Tumor necrosis factor-alpha and interleukin-1-beta in rheumatoid arthritis, juvenile rheumatoid arthritis, systemic lupus erythematosus and scleroderma: Correlations with clinical, laboratory and radiological indices of disease severity

ABSTRACT

This study included 84 patients with arthritis; 34 with rheumatoid arthritis [RA], 16 with juvenile rheumatoid arthritis [RA], 24 with systemic lupus erthematosus [SLE] and 10 with scleroderma. In addition, 25 normal healthy subjects' age and sex matched were included as controls. All studied cases have been subjected to careful history and clinical examination to joints to assess disease activity. They were also subjected to laboratory investigations which included hologram, acute phase reactants [erythroytic sedimentation rate EST; C-reactive protein CRP and alpha-macroglobulin alpha-MG, rheumatoid factor RF, antinative DNA ntibodies, LE cells and serum determination of tumor necrosis factor-alpha [TNF-alpha] and interleukin-1-beta [IL-1-beta]. Radiographic examination to the affected joints with quantitavite evaluation of joints erosin and narrowing in hands and feet were done. The results of the study revealed significantly higher serum levels pf TNF-alpha and IL-1-beta [p< 0.01 for each] in patients compared with controls. RA patients showed significantly higher serum levels of TNF-alpha than SLE scleroderma group [p< 0.01 for each]. The mean serum level of IL-1-beta was significantly higher in cases with RA than each of JRA, and scleroderma [p< 0.05, p< 0.001 respectively]. Significant positive correlation was found between the two cytokines; TNF-alpha and IL-1-beta [r=0.937, p< 0.001] and both showed positive significant correlation with ESR but not with CRP and alpha2mg, in spite of the significant correlation which were found between ESR and either CRP or alpha2m. Scores for bone erosions and joint space narrowing were significantly higher in RA group than either SLE or sclroderma group [p< 0.001 for each], but no significant difference was found between RA group and JRA group. Scores for bone erosins and joint space narrowing showed significant positive correlations with serum levels of either TNF-alpha or IL-1-beta in RA group [r=0.443 and 0.458, p< 0.04 and < 0.003 respectively], and in JRA group [r=0.451 and 0.416, p< 0.04 and < 0.05 respectively]. In conclusion, serum levels of TNF-alpha and IL-1-beta were found to be correlated with the degree of severity of arthritis as assessed clinically, laboratory and radiologically and the significantly higher levels of both TNF-alpha and IL-1-beta in RA and JRA can be attributed to more severe joints affection in both of them than SLE and scleroderma