IL-33/ST2 axis in systemic lupus erythematosus in relation to chronic kidney injury and disease activity

AIM: To elucidate the association between chronic kidney injury and interleukin-33 (IL-33; an alarmin)/suppression of tumorigencity 2 (ST2) in patients with systemic lupus erythematosus (SLE).METHODS: Serum levels of IL-33 and soluble ST2 (sST2) were assessed by ELISA in 50 SLE patients and 30 healthy controls (HC).RESULTS: The levels of IL-33 and sST2, and IL-33/sST2 ratio were significantly higher in SLE patients than those in the HC. The IL-33 and sST2 levels were positively associated with SLE disease activity index (SLEDAI), erythrocyte sedimentation rate (ESR), proteinuria and triglyceride, but negatively associated with complement C3. IL-33/sST2 ratio was positively associated with SLEDAI and estimated glomerular filtration rate (eGFR). Independent explanatory variables associated with high IL-33/sST2 included chronic kidney disease (CKD) staging and albumin (R²=0.442), especially CKD staging.CONCLUSION: Elevated serum sST2 and IL-33 levels in SLE patients are correlated with disease activity and risk factors of kidney injury. IL-33/sST2 ratio may serve as a potential biomarker for chronic kidney injury in SLE patients.