Tumour necrosis factor‐α (TNF), lymphotoxin and TNF receptor levels in serum from patients with Wegener's granulomatosis
Wegener's granulomatosis (WG) is a systemic inflammatory disease with vasculitis as the key feature. Abnormal expression of tumour necrosis factor α (TNFα) is considered of prime pathogenic importance in several inflammatory diseases. The effects of TNFα are mediated by TNF receptors (TNF‐R), and these receptors are often found in soluble forms (sTNF‐R), which can modulate TNFα actions. To evaluate the clinical importance of the TNF family of cytokines, the serum levels of TNFα, TNFβ, now termed lymphotoxin (LTα), and sTNF‐R1 and sTNF‐R2 were measured by ELISA in 8 patients with WG during active disease and during immunosuppressive treatment, and in 11 healthy controls in parallel. Serum concentrations of TNFα were undetectable in all except two controls (18%) and three patients with WG (37%). After 7 days of therapy, six of the WG patients had measurable TNFα levels. Examination of the relative amounts of TNFα and sTNF‐R indicated that TNFα was mostly bound to its soluble receptors. In WG, the serum levels of sTNF‐R1 and sTNF‐R2 were dramatically increased (p<0.01), with little or no variation during treatment. While the IL‐1β levels did not deviate significantly from controls, the IL‐1ra levels were significantly elevated in the WG patients throughout the study period (p<0.01).
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