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Interleukin-37 as an anti-inflammatory cytokine: does its relation to disease activity suggest its potential role in rheumatoid arthritis therapy?

• 2022
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Publication Information
Authors Eman A. Baraka1* , Mona G. Balata2,3, Shereen H. Ahmed4, Afaf F. Khamis5 and Enas A. Elattar2,6
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publication.type Local
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Abstract
Background: This study aimed to measure the serum and synovial interleukin (IL)-37 levels in rheumatoid arthritis
(RA) patients compared to patients with primary knee osteoarthritis (PKOA) and healthy controls and to detect its
relation to RA disease activity.
Results: This cross-sectional study included 50 RA patients with a mean age of 40.24 ± 8.62 years, 50 patients with
PKOA with a mean age of 56.69 ± 4.21, and 40 healthy controls with a mean age of 41.75 ± 7.38 years. The mean
serum IL-37 level in the RA patients (382.6 ± 73.97 pg/ml) was statistically significantly (P < 0.001) the highest
among the studied groups; however, it showed a non-significant difference between the PKOA patients (70.38 ±
27.49 pg/ml) and the healthy controls (69.97 ± 25.12 pg/ml) (P > 0.94). Both serum and synovial IL-37 levels were
significantly positively correlated with disease activity scores (r = 0.92, P< 0.001 and r = 0.85, P < 0.001), tender joint
counts (r = 0.83, P < 0.001 and r = 0.82, P < 0.001 ), swollen joint counts (r = 0.72, P < 0.001 and r = 0.60, P < 0.001),
visual analog scale (r = 0.82, P < 0.001 and r = 0.82, P < 0.001), erythrocyte sedimentation rate (r = 0.75, P < 0.001
and r = 0.65, P < 0.001), and C-reactive protein (r = 0.93, P < 0.001 and r = 0.79, P < 0.001), respectively.
Conclusion: Serum and synovial IL-37 were significantly elevated in the RA patients, and they were closely
correlated. Being less invasive, the serum IL-37 could be a marker of disease activity and could reflect the effective
disease control by drugs. Having an anti-inflammatory effect could not suggest IL-37 as the key player to control
inflammation alone, but its combination with other anti-proinflammatory cytokines could be investigated.