能测试异常（PFTs）的患者和有慢性呼吸道症状的患者进行胸部高分辨率CT（HRCT）扫描。结果 73%的患者PFTs异常；其中，只有25%的患者胸部HRCT有异常表现。与健康对照相比，pSLE患者血清IL-17 A水平显著升高（p < 0.001）。血清IL-17 A水平与SLE疾病活动指数（SLEDAI）呈高度显著正相关（r = 0.811，p < 0.001），与第一秒用力呼气容积（FEV1）和用力肺活量（FVC）均呈强负相关（p < 0.05）。结论 pSLE患者血清IL-17A升高，与疾病活动相关。IL-17似乎在亚临床肺部受累的发病机制中起作用。即使影像学正常，pSLE患者也可能出现异常的肺功能测试结果。
