Fatigue in primary Sjögren's syndrome (pSS) is associated with lower levels of proinflammatory cytokines: a validation study

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Fatigue in primary Sjögren's syndrome (pSS) is associated with lower levels of proinflammatory cytokines : a validation study. / UK Primary Sjögren’s Syndrome Registry ; Bowman, Simon J.

In: Rheumatology International, Vol. 39, No. 11, 11.2019, p. 1867-1873.

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@article{e7650c82a41e40508fb84277a205f481,
title = "Fatigue in primary Sj{\"o}gren's syndrome (pSS) is associated with lower levels of proinflammatory cytokines: a validation study",
abstract = "Primary Sj{\"o}gren's syndrome (pSS) is a chronic autoimmune rheumatic disease with symptoms including dryness, fatigue, and pain. The previous work by our group has suggested that certain proinflammatory cytokines are inversely related to patient-reported levels of fatigue. To date, these findings have not been validated. This study aims to validate this observation. Blood levels of seven cytokines were measured in 120 patients with pSS from the United Kingdom Primary Sj{\"o}gren's Syndrome Registry and 30 age-matched healthy non-fatigued controls. Patient-reported scores for fatigue were classified according to severity and compared to cytokine levels using analysis of variance. The differences between cytokines in cases and controls were evaluated using Wilcoxon test. A logistic regression model was used to determine the most important identifiers of fatigue. Five cytokines, interferon-γ-induced protein-10 (IP-10), tumour necrosis factor-α (TNFα), interferon-α (IFNα), interferon-γ (IFN-γ), and lymphotoxin-α (LT-α) were significantly higher in patients with pSS (n = 120) compared to non-fatigued controls (n = 30). Levels of two proinflammatory cytokines, TNF-α (p = 0.021) and LT-α (p = 0.043), were inversely related to patient-reported levels of fatigue. Cytokine levels, disease-specific and clinical parameters as well as pain, anxiety, and depression were used as predictors in our validation model. The model correctly identifies fatigue levels with 85% accuracy. Consistent with the original study, pain, depression, and proinflammatory cytokines appear to be the most powerful predictors of fatigue in pSS. TNF-α and LT-α have an inverse relationship with fatigue severity in pSS challenging the notion that proinflammatory cytokines directly mediate fatigue in chronic immunological conditions.",
keywords = "cytokines, fatigue, primary Sj{\"o}gren{\textquoteright}s syndrome, proinflammatory",
author = "{UK Primary Sj{\"o}gren{\textquoteright}s Syndrome Registry} and Kristen Davies and Kamran Mirza and Jessica Tarn and Nadia Howard-Tripp and Bowman, {Simon J} and Dennis Lendrem and Wan-Fai Ng",
year = "2019",
month = nov,
doi = "10.1007/s00296-019-04354-0",
language = "English",
volume = "39",
pages = "1867--1873",
journal = "Rheumatology International",
issn = "0172-8172",
publisher = "Springer",
number = "11",

}

RIS

TY - JOUR

T1 - Fatigue in primary Sjögren's syndrome (pSS) is associated with lower levels of proinflammatory cytokines

T2 - a validation study

AU - UK Primary Sjögren’s Syndrome Registry

AU - Davies, Kristen

AU - Mirza, Kamran

AU - Tarn, Jessica

AU - Howard-Tripp, Nadia

AU - Bowman, Simon J

AU - Lendrem, Dennis

AU - Ng, Wan-Fai

PY - 2019/11

Y1 - 2019/11

N2 - Primary Sjögren's syndrome (pSS) is a chronic autoimmune rheumatic disease with symptoms including dryness, fatigue, and pain. The previous work by our group has suggested that certain proinflammatory cytokines are inversely related to patient-reported levels of fatigue. To date, these findings have not been validated. This study aims to validate this observation. Blood levels of seven cytokines were measured in 120 patients with pSS from the United Kingdom Primary Sjögren's Syndrome Registry and 30 age-matched healthy non-fatigued controls. Patient-reported scores for fatigue were classified according to severity and compared to cytokine levels using analysis of variance. The differences between cytokines in cases and controls were evaluated using Wilcoxon test. A logistic regression model was used to determine the most important identifiers of fatigue. Five cytokines, interferon-γ-induced protein-10 (IP-10), tumour necrosis factor-α (TNFα), interferon-α (IFNα), interferon-γ (IFN-γ), and lymphotoxin-α (LT-α) were significantly higher in patients with pSS (n = 120) compared to non-fatigued controls (n = 30). Levels of two proinflammatory cytokines, TNF-α (p = 0.021) and LT-α (p = 0.043), were inversely related to patient-reported levels of fatigue. Cytokine levels, disease-specific and clinical parameters as well as pain, anxiety, and depression were used as predictors in our validation model. The model correctly identifies fatigue levels with 85% accuracy. Consistent with the original study, pain, depression, and proinflammatory cytokines appear to be the most powerful predictors of fatigue in pSS. TNF-α and LT-α have an inverse relationship with fatigue severity in pSS challenging the notion that proinflammatory cytokines directly mediate fatigue in chronic immunological conditions.

AB - Primary Sjögren's syndrome (pSS) is a chronic autoimmune rheumatic disease with symptoms including dryness, fatigue, and pain. The previous work by our group has suggested that certain proinflammatory cytokines are inversely related to patient-reported levels of fatigue. To date, these findings have not been validated. This study aims to validate this observation. Blood levels of seven cytokines were measured in 120 patients with pSS from the United Kingdom Primary Sjögren's Syndrome Registry and 30 age-matched healthy non-fatigued controls. Patient-reported scores for fatigue were classified according to severity and compared to cytokine levels using analysis of variance. The differences between cytokines in cases and controls were evaluated using Wilcoxon test. A logistic regression model was used to determine the most important identifiers of fatigue. Five cytokines, interferon-γ-induced protein-10 (IP-10), tumour necrosis factor-α (TNFα), interferon-α (IFNα), interferon-γ (IFN-γ), and lymphotoxin-α (LT-α) were significantly higher in patients with pSS (n = 120) compared to non-fatigued controls (n = 30). Levels of two proinflammatory cytokines, TNF-α (p = 0.021) and LT-α (p = 0.043), were inversely related to patient-reported levels of fatigue. Cytokine levels, disease-specific and clinical parameters as well as pain, anxiety, and depression were used as predictors in our validation model. The model correctly identifies fatigue levels with 85% accuracy. Consistent with the original study, pain, depression, and proinflammatory cytokines appear to be the most powerful predictors of fatigue in pSS. TNF-α and LT-α have an inverse relationship with fatigue severity in pSS challenging the notion that proinflammatory cytokines directly mediate fatigue in chronic immunological conditions.

KW - cytokines

KW - fatigue

KW - primary Sjögren’s syndrome

KW - proinflammatory

UR - http://www.scopus.com/inward/record.url?scp=85068212982&partnerID=8YFLogxK

U2 - 10.1007/s00296-019-04354-0

DO - 10.1007/s00296-019-04354-0

M3 - Article

C2 - 31250166

VL - 39

SP - 1867

EP - 1873

JO - Rheumatology International

JF - Rheumatology International

SN - 0172-8172

IS - 11

ER -