The pathogenic role of IL-19 in the occurrence of anti-TNF-α-associated inflammatory skin rash in rheumatoid arthritis patients

• Main Authors: Wei-Li Ho, 何瑋立
• Other Authors: 陳得源
• Format: Others
• Language: en_US
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/5c6yd9

碩士 === 國立中興大學 === 生命科學院碩士在職專班 === 102 === Background: Rheumatoid arthritis (RA), a chronic articular inflammation and autoimmune disease, may result in joint deformities and disability. Proinflammatory cytokines play an important role in the inflammation and destruction of joints in RA. Tumor necrosis factor-alpha (TNF-α) is one of the major pathogenic inflammatory cytokines in RA. The TNF-αantagonists are biologics that target TNF-α. Some patients developed non-infectious inflammatory skin rashes which are associated with anti-TNF-αtreatment. The exact pathogenic mechanism remains unknown. The change in plasma interleukin-19 (IL-19) levels in RA patients who receive anti-TNF-α treatment and develop non-infectious inflammatory skin rashes are needed to be determined. Methods: We obtained plasma for IL-19 analysis from 48 RA patients at baseline before anti-TNF-αtherapy and 3 months after the anti-TNF-α therapy. Plasma levels of IL-19 were determined by enzyme-linked immunosorbent assay (ELISA). The enrolled patients were stratified according to the presence and absence of biologic-related skin rashes. Results: There was a significant increase of plasma IL-19 level in patients of rheumatoid arthritis with anti-TNF-α-associated inflammatory skin rash after treatment (p < 0.001). No significant change of plasma IL-19 levels in RA patients without anti-TNF-α-therapy - associated inflammatory skin rash after treatment was noted. Comparing the plasma IL-19 level of RA patients after anti-TNF-αtherapy and the healthy contrasts showed a significant difference (p<0.05). Significant correlations between the rash severity and plasma IL-19 change before and after treatment (△ IL-19 ) and IL-19 levels of patients post anti-TNF-αtherapy (r=0.618, p<0.001; r=0.467, p<0.05, respectively) were noted. There was no significant correlation between rash severity and plasma IL-19 level of patients before anti-TNF-αtherapy. Significant correlations between the baseline immunoglobulin (IgE) and eosinophil cationic protein (ECP) levels and plasma IL-19 levels were also noted. Conclusions: Our results suggested that plasma IL-19 might play a major role as a T helper 2 (Th2) cells marker similar to IgE and ECP in RA patients with anti-TNF-α therapy-associated skin rashes. Plasma IL-19 could be a potential marker of rash severity. But, it could not served as a predicting factor for anti-TNF-αtherapy-associated skin rash.