| Part 1: Study on the Levels of Th1/Th2 cell-derived Cytokines and the State of their Balance in Patients with Systemic Lupus Erythematosus (SLE)Objective To detect the serum levels of Thl-type cytokines (IFN- Y) and Th2-type cytokines (IL-4 and IL-10) in patients with SLE and investigate the correlation between these cytokines and SLE disease activity.Methods Serum levels of IFN- Y , IL-4 and IL-10 in patients with SLE were detected by ELISAs.Results All of the detected cytokines were elevated compared to those in healthy control ( PO.05 ).And Serum titres of IL-10 in SLE patients were positively correlated with their SLEDAI scores. The serum mean concentration ratio :IFN-Y/IL-4, IFN-Y/IL-10 (PO.05) in SLE patients with renal involvement were significantly higher than those without renal impairment and those in healthy control (P<0.01) .On the contrary, the mean IFN-Y/IL-4 > IFN-Y/IL-10 ratio in SLE patients without renal impairment were significantly lower than those in healthy control. However, there was no strong correlation between the SLEDAI score and the IFN- Y /IL-4> IFN- Y /IL-10 ratio in SLE patients.Conclusions There was disfunction of Th cell-derived cytokines in SLE patients. For SLE patients with renal involvement, there was a strong predominance of Thl,but for those without renal involvement, there was a strong predominance of Th2. In addition, IFN-Y might take part in renal involvement, and IL-10 might be a novel factor to reflect the disease activity of SLE.Part 2: Effect of Corticosteroids on the expression of Th Cytokines mRNA in the peripheral blood mononuclear cells in Patients with Systemic Lupus Erythematosus (SLE)Objective To investigate the expression of Th cell-derived cytokines' mRNA in the peripheral blood mononuclear cells (PBMCs ) and the effect of corticosteroids on Thl/Th2 cytokines balance in patients with Systemic lupus erythematosus (SLE).IVMethods 48 cases of SLE patients were treated with corticosteroids. Their IFN- Y -> IL-4 and IL-10 levels were semi-quantitatively analyzed by reverse transcription-polymerase reaction (RT-PCR) and ELISA before and after treatment with corticosteroids respectively;and the SLEDAI scores of the patients were compared before and after treatment.Results Before treatment, the mean levels of IFN- Y > IL-4 and IL-10 and their mRNA expressions in SLE were higher than those in healthy control (P<0.05) . After treatment with corticosteroids , the elevated levels of IFN- Y > IL-4 and IL-10 in SLE patients were all significantly decreased than before treatment (P<0.05) . At the same time, the SLEDAI scores were significantly lower than before treatment (P<0.01) . Serum level of IFN-Y was significantly decreased in patients with SLE compared with healthy controls (P<0.05 ) .By contrast, levels of IL-4 and IL-10 of patients with SLE were significantly increased compared with the healthy controls (P<0.05 ) .Conclusions Our data support the idea that corticosteroids may induce a shift from the Thl to Th2 profile of cytokine secretion. This may be one aspect of the mechanisms for corticosteroids treatment.Part 3: Effects of Polysaccharide Nucleic Acid Fraction of Bacillus Calmette Guerin (BCG-PSN)on the Th cytokines'mRNA expressions from peripheral blood mononuclear cells (PBMCs) in Patients with Systemic Lupus Erythematosus (SLE) and disease activitiesObjective In order to investigate the effects of BCG-PSN on the Th cytokines' mRNA expressions from PBMCs in patients with SLE.Methods 66 cases of SLE were randomly divided into two groups, 34 cases in the treatment group treated with BCG-PSN plus corticosteroids and 32 cases in the control group treated with corticosteroids alone. The levels of serum IFN- Y mRNA . IL-4mRNA and IL-10 mRNA expressions were respectively determined by ELISA and RT-PCR methods before and after treatment.Results After treatment,the cytokines mRNA in the two groupswere lowered than before treatment.In the treatment group, IFN- Y > IL-4 and IL-10 productions were lowered to n...
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