Therapeutic potential of plasmapheresis in lupus erythematosus: Biomarkers and follow-up control

Introduction. Lupus erythematosus (LE) is a heterogeneous autoimmune disease, and pro-inflammatory cytokines play important roles in its pathogenesis. Despite numerous studies, the features of the cytokine profile in cutaneous LE (CLE), as well as its changes in response to plasmapheresis, remain unclear.

Aim. To assess the levels of IL-17A, IL-31, IL-13 and IL-10 in patients with discoid (DLE) and systemic (SLE) LE, as well as changes in their levels at different time points after membrane plasmapheresis.

Materials and methods. The study included 30 patients (21 with DLE, 9 with SLE), who were treated at the Moscow Scientific and Practical Center for Dermatovenereology and Cardiology of the Moscow Health Department. Cytokine levels were assessed before treatment, after the first plasmapheresis procedure, and at 14 days. The results were compared with reference values.

Results. Patients with DLE showed elevated levels of IL-17A and IL-31 at baseline. After the first procedure, a decrease in IL-17A and IL-13 with a sharp increase in IL-31 were observed. At 14 days, IL-17A and IL-10 levels continued to decrease, IL-13 levels recovered to baseline, and IL-31 levels remained elevated. In patients with SLE, a moderate decrease in IL-17A and an increase in IL-13 and IL-10 were observed. At 14 days, IL-17A and IL-10 levels decreased, IL-13 levels demonstrated significant fluctuations, and IL-31 levels remained stable in both cases.

Conclusions. Plasmapheresis has been shown to have a modulating effect on cytokine levels in patients with LE. IL-31 and IL-10 can be considered potential biomarkers of disease activity and systemic progression. The data obtained support the feasibility of plasmapheresis in the therapy of resistant forms of LE.

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