Changes in cytokine complexes in children with autoimmune diseases with different effectiveness of their biological therapy

Abstract

Introduction. Cytokines (CC) play an important pathogenetic role in the development of autoimmune diseases. Over the past decade, there has appeared a huge number of biological drugs that target certain cytokines. The main problem remains the choice of a suitable biological drug, as up to 40% of patients do not respond to treatment or become resistant to it. Aim: to identify informative cytokine complexes in children with psoriasis, MS, and IBD with different efficacy of biological therapy. 
 Materials and methods. Two hundred eighty eight children with autoimmune diseases were examined against the background of supportive biological therapy. Patients were divided into groups of exacerbation and remission depending on the lesion area index PASI for psoriasis (PS), clinical activity indices PUCAI for ulcerative colitis (UC), PCDIA for Crohn’s disease (CD), by the pre­sence of foci of demyelination on MRI for patients with multiple sclerosis (MS). All patients underwent a study of 25 cytokines in serum samples using multiplex analysis (X-MAP technology).
 Results. In PS, MS, UC, and CD patients, an increase in pathogenetically significant cytokine profiles associated with cells (c) and functions (f) of M1 cells, Th1, Th2, Th17 was revealed in the exacerbation of diseases relative to the groups in remission. There was a significant decrease in the levels of cytokines and cytokine complexes in patients with MS relative to patients with PS, UC and CD, with the exception of cTh1. Threshold values of the level of cytokine complexes above which the development of an exacerbation of the disease can be expected were obtained: for PS — 1431.1 pg/ml (fTh22 — IL13 + Il22), for PC — 33.1 pg/ml (cTh1 — IFN-γ + IL12p70 + TNF-β + IL2), UC — 20.9 pg/ml (M1 — IL-1 + IL-6 + TNF-α), CD — 1986 pg/ml (fIL12 — IL12 + IL23 + IL27).
 Conclusion. To assess the effectiveness of biological therapy and to predict the condition of patients, it is possible to evaluate specific cytokine complexes for a specific pathology.