High levels of maternal serum IL-17 and activin A in pregnant women affected by systemic lupus erythematosus

PROBLEM: To evaluate changes of serum IL-17, activin A, follistatin, and other cytokines during pregnancy in women with systemic lupus erythematosus (SLE). METHOD OF STUDY: A group of patients with SLE and controls were longitudinally studied, collecting a blood sample before and during three trimesters of pregnancy. Serum activin A, follistatin, IL-17, IL-6, IL-10, and TNF-α concentrations were evaluated by specific ELISA. RESULTS: Before pregnancy, while serum IL-17, IL-6, IL-10, and TNF-α resulted significantly higher in women with SLE (P<0.001), activin A and follistatin were not changed. Serum IL-17 concentrations were higher in SLE than in controls with no changes during pregnancy. IL-6 increased in both groups, resulting higher in SLE than in controls only in the first trimester (P<0.05). IL-10 concentration in SLE increased during pregnancy resulting significantly higher than in controls (P<0.01). TNF-α levels were higher in SLE than in controls in third trimester (P<0.01). Serum activin A levels in SLE were significantly higher than in controls (P<0.001) at third trimester. CONCLUSION: Women with SLE show increased secretions of activin A, IL-17, IL-6, IL-10, and TNF-α during gestation, with a different trend for the various cytokines. These data suggest that patients with SLE have a hyper-reactive immune system, probably receiving a placental contribution.