We discussed the role of IL-1β, IL-6, IL-8 and IFN-γ in the pathogenesis of central nervous system neuropsychiatric systemic lupus erythematous (CNS-NPSLE). Serum and cerebrospinal fluid samples were collected from CNS-NPSLE patients, non-CNS SLE patients, patients with intracranial infection and normal subjects. Levels of IL-1β, IL-6, IL-8 and IFN-γ in serum and cerebrospinal fluid were detected by ELISA, and the results were compared across the groups. All subjects received cerebral MRI. The risk threshold for each cytokine in CNS-NPSLE group was set as 2.5%. The positive rates of cytokines for different lesions in cerebral MRI findings in CNS-NPSLE group were compared. The correlations between cytokine levels and cerebral MRI findings were analyzed. All groups did not show significant differences in age and gender (F=1.34, P>0.05; x (2)=2.05, P>0.05); The IL-1β, IL-6, IL-8 and IFN-γ levels of serum and cerebrospinal fluid in CNS-NPSLE group were obviously higher than those of the normal control (serum Z14 =6.22, 6.04, 6.22, 5.70; cerebrospinal fluid Z14 =6.38, 7.10, 6.97, 6.34, P<0.0083); IL-1β, IL-6 and IL-8 levels of cerebrospinal fluid of CNS-NPSLE group were higher than those of the non-CNS SLE group (Z12 =2.73, Z12 =3.18, Z12 =3.86; P<0.0083); IL-1β, IL-6, IL-8 and IFN-γ levels of cerebrospinal fluid of CNS-NPSLE group were higher than those of the serum (Z=3.19, 6.30, 5.44, 3.19, P<0.05); IL-6>20.0679 pg/ml and IL-8>87.1811 pg/ml in the cerebrospinal fluid predicted a higher risk of CNS-NPSLE (x (2)=11.98, P<0.05; x (2)=4.65, P<0.05); The positive rates of IL-1β and IL-6 in the cerebrospinal fluid of CNS-NPSLE patients with demyelinating diseases were considerably higher than those of CNS-NPSLE patients with normal MRI findings (x (2)=10.89, P<0.005; x (2)=18.47, P<0.005). The positive rates of IL-6 and IFN-γ in the cerebrospinal fluid of CNS-NPSLE patients presenting with multiple ischemic foci were significantly higher than those with normal MRI findings (x (2)=5.56, P<0.005; x (2)=14.59, P<0.005). Some cytokines are involved in the pathogenesis of CNS-NPSLE and correlated with cerebral MRI findings in CNS-NPSLE.
Keywords: Neuropsychiatric systemic lupus erythematous (NPSLE); central nervous system (CNS); cytokines; logistic regression analysis.