Level of Interleukin-35, Interleukin-36, and the Interleukin-35/Interleukin-36 Ratio in Juvenile Idiopathic Arthritis

Qudus W. Jamal; Ghassaq Alubaidi; Yasmin Humadi

doi:10.3889/oamjms.2021.6671

Authors

Qudus W. Jamal Department of Microbiology, College of Medicine, Nahrain University, Baghdad, Iraq
Ghassaq Alubaidi Medical Research Unit, College of Medicine, Nahrain University, Baghdad, Iraq https://orcid.org/0000-0002-7287-9398
Yasmin Humadi Department of Internal Medicine, College of Medicine, Nahrain University, Baghdad, Iraq

DOI:

https://doi.org/10.3889/oamjms.2021.6671

Keywords:

Juvenile rheumatoid arthritis, Interleukin-35, Interleukin-36, Interleukin-35/interleukin-36 ratio, Juvenile Arthritis Disease Activity Score-27

Abstract

BACKGROUND: Cytokines are inflammatory mediators that regulate multiple processes potentially implicated in inflammation and autoimmunity.

AIM: This study aimed to investigate the levels of circulating interleukin (IL)-35, IL-36, and IL-35/IL-36 ratio in Juvenile Idiopathic Arthritis (JIA) patients.

METHODS: Fifty-one patients categorized based on the International League of Associations for Rheumatology classification criteria were enrolled, along with 46 healthy controls. Disease activity assessment was conducted according to the Juvenile Arthritis Disease Activity Score (JADAS-27) system. Serum cytokine levels were determined using the sandwich enzyme-linked immunosorbent assay.

RESULTS: Compared to controls, the serum levels of IL-36 were significantly higher among JIA children (p = 0.002), and serum IL-35 levels and the IL-35/IL-36 ratio were significantly lower in the patients (p = 0.002, p < 0.001, respectively). Furthermore, the IL-35/IL-36 serum ratio, but not the absolute IL levels, correlated positively with the JADAS-27, giving a good indication of the disease outcome. Further, the IL-35/IL-36 serum ratio showed higher sensitivity and specificity compared to the absolute cytokine levels.

CONCLUSION: A significant change in the circulating IL-35 and IL-36 levels and an imbalance in the IL35/IL36 ratio occur in JIA. This study is a novel attempt to explore the role of IL-35 and IL-36 in JIA; further studies are required to support our results. The IL-35/Il-36 ratio is a promising immunological marker to predict, diagnose, and monitor JIA.

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