Synovitis and its association with elevated circulating interferons and hydroxychloroquine response in discoid lupus erythematosus: a cross-sectional study.

IF 3.2 3区医学 Q2 RHEUMATOLOGY

Rheumatology International Pub Date : 2025-02-26 DOI:10.1007/s00296-025-05816-4

Magdalena Stec, Monika Krezelok, Magdalena Awsiuk, Ewa Wypasek, Bogdan Batko, Maciej Pastuszczak

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引用次数: 0

Abstract

A significant proportion of patients with discoid lupus erythematosus (DLE) experience joint pain, yet its underlying pathomechanism remains unclear. Recent ultrasound studies in systemic lupus erythematosus (SLE) patients indicate synovitis in up to 90%, even in clinically silent cases, with interferon-mediated immune responses implicated in joint inflammation. This study aimed to investigate joint pathology in DLE, focusing on synovitis and its immunological profile. We analyzed 23 patients with histologically confirmed DLE and joint pain, all treated for ≥ 5 months with prednisone (≤ 10 mg/day) and hydroxychloroquine (HCQ, 200 mg/day). Ultrasonographic assessment (24 joints per patient) was performed using power Doppler (PD) ultrasonography, with synovitis graded using the OMERACT-EULAR PDUS synovitis score. Serum levels of 37 cytokines were measured via Bio-Plex Pro™ Human Inflammation Panel (37Plex). Synovitis (OMERACT-EULAR score ≥ 1) was identified in 30% (7/23) of DLE patients, with minimal (grade 1) synovitis in six cases and moderate (grade 2) synovitis in one. Patients with synovitis had significantly higher levels of IFN-α2, IFN-γ, MMP-1, MMP-3, sTNF-R1, and sTNF-R2 (p < 0.05), more painful joints, and poorer response to HCQ treatment (71.4% vs. 25% non-responders). Joint pain in DLE may result from synovitis, with an interferon-mediated immune response contributing to inflammation. Patients with synovitis exhibited elevated interferon levels and a worse response to HCQ therapy. These findings suggest a shared pathogenic mechanism between DLE and SLE-related arthritis, warranting further investigation into targeted therapeutic strategies.

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来源期刊

Rheumatology International 医学-风湿病学

CiteScore

7.30

自引率

5.00%

发文量

191

审稿时长

16. months

期刊介绍： RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology. RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.