Disassociation of sex hormone levels and cytokine production in SLE patients

This study examines whether changes in the cytokine milieu of patients with systemic lupus erythematosus (SLE) are associated with abnormal levels of sex hormone levels in serum. The concentration of 17 beta -estradiol (E2), progesterone (Pg) and dehydroepiandrosterone-sulphate (DHEAS) was monitored in sera from 128 lupus patients and 96 controls, and correlated with the a ctivity of their cytokine secreting cells. Results indicate that SLE patien ts have (i) significantly fewer cells secreting IFN gamma, (ii) increased s erum E2 and Pg levels, and (iii) reduced serum DHEAS levels compared to nor mal controls. However, the observed abnormalities in the cytokine milieu of SLE patients did not correlate with abnormalities in serum sex hormone lev els. Instead, the association between IFN gamma production and DHEAS levels evident in healthy controls is absent in SLE patients, suggesting that cel ls from lupus patients are defective in their ability to produce IFN gamma in response to physiologic stimuli. Similarly, the normal correlation betwe en IL-4 production and E2 levels was Lost in patients with severe disease. Thus, while it remains possible that increased E2 and reduced DHEAS levels in lupus patients may help induce cytokine abnormalities early in disease, the subsequent cytokine imbalance does not correlate with sex hormone level s.