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将犬原发性免疫介导性溶血性贫血患者血清中白细胞介素-18 和单核细胞趋化蛋白-1 浓度用作预后指标。

Use of serum concentrations of interleukin-18 and monocyte chemoattractant protein-1 as prognostic indicators in primary immune-mediated hemolytic anemia in dogs.

机构信息

Department of Small Animal Clinical Sciences, Faculty of Life Sciences, University of Copenhagen, Frederiksberg C, Denmark.

出版信息

J Vet Intern Med. 2011 Jan-Feb;25(1):76-82. doi: 10.1111/j.1939-1676.2010.0642.x. Epub 2010 Nov 23.

Abstract

BACKGROUND

The cytokine response in immune-mediated hemolytic anemia (IMHA) is poorly characterized and correlation with outcome is unknown.

HYPOTHESIS/OBJECTIVES: To determine if cytokine activity is correlated with outcome in dogs with IMHA.

ANIMALS

Twenty dogs with primary IMHA and 6 control dogs.

METHODS

Prospective study on dogs with IMHA with blood sampling at admission. Serum activity of interleukin-2 (IL-2), IL-4, IL-6, IL-7, IL-8, IL-10, IL-15, IL-18, monocyte chemoattractant protein-1 (MCP-1), granulocyte-macrophage colony stimulating factor (GM-CSF), interferon-inducible protein-10, interferon-gamma, and keratinocyte chemoattractant (KC) was assessed.

RESULTS

Thirty-day case fatality rate was 25% (5/20 dogs). Increased concentrations (median [range]) of IL-2 (45.5 ng/L [0;830] versus 0 ng/L [0;46.8]), IL-10 (8.2 ng/L [0;60.6] versus 0 ng/L [0;88.2]), KC (1.7 μg/L [0.3;4.7] versus 0.5 μg/L [0.2;1.1]), and MCP-1 (162 ng/L [97.6;438] versus 124 ng/L [90.2;168]) were observed in dogs with IMHA compared with controls. The cytokine profile was indicative of a mixture of pro- and anti-inflammatory cytokines of various cellular origins. Cytokines/chemokines strongly associated with macrophage/monocyte activation and recruitment were significantly increased in nonsurvivors compared with survivors; IL-15 (179 ng/L [48.0;570] versus 21.3 ng/L [0;193]), IL-18 (199 ng/L [58.7;915] versus 37.4 ng/L [0;128]), GM-CSF (134 ng/L [70.0;863] versus 57.6 ng/L [0;164]), and MCP-1 (219 ng/L [135;438] versus 159 ng/L [97.6;274]), respectively. Logistic regression suggested increased IL-18 and MCP-1 concentrations were independently associated with mortality in this population (P<.05, Wald's type 3).

CONCLUSIONS AND CLINICAL IMPORTANCE

A mixed cytokine response is present in dogs with IMHA and mediators of macrophage activation and recruitment might serve as prognostic indicators.

摘要

背景

免疫介导性溶血性贫血(IMHA)中的细胞因子反应特征描述不足,且与预后的相关性尚不清楚。

假设/目的:确定细胞因子活性是否与 IMHA 犬的预后相关。

动物

20 只患有原发性 IMHA 的犬和 6 只对照犬。

方法

对患有 IMHA 的犬进行前瞻性研究,入院时进行血液采样。评估白细胞介素-2(IL-2)、IL-4、IL-6、IL-7、IL-8、IL-10、IL-15、IL-18、单核细胞趋化蛋白-1(MCP-1)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)、干扰素诱导蛋白-10、干扰素-γ和角质细胞趋化因子(KC)的血清活性。

结果

30 天病死率为 25%(5/20 只犬)。与对照组相比,患有 IMHA 的犬的 IL-2(45.5ng/L[0;830] 与 0ng/L[0;46.8])、IL-10(8.2ng/L[0;60.6] 与 0ng/L[0;88.2])、KC(1.7μg/L[0.3;4.7] 与 0.5μg/L[0.2;1.1])和 MCP-1(162ng/L[97.6;438] 与 124ng/L[90.2;168])浓度增加。与对照组相比,患有 IMHA 的犬的细胞因子谱表明存在各种细胞来源的促炎和抗炎细胞因子的混合物。与幸存者相比,非幸存者中与巨噬细胞/单核细胞激活和募集相关的细胞因子/趋化因子明显增加;IL-15(179ng/L[48.0;570] 与 21.3ng/L[0;193])、IL-18(199ng/L[58.7;915] 与 37.4ng/L[0;128])、GM-CSF(134ng/L[70.0;863] 与 57.6ng/L[0;164])和 MCP-1(219ng/L[135;438] 与 159ng/L[97.6;274])。逻辑回归表明,IL-18 和 MCP-1 浓度的增加与该人群的死亡率独立相关(P<.05,Wald 型 3)。

结论和临床意义

IMHA 犬存在混合细胞因子反应,巨噬细胞激活和募集的介质可能作为预后指标。

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