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Open Access Highly Accessed Research article

Effect of pregnancy on serum cytokines in SLE patients

Andrea Doria1*, Maurizio Cutolo2, Anna Ghirardello1, Margherita Zen1, Danilo Villalta3, Angela Tincani4, Leonardo Punzi1, Luca Iaccarino1 and Michelle Petri5

Author affiliations

1 Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Padova, Via Giustiniani 2, Padova, 35128, Italy

2 Research Laboratory and Academic Unit of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Viale Benedetto XV 6, Genova, 16132, Italy

3 Hospital S. Maria degli Angeli, Via Montereale 24, Pordenone, 33170, Italy

4 Rheumatology and Clinical Immunology, Spedali Civili and University of Brescia, Piazza Spedali Civili 1, Brescia, 25123, Italy

5 Division of Rheumatology and Immunology, Johns Hopkins University School of Medicine, North Wolfe Street 600, Baltimore, MD 21287, USA

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Citation and License

Arthritis Research & Therapy 2012, 14:R66  doi:10.1186/ar3782

Published: 14 March 2012

Abstract

Introduction

The aim of this study was to evaluate an extensive panel of cytokines involved in immune regulation during pregnancy in patients with systemic lupus erythematosus (SLE) and in healthy women.

Methods

A total of 47 consecutive successful pregnancies in 46 SLE patients and 56 pregnancies in 56 matched healthy subjects, as controls, were prospectively studied. Serum interleukin (IL)-1-α, IL-1-β, IL-2, IL-6, IL-8, IL-10, IL-12p70, interferon (INF)-γ and tumor necrosis factor (TNF)-α were detected in sera obtained at the first and third trimester of pregnancy by a highly sensitive, multiplexed sandwich ELISA.

Results

Medians (pg/ml) of serum levels of most helper T (Th)1-type cytokines were significantly lower in the third trimester compared with those observed in the first trimester of pregnancy in healthy women: INF-γ 2.0 vs 3.4, TNF-α 10.2 vs 11.5, IL-1-α 0.9 vs 1.1, IL-1-β 0.6 vs 1.0, IL-2 3.0 vs 3.5, and IL-12p70 4.9 vs 5.6 (P-values < 0.02 for all). By contrast, only the IL-1-α serum levels were lower in the third trimester compared with the first trimester in SLE patients (P = 0.006). IFN-γ/IL-6 and IFN-γ/IL-10 ratios were higher in controls than in SLE (P = 0.002, and P = 0.001, respectively); moreover, they were significantly reduced in the third compared to the first trimester of pregnancy in healthy women, but not in SLE.

Conclusions

In SLE patients, Th1/Th2 cytokine serum level ratio does not decrease during pregnancy progression as much as in healthy pregnant women. This could account for the observation of a low frequency of disease flares in the third trimester of gestation.