Lupus Clinic, Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, 9311Sapienza University of Rome, Rome, Italy.
Department of Internal Medicine, University of Perugia, Perugia, Italy.
Lupus. 2020 Oct;29(11):1377-1384. doi: 10.1177/0961203320941920. Epub 2020 Jul 23.
Caffeine, one of the most widely consumed products in the world, seems to interact with multiple components of the immune system by acting as a non-specific phosphodiesterase inhibitor. In vitro dose-dependent treatment with caffeine down-regulates mRNA levels of key inflammation-related genes in peripheral blood mononuclear cells. So far, no robust data are available about the possible contribution of caffeine in systemic lupus erythematosus (SLE). The aim of this study was to evaluate the impact of caffeine consumption on SLE-related disease phenotype and activity, in terms of clinimetric assessment and cytokine serum levels.
We performed a cross-sectional study, enrolling consecutive patients and reporting their clinical and laboratory data. Disease activity was assessed by SLE Disease Activity Index 2000 (SLEDAI-2K). Caffeine intake was evaluated by a 7-day food frequency questionnaire, including all the main sources of caffeine. As previously reported, patients were divided into four groups according to the daily caffeine intake: <29.1 mg/day (group 1), 29.2-153.7 mg/day (group 2), 153.8-376.5 mg/day (group 3) and >376.6 mg/day (group 4). At the end of questionnaire filling, blood samples were collected from each patient to assess cytokine levels. These were assessed by using a panel by Bio-Plex assays to measure the levels of IL-6, IL-10, IL-17, IL-27, IFNγ, IFNα and BLyS.
We enrolled 89 consecutive SLE patients. We observed a negative correlation between caffeine consumption and disease activity, measured with SLEDAI-2K. A significantly higher prevalence of lupus nephritis, neuropsychiatric involvement, haematological manifestations, hypocomplementaemia and anti-dsDNA positivity was observed in patients with a low intake of caffeine. Furthermore, patients with a low intake of caffeine were more frequently treated with glucocorticoids. Regarding cytokine analysis, a negative correlation between daily caffeine consumption and serum level of IFNγ was found ( = 0.03, = -0.2); furthermore, patients with a high intake of caffeine showed lower serum levels of IFNα ( = 0.02), IL-17 ( = 0.01) and IL-6 ( = 0.003).
In this report we demonstrated the impact of caffeine on SLE disease activity status, as confirmed by the inverse correlation between its intake and both SLEDAI-2K values and cytokine levels. Moreover, patients with a low caffeine consumption seem to have a more severe disease phenotype.
咖啡因是世界上最广泛消费的产品之一，它似乎通过充当非特异性磷酸二酯酶抑制剂与免疫系统的多个成分相互作用。体外剂量依赖性地用咖啡因处理可下调外周血单个核细胞中与关键炎症相关基因的 mRNA 水平。迄今为止，尚无关于咖啡因在红斑狼疮（SLE）中可能产生的影响的可靠数据。本研究的目的是评估咖啡因消耗对 SLE 相关疾病表型和活动的影响，包括临床评估和细胞因子血清水平。
我们进行了一项横断面研究，纳入了连续的患者并报告了他们的临床和实验室数据。疾病活动度通过 SLE 疾病活动指数 2000（SLEDAI-2K）进行评估。咖啡因摄入量通过包括所有主要咖啡因来源的 7 天食物频率问卷进行评估。如前所述，根据每日咖啡因摄入量将患者分为四组：<29.1mg/天（第 1 组）、29.2-153.7mg/天（第 2 组）、153.8-376.5mg/天（第 3 组）和>376.6mg/天（第 4 组）。在填写问卷结束时，从每位患者采集血样以评估细胞因子水平。使用 Bio-Plex 测定法通过面板进行评估以测量 IL-6、IL-10、IL-17、IL-27、IFNγ、IFNα 和 BLyS 的水平。
我们纳入了 89 例连续的 SLE 患者。我们观察到咖啡因消耗与 SLEDAI-2K 测量的疾病活动之间呈负相关。低咖啡因摄入的患者狼疮肾炎、神经精神受累、血液学表现、低补体血症和抗 dsDNA 阳性的发生率显著更高。此外，低咖啡因摄入的患者更常接受糖皮质激素治疗。关于细胞因子分析，发现每日咖啡因消耗与 IFNγ 血清水平呈负相关（r=0.03，p=-0.2）；此外，高咖啡因摄入的患者 IFNα（r=0.02）、IL-17（r=0.01）和 IL-6（r=0.003）的血清水平较低。
在本报告中，我们证明了咖啡因对 SLE 疾病活动状态的影响，这是通过其摄入与 SLEDAI-2K 值和细胞因子水平之间的反比关系得到证实的。此外，低咖啡因摄入的患者似乎具有更严重的疾病表型。
