Roles of Proinflammatory cytokines and nitric oxide metabolites in the pathogenesis of neuropsychiatric lupus erythematosus

ABSTRACT

Manifestations of neuropsychiatric lupus erythematosus [NPLE] is a common complaint of systemic lupus erythematosus [SLE]. This could be due to damage to CNS tissues and mediated by immune complex or autoantibodies that mediate inflammation and release of nitric oxide metabolites. The study of proinflammatory cytokines [TNF-alpha and IL-10] and nitric oxide [NO] metabolites in relation to NPLE manifestations of SLE could be helpful to understand this pathology. Twenty three women patients compared to 15 healthy controls with tension headache were subjected to this study. The results revealed that NO metabolites significantly increased in NPLE than controls and this increase was apparent in severe subgroup than mild subgroup. Moreover, there was a positive correlation between NO metabolites and both IL- 10 and TNF alpha levels in CSF. CSF levels of TNF alpha and IL-10 were significantly higher in patients with NPLE than controls. The levels of proinflammatory cytokines were correlated with NPLE severity and more significantly higher in severe than mild subgroup NPLE. On the other hand, there were no significant differences in all parameter levels between serum and CSF. The results supported the hypothesis that inflammatory mediators and NO metabolites are important in the pathogenesis of NPLE and that these substances are candidate targets for future treatment