Expressions of IFN-γ and IL-4 before and after Treatment of Lupus Nephritis with Traditional Chinese Medicine Combined with Cyclophosphamide and Their Values for Efficacy Prediction and Evaluation
Background: To explore IFN-γ (interferon-γ) and IL-4 (interleukin-4) expressions before and after the treatment of LN (lupus nephritis) and their values for efficacy prediction and evaluation.
Methods: Altogether 107 patients with LN treated in the First Hospital of Qiqihaer City, Qiqihar, China from March 2017 to September 2018 were enrolled. Sixty-two patients were treated with cyclophosphamide and prednisolone (control group), while another 45 patients were treated with Qing Shen Fang based on the control group (observation group). Their clinical efficacy and changes in immune indices after treatment were observed.
Results: Compared with those in the control group, clinical efficacy, IFN-γ, IL-4, hemoglobin, complements C3 and C4, ESR (erythrocyte sedimentation rate), serum IgG, SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) score, and TCMSSS (Traditional Chinese Medicine Syndrome Score Scale) score were significantly improved after treatment in the study group. Based on the observation, IFN-γ and IL-4 could be used as potential indicators for evaluating clinical efficacy.
Conclusion: The combination of cyclophosphamide, prednisolone, and Qing Shen Fang improves conditions of patients with LN and significantly reduces their IFN-γ and IL-4 levels in serum. IFN-γ and IL-4 can be used as potential indicators for the efficacy prediction and evaluation of the disease.
2. Furie R, Khamashta M, Merrill JT, et al (2017). Anifrolumab, an anti–interferon‐α receptor monoclonal antibody, in moder-ate‐to‐severe systemic lupus erythemato-sus. Arthritis Rheumatol, 69: 376-386.
3. Mohan C, Putterman C (2015). Genetics and pathogenesis of systemic lupus ery-thematosus and lupus nephritis. Nat Rev Nephrol, 11: 329-41.
4. Bertsias GK, Tektonidou M, Amoura Z, et al (2012). Joint European League Against Rheumatism and European Renal Asso-ciation–European Dialysis and Trans-plant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. Ann Rheum Dis, 71: 1771-1782.
5. Fanouriakis A, Pamfil C, Sidiropoulos P, et al (2016). Cyclophosphamide in combi-nation with glucocorticoids for severe neuropsychiatric systemic lupus erythe-matosus: a retrospective, observational two-centre study. Lupus, 25: 627-636.
6. Fassbinder T, Saunders U, Mickholz E, et al (2015). Differential effects of cyclophos-phamide and mycophenolate mofetil on cellular and serological parameters in pa-tients with systemic lupus erythematosus. Arthritis Res Ther, 17: 92.
7. Ma YC, Lin CC, Li CI, Chiang JH, Li TC, Lin JG (2016). Traditional Chinese medicine therapy improves the survival of systemic lupus erythematosus pa-tients[C]//Seminars in arthritis and rheumatism. Semin Arthritis Rheum, 45: 596-603.
8. Naradikian MS, Myles A, Beiting DP, et al (2016). Cutting edge: IL-4, IL-21, and IFN-γ interact to govern T-bet and CD11c expression in TLR-activated B cells. J Immunol, 197: 1023-1028.
9. Faraji F, Rastin M, Arab FL, et al (2016). Ef-fects of 1, 25-dihydroxyvitamin D3 on IL-17/IL-23 axis, IFN-γ and IL-4 ex-pression in systemic lupus erythematosus induced mice model. Iran J Basic Med Sci, 19: 374.
10. Gladman DD, Urowitz MB, Goldsmith CH, et al (1997). The reliability of the Systemic Lupus International Collaborating Clin-ics/American College of Rheumatology damage index in patients with systemic lupus erythematosus. Arthritis Rheum, 40: 809-813.
11. Kagami S, Saeki H, Komine M, et al (2005). Interleukin‐4 and interleukin‐13 enhance CCL26 production in a human keratino-cyte cell line, HaCaT cells. Clin Exp Immu-nol, 2005, 141(3): 459-466.
12. State Administration of Traditional Chinese Medicine. Guiding principles of clinical research on new drugs of Chinese medi-cines (2002). Beijing: China Medical Science Press: 111-115.
13. Hao Z, Dan W, Luan X (2016). Efficacy ob-servation of treatment of systemic lupus erythematosus of yin deficiency and in-ternal heat with nourishing yin and clear-ing heat method. Journal of Sichuan of Tradi-tional Chinese Medicine, 34: 96-99.
14. Ginzler EM, Wofsy D, Isenberg D, et al (2010). Nonrenal disease activity follow-ing mycophenolate mofetil or intrave-nous cyclophosphamide as induction treatment for lupus nephritis: Findings in a multicenter, prospective, randomized, open‐label, parallel‐group clinical trial. Ar-thritis Rheum, 62: 211-221.
15. Wang Y, Chen S, Chen S, et al (2018). Long noncoding RNA expression profile and association with SLEDAI score in mon-ocyte-derived dendritic cells from patients with systematic lupus erythematosus. Ar-thritis Res Ther, 20: 138.
16. Talaat RM, Mohamed SF, Bassyouni IH, Raouf AA (2015). Th1/Th2/Th17/Treg cytokine imbalance in systemic lupus erythematosus (SLE) patients: Correlation with disease activity. Cytokine, 72: 146-153.
17. Guimarães PM, Scavuzzi BM, Stadtlober NP, et al (2017) Cytokines in systemic lu-pus erythematosus: far beyond Th1/Th2 dualism lupus: cytokine profiles. Immunol Cell Biol, 95: 824-831.
18. Luo XY, Yuan JL, Liu J, et al (2018). In-creased Macroautophagy in Interferon-Gamma-Producing T Cells from Patients with Newly Diagnosed Systemic Lupus Erythematosus. Chin Med J (Engl), 131: 1527.
19. Sun J, Li X, Zhou H, et al (2019). Anti-GAPDH Autoantibody Is Associated with Increased Disease Activity and In-tracranial Pressure in Systemic Lupus Erythematosus. J Immunol Res, 2019: 7430780.
20. Zhao X, Cheng Y, Gan Y, Jia R, Zhu L, Sun X (2018). Anti-tubulin-α-1C auto-antibody in systemic lupus erythematosus: a novel indicator of disease activity and vasculitis manifestations. Clin Rheumatol, 37: 1229-1237.