RT Journal Article
SR Electronic
T1 Type 1 interferon status in systemic lupus erythematosus: a longitudinal analysis
JF Lupus Science & Medicine
JO Lupus Sci Med
FD Lupus Foundation of America
SP e000625
DO 10.1136/lupus-2021-000625
VO 9
IS 1
A1 Melissa Northcott
A1 Sarah Jones
A1 Rachel Koelmeyer
A1 Julie Bonin
A1 Fabien Vincent
A1 Rangi Kandane-Rathnayake
A1 Alberta Hoi
A1 Eric Morand
YR 2022
UL http://lupus.bmj.com/content/9/1/e000625.abstract
AB Objectives Type 1 interferon (IFN) is key to the pathogenesis of SLE, evidenced by the expression of IFN-stimulated genes (ISGs) in most patients, but the clinical utility of serial ISG assessment remains unknown. With the emergence of IFN-blocking drugs, we aimed to examine IFN status in relation to clinical findings longitudinally to provide insights into the value of testing ISG levels over time.Methods Clinical data and whole blood were collected prospectively on adult patients with SLE from a single tertiary lupus centre. IFN status was measured using a panel of ISGs.Findings 729 samples were analysed from 205 patients. At baseline, 62.9% of patients were IFN high, 30.2% IFN low and 6.8% borderline. 142 patients had multiple samples collected, and 87.3% of these demonstrated stable ISG status over time. In longitudinal follow-up, IFN high patients had higher activity in multiple organ domains and spent less time in Lupus Low Disease Activity State, but IFN score did not correlate with SLE Disease Activity Index in individual patients. In the small subset of patients who had large fluctuations in ISG across the observation period, most had high-dose glucocorticoids that correlated with ISG suppression. However, low-moderate-dose glucocorticoids did not suppress ISG expression.Conclusion Although IFN high status is associated with indicators of more severe SLE, in the majority of patients, ISGs are stable across time and do not correlate with disease activity. Changes in ISG expression may be seen with high-dose, but not routine dose, glucocorticoid exposure. These findings suggest baseline but not serial ISG measurement may be of value in the management of SLE.Data are available upon reasonable request. The data underlying this article will be shared on reasonable request to the corresponding author.