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Type 1 interferon status in systemic lupus erythematosus: a longitudinal analysis
Melissa Northcott1, Sarah Jones1, Rachel Koelmeyer1
1Centre for Inflammatory Diseases, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
Lupus Science & Medicine
|February 24, 2022
Summary
Type 1 interferon-stimulated gene (ISG) levels in systemic lupus erythematosus (SLE) are generally stable over time and correlate with more severe disease indicators. Baseline ISG testing may be useful, but serial assessments are not recommended for managing SLE patients.
Area of Science:
- Immunology
- Rheumatology
- Genetics
Background:
- Type 1 interferon (IFN) is implicated in systemic lupus erythematosus (SLE) pathogenesis, indicated by elevated IFN-stimulated gene (ISG) expression in many patients.
- The clinical value of monitoring ISG levels longitudinally in SLE patients remains unclear, especially with the advent of IFN-blocking therapies.
Purpose of the Study:
- To investigate the longitudinal stability of ISG status in SLE patients.
- To correlate ISG levels with clinical disease activity and treatment over time.
- To determine the utility of serial ISG measurements in SLE management.
Main Methods:
- Prospective collection of clinical data and whole blood samples from adult SLE patients.
- Measurement of IFN status using a panel of ISGs.
- Analysis of 729 samples from 205 patients, with longitudinal follow-up for a subset.
Main Results:
- At baseline, 62.9% of patients were classified as IFN high.
- Most patients (87.3%) exhibited stable ISG status over time.
- IFN high status was linked to higher disease activity and less time in Lupus Low Disease Activity State, but ISG scores did not correlate with SLE Disease Activity Index in individuals.
- High-dose glucocorticoids, but not low-moderate doses, were associated with ISG suppression in a small subset with fluctuating ISG levels.
Conclusions:
- Baseline ISG status in SLE patients is associated with indicators of more severe disease.
- ISG levels are generally stable longitudinally and do not correlate with disease activity in most patients.
- Serial ISG testing is unlikely to be beneficial for SLE management, although baseline assessment may offer insights.
