Interferon-α biological activity is associated with disease activity and risk of flare in cutaneous lupus erythematosus: A monocentric study of 184 patients - 11/02/25

Doi : 10.1016/j.jaad.2024.12.041

Quitterie Murat de Montai, MD ^a, Clémence Masseran, MD ^a, Laura Perray, MD ^a,^b, Alexis Mathian, MD ^c, Karim Dorgham, PhD ^b,^c, Guy Gorochov, MD, PhD ^b,^c,^d, Alexandre Teboul, MD ^a, Camille Francès, MD ^a, Laurent Arnaud, MD, PhD ^e, Annick Barbaud, MD, PhD ^a, Zahir Amoura, MD, MSc ^c, Caroline Charre, PharmD, PhD ^f,^g, François Chasset, MD, PhD ^a,^b,^⁎
^a Sorbonne Université, Faculté de médecine, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France
^b Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses-Paris (Cimi-Paris), INSERM U1135, Paris, France
^c Sorbonne Université, Faculté de médecine, AP-HP, Groupement Hospitalier Pitié–Salpêtrière, Centre national de référence du lupus systémique, du syndrome des antiphospholipides et autres maladies auto-immunes, Service de Médecine Interne 2, Institut E3M, INSERM U1135, Paris, France
^d Sorbonne Université, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, Département d'Immunologie, Paris, France
^e Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Centre National de Références des Maladies Systémiques et Auto-immunes Rares Est Sud-Ouest (RESO), Université de Strasbourg, Strasbourg, France
^f Department of Virology, Hospital Cochin, AP-HP, Paris, France
^g INSERM U1016, CNRS UMR8104, Université Paris Cité, Institut Cochin, Paris, France

^∗Correspondence to: François Chasset, MD, PhD, AP-HP, Service de Dermatologie et d’Allergologie, Sorbonne Université, Hôpital Tenon, 4 Rue de la Chine 75970, CEDEX 20, Paris, France.AP-HPService de Dermatologie et d’AllergologieSorbonne UniversitéHôpital Tenon4 Rue de la Chine 75970, CEDEX 20ParisFrance

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Abstract

Background

Cutaneous lupus erythematosus (CLE) is associated with unpredictable flares and may induce permanent damage. There is currently no biomarker routinely available in CLE.

Objective

To evaluate the performance of interferon-α (IFN-α) biological activity as biomarker of CLE activity and risk of flare.

Methods

Cohort study including consecutive CLE patients with or without associated systemic lupus erythematosus. Serum IFN-α biological activity (IU/mL) was determined by assessing the antiviral protection afforded by patients' serum.

Results

At first sampling, among 184 included patients, the prevalence of positive IFN-α activity (≥2 IU/mL) was 38%. Positive IFN-α activity was associated with active CLE (odds ratio = 3.11 [95% CI: 1.61-6.01], P = .006), moderate-to-severe CLE activity (odds ratio = 4.43 [95% CI: 1.99-9.86], P = .001) and associated systemic lupus erythematosus (odds ratio = 2.17 [95% CI: 1.19-4.00], P = .01). Among 65 patients with inactive CLE, the risk of CLE flare at 6 months was significantly higher among patients with positive vs undetectable IFN-α activity (hazard ratio 4.95 [95% CI: 1.12-21.78], P = .03). No association was found with anti-double-stranded DNA antibodies and low complement levels.

Limitations

IFN-α activity is not universally available.

Conclusion

IFN-α activity is associated with cutaneous activity and prognosis in CLE and can be used to predict CLE flares in clinical practice.

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Key words : bioassay, biomarker, cutaneous lupus erythematosus, evolution, interferon-alpha, progression

Abbreviations used : ACLE, ACR, ANA, Anti-dsDNA ab, AUC, CIs, CLASI-A, CLE, CXCL10, DLE, HRs, IFN, IQR, ISGs, LEP, LET, OR, ROC, SCLE, Se, SIMOA, SLE, Sp

Plan

Introduction

Material and methods

Study population and data collection

Definitions

Determination of IFN-α activity by IFN-α bioassay

Outcomes

Statistical analysis

Results

Patient characteristics

Prevalence of positive serum IFN-α activity and association with clinical, biological, immunological features, and therapeutic prognosis

Serum IFN-α activity as potential surrogate biomarker of treatment response

Serum IFN-α activity as surrogate biomarker of CLE flare among patients in remission

Discussion

	Drs Masseran and Perray contributed equally to this work.
	Funding sources: This work was supported by a grant from the French National Society of Dermatology (SFD).
	Patient consent: Not applicable.
	IRB approval status: Reviewed and approved by our Institutional Review Board CER-2021-099 (Comité Ethique de la Recherche Sorbonne Université).