Limited Utility of APRIL, BAFF, and IL-10 as Biomarkers in Systemic Lupus Erythematosus

Overview

This correction clarifies previously omitted data regarding patient characteristics and cytokine measurements in systemic lupus erythematosus (SLE). The findings confirm that serum levels of APRIL, BAFF, and IL-10 do not significantly differ between SLE patients with or without prior cyclophosphamide treatment, nor between active and inactive disease states.

Background

Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by periods of activity and remission. Biomarkers such as APRIL, BAFF, and IL-10 have been investigated for their potential to reflect disease activity and predict flares. Accurate assessment of these cytokines could improve disease monitoring and management, especially in patients with lupus nephritis (LN). However, the clinical utility of these markers remains uncertain.

Data Highlights

Among enrolled patients, 33.3% had renal flare at enrollment, with 41.7% of lupus nephritis cases confirmed by renal biopsy. Only two patients were receiving immunosuppressive drugs other than hydroxychloroquine (azathioprine and mycophenolate mofetil). No significant differences in serum APRIL, BAFF, and IL-10 levels were observed between SLE patients with or without prior cyclophosphamide treatment (APRIL: p=0.39; BAFF: p=0.07; IL-10: p=0.75) or between active and inactive disease subgroups (all p>0.05).

Key Findings

• 33.3% of SLE patients had renal flare at study enrollment.
• 41.7% of lupus nephritis diagnoses were confirmed via renal biopsy.
• Only two patients were on immunosuppressive therapies other than hydroxychloroquine at enrollment.
• No significant differences in APRIL, BAFF, and IL-10 serum levels between patients with or without prior cyclophosphamide treatment.
• No significant cytokine level differences between active and inactive SLE disease states.

Clinical Implications

These findings suggest that serum APRIL, BAFF, and IL-10 levels have limited value as biomarkers for assessing disease activity or predicting flares in SLE patients, including those with lupus nephritis. Clinicians should be cautious in relying on these cytokines for clinical decision-making and continue to use comprehensive clinical and laboratory evaluation for disease monitoring.

Conclusion

The corrected data reinforce that APRIL, BAFF, and IL-10 serum levels do not reliably reflect disease activity or treatment history in SLE, limiting their role as biomarkers in clinical practice.

References

1. Clinical Rheumatology 2025 -- Reevaluation of Serum Levels of APRIL, BAFF, and IL-10 in Systemic Lupus Erythematosus