The Role of Cytokines in Henoch Schonlein Purpura

Abstract

Serum levels of tumor necrosis factor (TNF) and interleukin(IL-l) were studied in 20 HSP patients, in the acute phase and after remission, by ELISA technique. Skin biopsies obtained during the acute phase both from a lesion and from unaffected skin, as well as during remission, were immunostained for TNF, IL-1, and IL-6. The mean age of the patients was 9.8 (5–13). Mean serum TNF levels during the acute phase and remission 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 remission were undetectable.

All specimens showed leukocytoclastic vasculitis. Immunohistochemical studies revealed TNF, and a less intense IL-1 and IL-6 staining in the nucleated epidermal layer, with a granular, intracellular pattern. Staining was significantly increased in the affected 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.

Key Words:

• Henoch Schonlein Purpura
• TNF, IL-1, Il-6
• immunohistochemistry