Xuyan Yang1, Yin Gao1, Huiying Wang1, Xiaoying Zhao2, Xubo Gong1, Qingqing Wang1, Xiaofei Zhang1. 1. From the Department of Rheumatology, Second Affiliated Hospital, College of Medicine, and Department of Immunology, Institute of Basic Medical Sciences, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.X.Y. Yang, MD; Y. Gao, MD, Department of Rheumatology; H.Y. Wang, MD, PhD, Department of Allergy and Clinical Immunology; X.Y. Zhao, MD, Department of Hematology; X.B. Gong, MD, Laboratory of Bone Marrow, Second Affiliated Hospital, College of Medicine, Zhejiang University; Q.Q. Wang, MD, PhD, Department of Immunology, Institute of Basic Medical Sciences; X.F. Zhang, MD, Department of Clinical Epidemiology and Biostatistics, Second Affiliated Hospital, College of Medicine, Zhejiang University. 2. From the Department of Rheumatology, Second Affiliated Hospital, College of Medicine, and Department of Immunology, Institute of Basic Medical Sciences, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.X.Y. Yang, MD; Y. Gao, MD, Department of Rheumatology; H.Y. Wang, MD, PhD, Department of Allergy and Clinical Immunology; X.Y. Zhao, MD, Department of Hematology; X.B. Gong, MD, Laboratory of Bone Marrow, Second Affiliated Hospital, College of Medicine, Zhejiang University; Q.Q. Wang, MD, PhD, Department of Immunology, Institute of Basic Medical Sciences; X.F. Zhang, MD, Department of Clinical Epidemiology and Biostatistics, Second Affiliated Hospital, College of Medicine, Zhejiang University. zrxz@zju.edu.cn.
Abstract
OBJECTIVE: Interleukin 22 (IL-22) plays an important role in the promotion of antimicrobial immunity. However, dysregulated IL-22 action leads to inflammation and is involved in autoimmune diseases, including systemic lupus erythematosus (SLE). IL-22 binding protein (IL-22BP) is a soluble inhibitory IL-22 receptor and may represent a crucial regulator of IL-22. We investigated the expression and potential significance of serum and urinary IL-22BP levels in patients with SLE. METHODS: A total of 112 patients with SLE and healthy control subjects participated in our study. Patients were classified according to kidney involvement and disease activity based on clinical and laboratory measures such as urinary sediment, proteinuria, kidney function, complement factor 3 (C3), C4, anti-dsDNA, disease activity index, and renal SLE disease activity index. The concentrations of IL-22BP and IL-22 were measured by ELISA. The expression of IL-22BP in the renal tissue was detected by immunohistochemistry. RESULTS: Patients with active renal disease had urinary levels of IL-22BP higher than (1) patients with active SLE but no renal involvement, (2) patients with a history of lupus nephritis in remission with no systemic disease activity and no history of renal involvement, and (3) control subjects. There was no difference in serum levels of IL-22BP among the groups. Urinary levels of IL-22BP in patients with active renal disease were positively correlated with SLE Disease Activity Index, Systemic Lupus International Collaborating Clinics renal activity score, and histological activity index. IL-22BP was highly expressed in renal tissue of patients with active renal disease. After 6 months of treatment, urinary IL-22BP levels decreased significantly in patients with complete response, but remained unchanged in those with partial or no response. CONCLUSION: Urinary but not serum IL-22BP levels were associated with active renal disease. Urinary levels of IL-22BP might be a potential marker for the presence of renal involvement in patients with SLE.
OBJECTIVE:Interleukin 22 (IL-22) plays an important role in the promotion of antimicrobial immunity. However, dysregulated IL-22 action leads to inflammation and is involved in autoimmune diseases, including systemic lupus erythematosus (SLE). IL-22 binding protein (IL-22BP) is a soluble inhibitory IL-22 receptor and may represent a crucial regulator of IL-22. We investigated the expression and potential significance of serum and urinary IL-22BP levels in patients with SLE. METHODS: A total of 112 patients with SLE and healthy control subjects participated in our study. Patients were classified according to kidney involvement and disease activity based on clinical and laboratory measures such as urinary sediment, proteinuria, kidney function, complement factor 3 (C3), C4, anti-dsDNA, disease activity index, and renal SLE disease activity index. The concentrations of IL-22BP and IL-22 were measured by ELISA. The expression of IL-22BP in the renal tissue was detected by immunohistochemistry. RESULTS:Patients with active renal disease had urinary levels of IL-22BP higher than (1) patients with active SLE but no renal involvement, (2) patients with a history of lupus nephritis in remission with no systemic disease activity and no history of renal involvement, and (3) control subjects. There was no difference in serum levels of IL-22BP among the groups. Urinary levels of IL-22BP in patients with active renal disease were positively correlated with SLE Disease Activity Index, Systemic Lupus International Collaborating Clinics renal activity score, and histological activity index. IL-22BP was highly expressed in renal tissue of patients with active renal disease. After 6 months of treatment, urinary IL-22BP levels decreased significantly in patients with complete response, but remained unchanged in those with partial or no response. CONCLUSION: Urinary but not serum IL-22BP levels were associated with active renal disease. Urinary levels of IL-22BP might be a potential marker for the presence of renal involvement in patients with SLE.