{
  "abstract": "Introduction Fibrosis of the skin and internal organs is a main manifestation of systemic sclerosis (SSc). Interleukin-4 (IL-4) is considered as one of the profibrotic cytokines in pathogenesis of SSc. IL-4 participate in fibrosis of skin and internal organs in SSc and could be a potential therapeutic target. The aim of our study was to evaluate changes of serum level of IL-4 in patient with SSc during immunosuppressive therapy.Material and Methods There were 83 patients with SSc included in this study. The mean follow-up period was 18±13 months. There were 67 female patients (81%). Mean age was 49±13 years. The diffuse cutaneous subset of the disease had 48 patients (58%), limited – 35 (42%). The mean disease duration was 7.4±6.4 years. All pts received prednisolone at mean dose of 10±4 mg/day. 11% of patients received cyclophosphamide, 47% - mycophenolate mofetil and 61% - rituximab (RTX) at inclusion. The cumulative mean dose of RTX was 3.4±2.2 grams. The cumulative mean dose of cyclophosphamide was 11.2±9.5 grams. As a measure of skin thickness, we evaluate modified Rodnan skin score (mRss). Serum IL-4 levels were examined by ELISA. The results are presented in the form of mean values, median, lower and upper quartile.Results There was a significant improvement of mRss from 11.3±10.4 to 8.9±8.1 (p=0.003). The disease activity index (EScSG-AI) decreased from 3.5±1.7 to 2.4±1.5 (p=0.0001). Serum level of IL-4 changes from 0.003 [0.001; 0.005] to 0.001 [0.001; 0.005] pg/ml in general group. Higher level of IL-4 was in patients with more severe skin fibrosis. We found a moderate statistically significant correlation between the IL-4 and mRss (r=0.319; p=0.001), between IL-4 and the disease activity index (EScSG-AI) (r=0.320; p=0.001). Also, there was a correlation between IL-4 and presence of telangiectasias (r=-0.273; p=0.001), between IL-4 and proximal skin fibrosis (r=0.336; p=0.001).Conclusions There was an improvement of skin fibrosis in our study. It was accompanied with a decrease of the disease activity index. Serum level of IL-4 did not significantly change in our study, but it was correlated with mRss, disease activity index and other evaluated parameters. Serum level of IL-4 could be a marker of progression and severe course of skin fibrosis in SSc, but further studies are required.",
  "authors": [
    {
      "affiliations": [
        "VA Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Liudmila Garzanova"
    },
    {
      "affiliations": [
        "VA Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Lidia Ananyeva"
    },
    {
      "affiliations": [
        "VA Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Olga Koneva"
    },
    {
      "affiliations": [
        "VA Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Olga Ovsyannikova"
    },
    {
      "affiliations": [
        "VA Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Oxana Desinova"
    },
    {
      "affiliations": [
        "VA Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Mayya Starovoytova"
    },
    {
      "affiliations": [
        "VA Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Rushana Shayakhmetova"
    },
    {
      "affiliations": [
        "VA Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Anna Khelkovskaya-Sergeeva"
    },
    {
      "affiliations": [
        "VA Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Anastasiya Avdeeva"
    },
    {
      "affiliations": [
        "VA Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Mikhail Diatroptov"
    }
  ],
  "title": "P.218 Changes of interleukin-4 in systemic sclerosis during immunosuppressive therapy",
  "uid": "cf9582f1-8954-534f-b79b-67c304e0d8fb"
}