Role of Serum TNFα Level in Atherosclerosis in Egyptian Systemic Lupus Erythematosus Patients

Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease that principally affects women in their childbearing years. Many cytokines have been implicated in regulating disease activity and the involvement of different organs in patients with SLE. The study was conducted to determine serum tumor necrosis factor alpha (TNFα) levels in SLE patients and its relation to clinically active disease and to assess the possible role of serum TNFα level in atherosclerosis. Thirty Egyptian female patients with SLE and 15 matched healthy control subjects had serum TNFα levels measured. In addition, the relation of common carotid artery intima-media thickness (CIMT) to serum TNFα was evaluated. Mean serum TNFα level of SLE patients was 48.36 ± 58.27 pg/ml, significantly different from the control group (17.62 ± 16.63 pg/ml; P = .014). There was a statistically significant difference in right carotid CIMT between SLE patients (0.06 ± 0.01 cm) and the control group (0.054 ± 0.009; P = .002). There was also a statistically significant difference in left carotid CIMT between lupus nephritis patients (0.07 ± 0.01) and non–lupus nephritis patients (0.06 ± 0.01; P = .027). These data indicate the activation of immune response in SLE patients suggested by their high levels of TNFα. Increased CITM in lupus patients was not related to TNFα and the lipid profile, suggesting an underlying etiology for atherosclerosis in lupus patients other than those factors. High CIMT in nephritis patients denote the role of nephritis in atherosclerosis.