La Montagna Giovanni, D'Angelo Salvatore, Valentini Gabriele
Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale F. Magrassi e A. Lanzara, Unità Operativa di Reumatologia, Seconda Università di Napoli, Policlinico Via S. Pansini 5, 80131 Naples, Italy.
J Rheumatol. 2003 Oct;30(10):2147-51.
To investigate the behavior of serum YKL-40 in a cohort of patients with systemic sclerosis (SSc).
Forty SSc patients (35 women, 5 men) were investigated for serum YKL-40, soluble interleukin 2 receptor alpha (sIL-2Ra; by ELISA), von Willebrand factor (vWF; ELISA), and aminoterminal propeptide of type III procollagen (PIIINP; radioimmunoassay) concentrations. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were evaluated. Skin and organ system involvement were scored according to the Medsger organ/system severity scale.
Serum YKL-40 in SSc patients (mean 132.9 ng/ml; median 75.5, 95% CI 87.8-175) was significantly higher than in controls (mean 66.6 ng/ml; median 52, 95% CI 54.6-78.6). Fourteen patients had levels > 135 ng/ml (cutoff value) with a mean of 264.7 +/- 160 ng/ml. Serum YKL-40 values were found to be more frequently increased in patients with arthralgias/arthritis (18 cases) than in patients without such features (4/22) (p = 0.021). Significant differences were found comparing serum YKL-40 concentrations in the patients with or without joint involvement (median 138 vs 57.5 ng/ml, respectively; p = 0.007). Serum YKL-40 levels correlated with the joint involvement severity score (p = 0.018) and sIL-2Ra levels (p < 0.001). No differences were found with any therapeutic regimen.
This preliminary study shows that YKL-40 serum levels are increased in SSc and that they are correlated with sIL-2Ra and joint involvement, suggesting a relationship with cartilage and/or fibroblast activity.
研究系统性硬化症（SSc）患者队列中血清YKL-40的表现。
对40例SSc患者（35名女性，5名男性）进行血清YKL-40、可溶性白细胞介素2受体α（sIL-2Ra；采用酶联免疫吸附测定法）、血管性血友病因子（vWF；酶联免疫吸附测定法）以及III型前胶原氨基端前肽（PIIINP；放射免疫测定法）浓度的检测。评估红细胞沉降率（ESR）和C反应蛋白（CRP）。根据梅兹格器官/系统严重程度量表对皮肤和器官系统受累情况进行评分。
SSc患者的血清YKL-40（均值132.9 ng/ml；中位数75.5，95%置信区间87.8 - 175）显著高于对照组（均值66.6 ng/ml；中位数52，95%置信区间54.6 - 78.6）。14例患者的水平>135 ng/ml（临界值），均值为264.7±160 ng/ml。发现关节痛/关节炎患者（18例）血清YKL-40值升高的频率高于无此类特征的患者（4/22）（p = 0.021）。比较有或无关节受累患者的血清YKL-40浓度存在显著差异（中位数分别为138 vs 57.5 ng/ml；p = 0.007）。血清YKL-40水平与关节受累严重程度评分（p = 0.018）和sIL-2Ra水平（p < 0.001）相关。在任何治疗方案中均未发现差异。
这项初步研究表明，SSc患者血清YKL-40水平升高，且与sIL-2Ra和关节受累相关，提示与软骨和/或成纤维细胞活性有关。
