Fatigue in primary Sjögren's syndrome is associated with lower levels of proinflammatory cytokines

Howard Tripp, Nadia, Tarn, Jessica, Natasari, Andini, Gillespie, Colin, Mitchell, Sheryl, Hackett, Kate, Bowman, Simon, Price, Elizabeth, Pease, Colin, Emery, Paul, Lanyon, Peter, Hunter, John, Gupta, Monica, Bombardieri, Michele, Sutcliffe, Nurhan, Pitzalis, Costantino, McLaren, John, Cooper, Annie, Regan, Marian, Giles, Ian, Isenberg, David, Saravanan, Vadivelu, Coady, David, Dasgupta, Bhaskar, McHugh, Neil, Young-Min, Steven, Moots, Robert, Gendi, Nagui, Akil, Mohammed, Griffiths, Bridget, Lendrem, Dennis and Ng, Wan-Fai (2016) Fatigue in primary Sjögren's syndrome is associated with lower levels of proinflammatory cytokines. RMD Open, 2 (2). e000282. ISSN 2056-5933

[img]
Preview
Text
e000282.full.pdf - Published Version
Available under License Creative Commons Attribution 4.0.

Download (1MB) | Preview
Official URL: https://doi.org/10.1136/rmdopen-2016-000282

Abstract

Objectives This article reports relationships between serum cytokine levels and patient-reported levels of fatigue, in the chronic immunological condition primary Sjögren's syndrome (pSS).

Methods Blood levels of 24 cytokines were measured in 159 patients with pSS from the United Kingdom Primary Sjögren's Syndrome Registry and 28 healthy non-fatigued controls. Differences between cytokines in cases and controls were evaluated using Wilcoxon test. Patient-reported scores for fatigue were evaluated, classified according to severity and compared with cytokine levels using analysis of variance. Logistic regression was used to determine the most important predictors of fatigue levels.

Results 14 cytokines were significantly higher in patients with pSS (n=159) compared to non-fatigued healthy controls (n=28). While serum levels were elevated in patients with pSS compared to healthy controls, unexpectedly, the levels of 4 proinflammatory cytokines—interferon-γ-induced protein-10 (IP-10) (p=0.019), tumour necrosis factor-α (p=0.046), lymphotoxin-α (p=0.034) and interferon-γ (IFN-γ) (p=0.022)—were inversely related to patient-reported levels of fatigue. A regression model predicting fatigue levels in pSS based on cytokine levels, disease-specific and clinical parameters, as well as anxiety, pain and depression, revealed IP-10, IFN-γ (both inversely), pain and depression (both positively) as the most important predictors of fatigue. This model correctly predicts fatigue levels with reasonable (67%) accuracy.

Conclusions Cytokines, pain and depression appear to be the most powerful predictors of fatigue in pSS. Our data challenge the notion that proinflammatory cytokines directly mediate fatigue in chronic immunological conditions. Instead, we hypothesise that mechanisms regulating inflammatory responses may be important.

Item Type: Article
Subjects: B900 Others in Subjects allied to Medicine
Department: Faculties > Health and Life Sciences > Social Work, Education and Community Wellbeing
Depositing User: Becky Skoyles
Date Deposited: 14 Feb 2018 12:54
Last Modified: 14 Feb 2018 14:01
URI: http://nrl.northumbria.ac.uk/id/eprint/33366

Actions (login required)

View Item View Item

Downloads

Downloads per month over past year

View more statistics


Policies: NRL Policies | NRL University Deposit Policy | NRL Deposit Licence