INTERLEUKIN-23 IN PATIENTS WITH ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED SYSTEMIC VASCULITIDES: THE AUTHORS’ RESULTS AND A REVIEW OF LITERATURE

T helper type 17 (Th17) cell-mediated reactions can be implicated in the pathogenesis of antineutrophil cytoplasmic antibody (ANCA)-associated systemic vasculitides (SV) (ANCA-SV). The relationship of clinical parameters to the serum levels of interleukin-23 (IL-23) that is involved in a Th17 response and the impact of therapy on this factor were studied in patients with ANCA-SV.

Objective: to study serum IL-23 concentrations in patients having varying ANCA-SV activities and different induction treatment regimens as compared to healthy donors.

Subjects and methods. Enzyme immunoassay was used to investigate IL-23 concentrations in 40 patients with ANCA-SV [median age, 44 years (20 to 65 years); female/male ratio, 1.11] and 8 healthy donors [median age, 47 years (21 to 66 years); female/male ratio, 1.67]. ANCA-SV was classified as granulomatosis with polyangiitis in 23 patients, as microscopic polyangiitis in 14, and as eosinophilic granulomatosis with polyangiitis in 3. Examinations were made in 26 patients with ANCA-SV in active stage and in 28 in remission (induced with rituximab in 22 of the 28 patients). The association was analyzed between IL-23 concentrations and disease activity, as well as clinical features of ANCA-SV.

Results and discussion. Significantly elevated serum IL-23 concentrations were noted only in the untreated patients at the onset of ANCA-SV as compared to the healthy donors (median 41.9 and 13.1 pg/ml, respectively; p < 0.05). Both immunosuppressive and anti-B-cell therapy persistently decreased serum IL-23 concentrations (to 5.2–88 pg/ml).

Conclusion. Further investigation of IL-23 and functionally related cytokines in ANCA-SV is promising

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