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Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease in which assessing disease activity is essential for managing treatment and preventing organ damage. Beyond traditional markers such as anti-dsDNA and complement, the significance of other autoantibodies and cytokines is being investigated [1], [2], [3]. The aim of this study was to evaluate the relationship between selected autoantibodies, cytokines, and disease activity in patients with SLE.

Methods: The study included 110 patients with SLE with a known disease activity score according to SLEDAI-2K and 110 healthy controls. Serum levels of cytokines (IP-10, BAFF, sCTLA-4, IL-18) were measured by ELISA (with some variation in sample numbers across analytes). In addition, patients were tested for autoantibodies against dsDNA, nucleosomes, and C1q (ELISA method) and a broader panel of autoantibodies using immunoblotting. Differences in marker levels between patients and controls were assessed using the Wilcoxon test with Benjamini–Hochberg correction for multiple comparisons, as well as between patients in remission and patients with active SLE; the latter were further stratified into mild, moderate, and high disease activity according to SLEDAI-2K and tested for correlation.

Results: Patients with active disease compared to those in remission showed higher levels of anti-dsDNA (p = 0.002) and anti-Ro/SSA antibodies (p = 0.003). IP-10 levels were significantly elevated in patients compared with controls (p < 0.001) and gradually increased with disease activity (p < 0.001). BAFF levels were significantly higher in patients than in controls (p < 0.001), including patients in remission and those with mild and moderate disease activity. sCTLA-4 levels were higher in patients than in controls (p = 0.041). IL-18 was significantly elevated in patients compared to controls (p < 0.001), and its levels correlated with disease activity (p = 0.029).

Conclusion: Selected autoantibodies and cytokines showed a significant correlation with disease activity. In addition to the expected association with anti-dsDNA antibodies, we also observed associations with other autoantibodies and cytokines (anti-Ro/SSA, IP-10, IL-18, BAFF, sCTLA-4), suggesting their potential role in monitoring disease activity.

Disclosures: Supported by the Ministry of Health of the Czech Republic, grant nr. NW24J-10-00024. The authors declare no conflict of interest.

Literatur

[1] Pagkopoulou E, Loutradis C, Papaioannou M, Daoudaki M, Stangou M, Dimitroulas T. Autoantibodies in Systemic Lupus Erythematosus: Diagnostic and Pathogenic Insights. J Clin Med. 2025 Aug 12;14(16):5714. DOI: 10.3390/jcm14165714
[2] Xue D, Qian Y, Tu X, He M, Xing F, Ren Y, Yuan C. The effect of circulating cytokines on the risk of systemic lupus erythematosus: Mendelian randomization and observational study. Immunogenetics. 2024 Dec;76(5-6):315-322. DOI: 10.1007/s00251-024-01351-x
[3] Rybka G, Dziedzic R, Węglarczyk K, Milewski M, Siwiec-Koźlik A, Dziedzina S, Sanak M, Musiał J, Siedlar M, Korkosz M, Kosałka-Węgiel J. Serum levels of APRIL, BAFF, and IL-10 in systemic lupus erythematosus have limited utility as biomarkers for disease activity or flare prediction. Clin Rheumatol. 2026 Jan;45(1):163-177. DOI: 10.1007/s10067-025-07779-0