POS1416 IL-6, IL-8, TNF-Α ARE SIGNIFICANTLY INCREASED IN CEREBROSPINAL FLUID AND ASSOCIATED WITH ALTERATIONS OF EYE SIGN IN PATIENTS WITH NEUROPSYCHIATRIC LUPUS ERYTHEMATOSUS

Abstract

BackgroundSeveral pro-inflammatory cytokines such as interleukin (IL)-6, IL-8 have been implicated in the pathogenesis of in patients with neuropsychiatric systemic lupus erythematosus (NPSLE) [1]. The alterations of eye sign has been reported and correlated with disease activity in NPSLE [2].ObjectivesTo ascertain whether the intrathecal levels of cytokines/chemokines relative to serum levels is associated with microvacular changes of eye sign in the patients with neuropsychiatric systemic lupus erythematosus (NPSLE).MethodsSLE Patients (>18 years) were consecutively enrolled, for whom the cerebrospinal fluid (CSF) and serum samples were collected at the same time, 6 kinds of cytokine/chemokine concentrations in the CSF and serum samples were measured by Chemiluminescent Immunoassey. The diagnosis of NPSLE was evaluated and based on the consensus from rheumatologist, neurologist, radiologist and psychiatrist. Bulbar conjunctival microvascular changes in eye sign were performed and scored for all SLE patients by rheumatologist using our criteria. NP assessments were evaluating in all SLE patients by psychiatrist, including the mini-mental state examination (MMSE), self-rating anxiety scale (SAS), self-rating depression scale (SDS). Demographic and clinical data were compared between two groups and to identify potential predictors for NPSLE by using multivariable logistic regression analysis.Results120 SLE patients were recruited (30 [24-41] years) including 30 NPSLE and 90 non-NPSLE. In multivariable logistic analysis, total score of eye sign in model 1 and ramified loops, microangloma and wound spot of eye sign in model 2 were predictors for NPSLE after adjusting SLEDAI (Table 1). A significant positive correlation between IL-6, IL-8, TNF-α in CSF and total score microangioma in eye sign and between TNF-α in CSF and ramified loops, wound spot in eye sign were found (Figure 1), moreover, significant positive correlation between IL-6, IL-8, TNF-α in CSF and SLEDAI were also observed (r=0.35, p<0.001, r=0.43, p<0.001, r=0.22, p=0.027, respectively), while no significant positive correlation was observed between CSF levels and serum levels of each cytokine/chemokine in these 120 SLE patients.ConclusionIn NPSLE the production of IL-6, IL-8, TNF-α in CSF might take place in the nervous system, especially in active disease state. These increased CSF cytokines/chemokines along with ramified loops, microangioma and wound spot in eye sign might have an interaction and prerequisite role in the pathogenesis of NPSLE.