Cytokine production (IL-6 and TNF alpha) in whole blood cell cultures of patients with systemic lupus erythematosus.

Whole blood cell culture has great advantage over isolated peripheral blood mononuclear cell culture, because it needs only small amounts of blood and is fast to perform. The current report focuses on the measurement of IL-6 and TNF alpha produced by peripheral blood monocytes of patients with systemic lupus erythematosus (SLE) in the whole blood cell culture system. After an initial triggering with lipopolysaccharide (LPS), a specific stimulus for monocytes, a decreased production of IL-6 relative to the controls was observed. Dividing our SLE patients according to treatment with corticosteroids, overall the IL-6 production was decreased in the patients treated with corticosteroids. TNF alpha production was comparable with normals, with the exception of an increased spontaneous production and using LPS stimulus of 4 pg/ml. In the patients treated with corticosteroids a decreased TNF production was observed, in contrast to the non-treated patients in which an increased TNF production was found compared with the controls using LPS doses higher than 62 pg/ml. The impaired acute phase reaction (APR) that has been described in the literature, might be explained by our observation of a decreased production of mainly IL-6. However, also this study showed that treatment has a strong impact on ex vivo IL-6 and TNF production.