The following is a summary of “Interleukin-8 and neutrophil extracellular traps in children with lupus nephritis and vitamin C deficiency,” published in the October 2023 issue of Nephrology by Santiworakul et al.
Vitamin C deficiency promotes neutrophil extracellular trap (NET) formation, which involves systemic lupus erythematosus (SLE) pathogenesis.
Researchers started a retrospective study to assess vitamin C status, NET formation, and inflammatory cytokines in children with lupus nephritis.
They measured serum vitamin C in 46 patients (82.6% females, mean age 14.5 ± 0.3 years). Vitamin C levels below 0.3 mg/dL indicated a deficiency. Patients were categorized based on vitamin C levels: standard and low (< 0.3 mg/dL). A comparison of NET formation and SLE-related cytokines (IL-8, IL-10, TNF-α) was conducted between these groups. The NET figure was evaluated using serum citrullinated histone 3 levels, peptidyl arginine deiminase-4 mRNA expression, and immunofluorescence to determine the percentage of neutrophils with NETs.
The results showed vitamin C deficiency in nine patients (19.6%). Kidney pathology assessment during disease onset indicated higher histological activity index and crescentic glomeruli in biopsies of vitamin C-deficient patients, although the chronicity index remained unaffected. Vitamin C-deficient patients exhibited increased NET formation and more elevated serum IL-8 levels. Specifically, serum IL-8 levels were 12.9 ± 5.2 pg/mL in the low vitamin C group and 5.2 ± 0.9 pg/mL in the normal vitamin C group (P=0.03). Serum IL-10 and TNF-α levels showed no significant differences between the groups.
Investigators concluded that vitamin C deficiency correlates with increased NET formation and IL-8 upregulation in children with lupus nephritis.