CYTOKINE PROFILE (TNFA, IL1B, IL6, IL10) AND ITS ASSOCIATION WITH CLINICAL FEATURES IN JUVENILE IDIOPATHIC ARTHRITIS

Different cytokines are believed to play an important role in the pathogenesis of juvenile idiopathic arthritis (JIA). Some of them may serve as the prognostic markers for the disease severity, the eye lesion, and the effectiveness of therapy in JIA patients. To evaluate the serum concentration of TNF alpha, IL1 beta, IL6 and IL10, their spontaneous and mitogen-induced production levels in the whole blood cell culture of JIA patients and to correlate these indicators with the disease features and with the effectiveness of methotrexate therapy. Twenty-eight Russian patients with JIA, naive for disease-modifying antirheumatic drugs, were enrolled in the study. The serum levels of cytokines (TNF alpha, IL1 beta, IL6, and IL10); the levels of their spontaneous and mitogen-induced production in the whole blood cell culture were studied by solid-phase enzyme immunoassay. The serum levels and spontaneous production levels of TNF alpha, IL1 beta, IL10 were low in JIA patients. The levels of TNF alpha, IL1 beta, IL6, IL10 in mitogen-induced production were significantly higher than those in spontaneous production (pcor<0,05). The association of some clinical features (disease duration, uveitis, elevated ESR, hyperimmunoglobulinemia M with the cytokines (TNF alpha, IL6, and IL10) levels was established in JIA. The most promising is the association between the uveitis in JIA patients and an increase of spontaneous IL6 production (pcor=0,004), as well as a decrease of mitogen-induced TNF alpha production (pcor=0,029) in the whole blood cell culture. Statistically significant associations with a response to methotrexate therapy and disease severity in JIA patients were not observed. As a result of studying levels of cytokines (TNF alpha, IL1 beta, IL6, and IL10) in JIA patients, the relationship of TNF alpha, IL6 and IL10 was established with the number of clinical manifestations of the disease. If confirmed in larger samples, the study of the spontaneous IL6 production in the whole blood cell culture might be used for the early diagnosis of the uveitis in JIA patients.