Effect Of treatment on serum C3, C4, IL-10, IL1-β, IL-6, TNF-α in patients with systemic lupus erythematosus.

BACKGROUND

This study aimed to evaluate the effects of structured lifestyle optimisation, including nutritional intake and exercise training, on serum levels of Complement C3, C4, IL-10, IL1-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">β</span>, IL-6, and TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">α</span> in patients with systemic lupus erythematosus (SLE) and Libman-Sacks endocarditis (LSE).

METHODS

A total of 122 SLE patients with LSE, treated at our hospital from May 2022 to May 2024, were randomised into a control group (CG, n = 61) receiving conventional medical interventions and an intervention group (IG, n = 61) receiving additional personalised exercise and nutritional interventions for 24 weeks. Serum levels of Complement C3, C4, IL-10, IL1-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">β</span>, IL-6, and TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">α</span> were measured at baseline, 3 months, and 6 months. Secondary endpoints included nutritional status (as measured by albumin and haemoglobin levels) and patient compliance.

RESULTS

Of 113 patients completing the study, the intervention group (IG) showed significant improvement in serum Complement C3 (0.84 ± 0.18 g/L vs. 0.75± 0.16 g/L in the control group [CG], P= 0.006) and albumin levels (37.12± 5.37 g/L vs. 35.00 ± 4.89 g/L, P= 0.03) at 6 months. Complement C4 levels increased in the IG (0.20 ± 0.09 g/L vs. 0.17± 0.12 g/L, P= 0.136, not significant). IL-1<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">β</span> (3 .9 ± 3 .7 7 pg/mL vs. 4.6± 4.1 pg/mL, P= 0.468) and TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">α</span> (12.6± 4.1 pg/mL vs. 14.1 ±5.2 pg/mL, P= 0.092) showed non-significant reductions in the IG compared to the CG. No significant changes were observed in IL-10 or IL-6 levels. Compliance was significantly higher in the IG (92.86% vs. 78.95% , P= 0.038).

CONCLUSIONS

Structured lifestyle optimisation significantlyimproved serum Complement C3 and albumin levels andshowed non-significant trends toward reductions in IL-1<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">β</span> and TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">α</span> in SLE patients with LSE, suggesting a potentialadjunctive role in managing immune and nutritional status.