Correlation between clinical data and cytokines parameters in patients with Granulomatosis with Poilyangiitis (Wegener Granulomatosis)

Abstract

Study Objective . To evaluate the correlation between cytokine synthesis and organ involvement in patients with granulomatosis with polyangiitis (GPA). Methods. The study involved 60 patients with GPA diagnosed following the ACR criteria and the CHCC-2012 definition. Cytokines genes expression was studied in blood samples from 57 patients with reverse transcription polymerase chain reaction. We evaluated mRNA for the following cytokines: interferon (IFN)-α, IFN-γ, interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-18, tumor necrosis factor (TNF)-α production. Also, we investigated the serum concentration of IFN-α, IL-1β, IL-8 IL-18 and TNF-α by ELISA in 40 patients with GPA. Results . Markers for granulomatous disease were detected in 45 (75,0%) GPA patients, markers for vasculitis - in 23 (38,3%) patients. GPA affected eyes in 33 patients (55,0%), ears in 29 (48,3%), nose and sinuses in 57 (95,0%), lungs in 35 (58,3%) and kidneys in 28 (46,7%). There was total positive correlation between eye disease and IL4 and IL12 genes expression ( r =1,00). Total negative correlations were between ear disease and IL-12 gene expression; glomerular filtration rate reduction more than 50% and serum IFN-α ( r =-1,00). Conclusion. Cytokines may upregulate the direct immune response in organ damage in GPA patients. Markers for granulomatous disease correlated with cytokines, that suppressed Th2 type immune response and promoted Th1 type immune response. Correlation between vasculitis markers and cytokines showed that IFN-α, TNF-α, IL-1β and IL-6 participated in vascular damage in GPA patients.