RESUMEN
The aim of the study was to investigate serum concentrations of interleukin (IL)-17 and IL-17-inducing cytokines IL-23 and transforming growth factor (TGF)-ß, as well as IL-17 single nucleotide polymorphism (SNP) rs2275913 in patients with primary antiphospholipid syndrome (PAPS). We studied fifty patients with PAPS and fifty age- and sex-matched healthy controls. The cytokine levels were measured by ELISA, while the rs2275913 SNP located in promoter region of IL-17 gene was genotyped using real-time PCR. The significantly higher levels of IL-17 (p=0.002), IL-23 (p<0.001) and TGF-ß (p=0.042) were found in PAPS patients (median 13.1, 9.4, and 125.6 pg/ml, respectively) compared to the control group (6.8, 4.9 and 44.4 pg/ml). There was a significant positive correlation between concentrations of IL-17 and IL-23 (r=0.540, p<0.001), but not between those of IL-17 and TGF-ß. No statistically significant differences were observed in the distribution of genotypes and alleles of the IL-17 rs2275913 variants in patients with PAPS compared to healthy subjects. The blood concentrations of IL-17 did not differ in subjects with different rs2275913 genotypes or patients with or without antiphospholipid antibodies. Finally, a trend toward higher IL-17 levels (p=0.063) and the significantly higher IL-17 concentrations (p=0.012) were observed in PAPS patients with deep vein thrombosis and thrombocytopenia, respectively. These data demonstrate that IL-23/IL-17 axis, stimulated independently of TGF-ß increase IL-17A gene polymorphism and antiphospholipid antibody production, might contribute to vascular manifestations of PAPS.
Asunto(s)
Síndrome Antifosfolípido/inmunología , Interleucina-17/inmunología , Interleucina-23/inmunología , Células Th17/inmunología , Adulto , Síndrome Antifosfolípido/diagnóstico , Síndrome Antifosfolípido/genética , Células Cultivadas , Análisis Mutacional de ADN , Ensayo de Inmunoadsorción Enzimática , Femenino , Estudios de Asociación Genética , Genotipo , Humanos , Interleucina-17/sangre , Interleucina-17/genética , Interleucina-23/sangre , Activación de Linfocitos/genética , Activación de Linfocitos/inmunología , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Regiones Promotoras Genéticas/genética , Factor de Crecimiento Transformador beta/sangre , Factor de Crecimiento Transformador beta/inmunologíaRESUMEN
Churg-Strauss syndrome (CSS) is medium blood vessels vasculitis with predilection for lungs in patients with bronchial asthma, chronic eosinophilic pneumonia and positive ANCA in the sera in 55-67%. This is a case report of a 60 years old female patient with bronchial asthma, peripherial pulmonary infiltrations, blood eosinophilia, xerophtalmia, tachycardia, chronic rhinosinustis, polyneuropathia and negative imunological tests: CIC (PEG), CRYO, ANA (IIF), RF (aglutination) and ANCA (IFF: pANCA and cANCA; ELISA: proteinase 3, lactoferrin, myeloperoxidase. elastase, cathepsin G). Eosinophilic infiltrates in the tissues tested by skin and salivery gland biopsies were not found. The patient had fulfilled five clinical diagnostic criteria and responded well to imunosuppressive therapy, so this case could be classified as the ANCA negative angiitis and granulomatosis of CSS type.