白细胞介素-18用于预测全身型幼年特发性关节炎巨噬细胞活化综合征的发生
Interleukin-18 for predicting the development of macrophage activation syndrome in systemic juvenile idiopathic arthritis.
作者信息
Shimizu Masaki, Nakagishi Yasuo, Inoue Natsumi, Mizuta Mao, Ko Giyo, Saikawa Yutaka, Kubota Tomohiro, Yamasaki Yuichi, Takei Syuji, Yachie Akihiro
机构信息
Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8641, Japan.
Department of Pediatric Rheumatology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan.
出版信息
Clin Immunol. 2015 Oct;160(2):277-81. doi: 10.1016/j.clim.2015.06.005. Epub 2015 Jun 20.
To assess the role of IL-6/IL-18 in the pathogenesis of systemic juvenile idiopathic arthritis (s-JIA) and to investigate the clinical significance of serum IL-18 levels for predicting macrophage activation syndrome (MAS) development, we measured the serum IL-6/IL-18 levels in 76s-JIA patients, including 15 with MAS, and compared them with the clinical features. We identified 2 distinct subsets on the basis of serum IL-6/IL-18 levels. The IL-18-dominant subset had more patients who developed MAS. Serum IL-18 levels during active phase in patients with MAS were significantly higher than those without MAS. The cutoff value of serum IL-18 levels for predicting MAS development was 47750 pg/ml. The patients with IL-18 dominant subset at their disease onset were significantly more likely to develop MAS after TCZ therapy started. IL-18 might have a key role in the pathogenesis of MAS. Serum IL-18 levels >47750 pg/ml might be useful to predict MAS development.
为评估白细胞介素-6（IL-6）/白细胞介素-18（IL-18）在全身型幼年特发性关节炎（s-JIA）发病机制中的作用，并探讨血清IL-18水平对预测巨噬细胞活化综合征（MAS）发生的临床意义，我们检测了76例s-JIA患者（包括15例MAS患者）的血清IL-6/IL-18水平，并将其与临床特征进行比较。我们根据血清IL-6/IL-18水平确定了2个不同的亚组。以IL-18为主的亚组中有更多患者发生MAS。MAS患者活动期的血清IL-18水平显著高于无MAS患者。预测MAS发生的血清IL-18水平临界值为47750 pg/ml。疾病发作时以IL-18为主的亚组患者在开始托珠单抗（TCZ）治疗后发生MAS的可能性显著更高。IL-18可能在MAS发病机制中起关键作用。血清IL-18水平>47750 pg/ml可能有助于预测MAS的发生。
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