Role of IL-6 and IL-10 in IgA Nephropathy and Lupus Nephritis

Abstract

Background:IgA nephropathy (Berger’s disease or mesangial IgA deposition) is characterized by deposition of the IgA auto-antibody in the glomerulus causes a variety of lesions and inflammation in renal tissue.  The clinical course of IgA nephropathy is usually mild, although in 40% of the cases it may lead to end-stage renal disease and it is considered is the most common type of primary GN in the world.One of the mostfrequent organ manifestations of SLE is LN, The disease most affected patients are women of childbearing age, and it is characterized by overproduction of antibodies to self-antigens, which are mostly extracted from cell components including the nucleus, cell membranes, cytoplasm, and ribosomes.which in many cases leads to end-stage renal disease.

Objective:biopsy is the best way to diagnose patients with IgA Nephropathy  and Lupus Nephritis But it is considered an invasive method for diagnosis, therefore present study suggests to evaluate the significant importance of IL-6 and IL-10  as biomarkers for diagnosis of IgA Nephropathy  and Lupus Nephritis

Materials and Methods :A case control study based on three groups, first group consist from 30 patients previously diagnosed as IgA Nephropathy(IgAN)   which include (19 male and 11 female), also Second group was 30 patients who have  Lupus Nephritis(LN) which include (10 male and 20 female )who were observation  in  Al Hussein Teaching Hospital in Holy karbala province, the period from December2019 toDecember 2020 under the supervision of nephrology specialists. Third group was include 30 healthy volunteers (non IgA Nephropathy  and non Lupus Nephritis ). The blood sample were  collected by venipuncture from three groups were drawing approximately five millimeter of venous blood by disposable syringe under aseptic technique ,Each blood sample of these groups were collected in plane tube then serum was separated by centrifugation 13000 for 5 minute,IL-6 and IL-10 ELISA assays were performed using serum collected in Eppendrof tubes and stored at -20°C.

Result : The demographic characteristics, age and gender, of patients with IgA nephropathy, lupus nephritis and control subjects. The group of IgA nephropathy included significantly more males than control subjects; whereas, the group of lupus nephritis included more females than control group (p = 0.008). There was also highly significant difference in mean age among patients and control groups (p < 0.001), in such a way that highest age was observed in lupus nephritis group followed by IgA nephropathy and lastly by control group, 46.03 ±12.43 years versus 39.17 ±10.40 years versus 25.87 ±6.67 years, respectively.

There was highly significant difference in serum IL-6 level among study groups (p< 0.001); the level being highest in lupus nephritis and IgA nephropathy groups and then followed by control group.There was highly significant difference in serum IL -10 level among study groups (p< 0.001); the level being highest in lupus nephritis and IgA nephropathy groups and then followed by control group.Regarding IgA nephropathy ,the results showed that the cutoff values for IL-6 and IL-10 were >8.62 and >136.04, respectively; the most accurate one was IL-6 followed by IL-10 and accuracy levels of 96.2 and 95.1, respectively.while Regarding lupus nephritis ,the results also showed that the cutoff values for IL-6 and IL-10 were >7.99 and >136.04, respectively; the most accurate one was IL-6 followed by IL-10 and accuracy levels of 99.2 and 94.8, respectively.

Conclusion:Present study concluded that, IL-6 consider a good biomarker with high sensitivity and specificity for IgA nephropathy and Lupus nephritis, while IL-10 consider an inflammatory biomarker for nephritis in general. More studies are needed to solidify the result of present study.