THE ROLE OF CYTOKINES IN HENOCH-SCHONLEIN PURPURA

Serum levels of tumor necrosis factor (TNF) and interleukin(IL-1) were studied in 20 HSP patients, in the acute phase and after remission, b y ELISA technique. Skin biopsies obtained during the acute phase both from a lesion and from unaffected skin, as well as during remission, w ere immunostained for TNF, IL-1, and IL-6. The mean age of the patient s was 9.8 (5-13). Mean serum TNF levels during the acute phase and rem ission were 14.0 +/- 8.9 pg/ml, and 6.8 +/- 2.4 pg/ml, respectively (p <0.05). Serum TNF levels in patients with renal involvement (18.8 +/- 10.2 pg/ml) were significantly higher than in those without (10.8 +/- 6.5 pg/ml) (p<0.05). Serum levels of IL-1 in the acute phase and remis sion were undetectable. All specimens showed leukocytoclastic vasculit is. Immunohistochemical studies revealed TNF, and a less intense IL-1 and IL-6 staining in the nucleated epidermal layer, with a granular, i ntracellular pattern. Staining was significantly increased in the affe cted skin during the acute phase. These results suggest that TNF, IL-1 , and IL-6 may play a role as a mediator of inflammation in HSP.