Real-Life Cause-Effect Relations Between Urinary IL-6 Levels and Specific and Nonspecific Symptoms in a Patient With Mild SLE Disease Activity
Metadatos
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Frontiers
Materia
Lupus Interleukin-6 Proteinuria Oral ulcer Facial rash Integrative single-case design Time-series analysis
Fecha
2021-12-17Referencia bibliográfica
Schubert C... [et al.]. (2021) Real-Life Cause-Effect Relations Between Urinary IL-6 Levels and Specific and Nonspecific Symptoms in a Patient WithMild SLE Disease Activity. Front. Immunol. 12:718838. doi: [10.3389/fimmu.2021.718838]
Patrocinador
National Bank of Austria (No. 6990)Resumen
Background: Little is known about the real-time cause-effect relations between IL-6
concentrations and SLE symptoms.
Methods: A 52-year-old woman with mild SLE activity collected her entire urine for the
determination of IL-6/creatinine and protein/creatinine levels (ELISA, HPLC) for a period of
56 days in 12 h intervals (total: 112 measurements). Additionally, she answered
questionnaires (VAS) on oral ulceration, facial rash, joint pain, fatigue and tiredness and
measured her temperature orally twice a day. Time-series analyses consisted of ARIMA
modeling and cross-correlational analyses (one lag = 12 h, significance level = p < 0.05).
Results: Statistical analyses showed that increased urinary IL-6 concentrations preceded
increased urinary protein levels by 36–48 h (lag3: r=+.225; p=.017) and that, in the
opposite direction of effect, increased urinary protein preceded urinary IL-6 decreases by
12–24 h (lag1: r=–.322; p<.001). Moreover, urinary IL-6 increases co-occurred with
increased oral ulceration (lag0: r=+.186; p=.049); after 48–60 h, however, IL-6 increases
showed a strong tendency to precede oral ulceration decreases (lag4: r=–.170; p=.072).
Increases in facial rash preceded decreases in urinary IL-6 after 84–96 h (lag7: r=–.215;
p=.023). As to fatigue, increases in urinary IL-6 co-occurred with decreased fatigue (lag0:
r=–.193; p=.042); after 84–96 h, however, IL-6 increases preceded fatigue increases
(+lag7: r=+.189; p=.046). Finally, joint pain, tiredness and body temperature did not
significantly correlate with urinary IL-6 concentrations in either direction of effect. Conclusions: The results of this evaluation point to real-life feedback mechanisms
between immune activity and SLE symptoms. Comparison with a previous evaluation
of this patient suggests a counterregulatory mechanism between Th1 activity and IL-6.
These findings are preliminary and require replication to draw firm conclusions about the
real-time relation between IL-6 and SLE disease activity.