engleski

Interleukin-18 as a mediator of systemic juvenile idiopathic arthritis (JIA).

Objective: To explore the balance between serum and synovial fluid levels of interleukin-10 (IL- 10) and IL-18 in children with juvenile idiopathic arthritis (JIA). Methods: Blood samples were obtained from 81 child with JIA and 18 control children. Synovial fluid samples were collected from 16 children with pauciarticular JIA. Concentrations of IL-10 and IL-18 were determined using commercial kits. Results: Patients with systemic JIA had higher serum levels of IL-18 than patients with other forms of JIA or control children, both during the active (median, range: 6065, 387 – 78750 pg/mL) and inactive (1523, 121 – 3270 pg/mL) phase of disease (ANOVA, P<0.05). Levels of IL-18 in sera of children with pauciarticular JIA (255, 89 – 4342 pg/mL) were similar to the corresponding synovial fluid levels (217, 89 – 1245 pg/mL). Serum levels of IL-18 were proportional to the erythrocyte sedimentation rate and levels of C-reactive protein, but inversely proportional to the haemoglobin levels. Clinical remission was characterised by higher serum levels of IL-10 in children with systemic JIA (ANOVA, P < 0.05 vs. the other groups) while the differences during the active phase were not significant. Moreover, synovial levels of IL-10 in patients with pauciarticular JIA (20.8, 1.6 – 67.6 pg/mL) were higher than serum levels of IL-10 in the same patients (3.0, 0.0 – 32.7 pg/mL) (t-test, P<0.05). Conclusion: As IL-18 appears to be an important mediator of systemic JIA, its inhibition should be a base for a successful therapeutic approach. Role of IL-10 in pathogenesis of JIA is less clear, but it seems to be predominantly involved in local, rather than systemic pathogenetic processes.

juvenile idiopathic arthritis; IL-10; IL-18

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