Choi Jeong-Hee, Suh Chang-Hee, Lee Young-Mok, Suh Yu-Jin, Lee Soo-Keol, Kim Sun-Sin, Nahm Dong-Ho, Park Hae-Sim
Department of Allergy and Rheumatology, Ajou University School of Medicine, Paldalgu Woncheondong San-5, Suwon, Korea 442-749.
J Rheumatol. 2003 Nov;30(11):2422-7.
Adult onset Still's disease (AOSD) is a systemic inflammatory disorder characterized by fever, arthritis, and rash. Although the pathogenesis is not known, immunologically mediated inflammation occurs in active AOSD. To evaluate the pathogenesis and disease activity of AOSD, we measured serial serum concentrations of several cytokines in patients with active and inactive disease.
Seventeen patients diagnosed as having AOSD were enrolled. We analyzed clinical and laboratory findings retrospectively. Serial serum samples were obtained from 14 patients with active and inactive AOSD. Interleukin 18 (IL-18), soluble IL-2 receptor (sIL-2R), IL-6, interferon-g (IFN-g), and IL-8 were determined by ELISA.
Serum levels of IL-18, IFN-g, and IL-8 were significantly higher in patients with AOSD than in healthy controls (p < 0.01), but there were no significant differences between patients with active and inactive AOSD. Serum sIL-2R levels tended to be higher in the active state than in healthy controls, but there was no statistically significant difference between the 2 groups. Serum sIL-2R levels decreased significantly with antiinflammatory therapy (p < 0.05). Serum IL-18 and sIL-2R levels correlated significantly with serum ferritin levels in the active AOSD group (p < 0.05).
Overproduction of IL-18 may contribute to the pathogenic mechanism of AOSD, and serum sIL-2R levels may be used as a marker for monitoring disease activity in AOSD.
成人斯蒂尔病（AOSD）是一种以发热、关节炎和皮疹为特征的全身性炎症性疾病。尽管其发病机制尚不清楚，但在活动性AOSD中存在免疫介导的炎症。为了评估AOSD的发病机制和疾病活动度，我们检测了活动期和非活动期患者血清中多种细胞因子的系列浓度。
纳入17例诊断为AOSD的患者。我们回顾性分析了临床和实验室检查结果。从14例活动期和非活动期AOSD患者中获取系列血清样本。采用酶联免疫吸附测定法（ELISA）检测白细胞介素18（IL-18）、可溶性IL-2受体（sIL-2R）、IL-6、干扰素-γ（IFN-γ）和IL-8。
AOSD患者血清IL-18、IFN-γ和IL-8水平显著高于健康对照组（p < 0.01），但活动期和非活动期AOSD患者之间无显著差异。血清sIL-2R水平在活动期倾向于高于健康对照组，但两组之间无统计学显著差异。抗炎治疗后血清sIL-2R水平显著下降（p < 0.05）。活动期AOSD组血清IL-18和sIL-2R水平与血清铁蛋白水平显著相关（p < 0.05）。
IL-18的过度产生可能参与AOSD的发病机制，血清sIL-2R水平可作为监测AOSD疾病活动度的标志物。
