AUTHOR=Yen Chung-Yang , Yu Sheng-Jie , Chen Yi-Ming , Lai Kuo-Lung , Wu Yi-Da , Liao En-Chih , Hsieh Ching-Liang 

TITLE=Mechanisms of Tumor Necrosis Factor-Alpha Inhibitor-Induced Systemic Lupus Erythematosus

JOURNAL=Frontiers in Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.870724

DOI=10.3389/fmed.2022.870724

ISSN=2296-858X

ABSTRACT=<p>Systemic lupus erythematosus induced by biologics mainly results from tumor necrosis factor-alpha remains unclear. The objectives of the study were to investigate the mechanisms of tumor necrosis factor-alpha inhibitor-induced systemic lupus erythematosus. Peripheral blood mononuclear cells obtained from thirteen psoriasis patients were cultured and treated with the following: untreated control, <italic>Streptococcus pyogenes</italic> with or without different biologics. The supernatants were collected for cytokines assay. Analysis of cytokine expression revealed that IL-2 and IL-10 levels decreased only in the TNF-α inhibitor-treated groups but not in the groups treated with biologics involving IL-17, IL-12/IL-23 or IL-23 inhibitor mechanisms (<italic>p</italic> &lt; 0.001, <italic>p</italic> &lt; 0.05). The IFN-γ/IL-13 ratio increased significantly in patients with SLE inducing biologics to <italic>S. pyogenes</italic> induction only compared with non-SLE inducing biologics to <italic>S. pyogenes</italic> induction only (<italic>p</italic> = 0.001). IL-2 and IL-10 depletion and a shift to the Th-1 pathway in the innate response are the correlated mechanism for tumor necrosis factor-alpha inhibitor-induced systemic lupus erythematosus.</p>