Han Jae Ho, Suh Chang-Hee, Jung Ju-Yang, Ahn Mi-Hyun, Kwon Ji Eun, Yim Hyunee, Kim Hyoun-Ah
From the Department of Pathology, and the Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
J.H. Han, MD, PhD, Department of Pathology, Ajou University School of Medicine; C.H. Suh, MD, PhD, Department of Rheumatology, Ajou University School of Medicine; J.Y. Jung, MD, Department of Rheumatology, Ajou University School of Medicine; M.H. Ahn, PhD, Department of Rheumatology, Ajou University School of Medicine; J.E. Kwon, MD, PhD, Department of Pathology, Ajou University School of Medicine; H. Yim, MD, PhD, Department of Pathology, Ajou University School of Medicine; H.A. Kim, MD, PhD, Department of Rheumatology, Ajou University School of Medicine.
J Rheumatol. 2017 Jun;44(6):740-747. doi: 10.3899/jrheum.170020. Epub 2017 Apr 1.
Interleukin 33 (IL-33), a member of the IL-1 family and a ligand of the orphan receptor ST2, plays key roles in innate and adaptive immunity. We examined the associations between IL-33/ST2 levels and clinical manifestations of patients with active adult-onset Still's disease (AOSD).
Blood samples were collected from 40 patients with active AOSD, 28 patients with rheumatoid arthritis (RA), and 27 healthy controls (HC). The serum levels of IL-33 and soluble ST2 were determined using ELISA. Expression levels of IL-33 and ST2 in biopsy specimens obtained from 34 AOSD patients with rash were immunohistochemically investigated.
IL-33 levels of patients with AOSD were higher than those of patients with RA and HC. Soluble ST2 levels of patients with AOSD were higher than those of HC, but not of patients with RA. Serum IL-33 levels correlated with systemic score, erythrocyte sedimentation rate, ferritin levels, and aspartate transaminase levels. However, serum soluble ST2 levels correlated only with ferritin levels. The numbers of inflammatory cells expressing IL-33 and ST2 were elevated in skin lesions of patients with AOSD compared to HC, but did not differ from those of the skin lesions of eczema or psoriasis.
We found significantly higher serum IL-33 and soluble ST2 levels in patients with active AOSD. Results indicate that the IL-33/ST2 signaling pathway may play a role in the pathogenesis of the acute inflammation and skin manifestations associated with AOSD.
白细胞介素33（IL-33）是IL-1家族成员，也是孤儿受体ST2的配体，在先天性和适应性免疫中起关键作用。我们研究了IL-33/ST2水平与成年起病型Still病（AOSD）活动期患者临床表现之间的关联。
采集40例AOSD活动期患者、28例类风湿关节炎（RA）患者和27名健康对照者（HC）的血样。采用酶联免疫吸附测定法（ELISA）测定血清IL-33和可溶性ST2水平。对34例有皮疹的AOSD患者活检标本中IL-33和ST2的表达水平进行免疫组织化学研究。
AOSD患者的IL-33水平高于RA患者和HC。AOSD患者的可溶性ST2水平高于HC，但低于RA患者。血清IL-33水平与全身评分、红细胞沉降率、铁蛋白水平和天冬氨酸转氨酶水平相关。然而，血清可溶性ST2水平仅与铁蛋白水平相关。与HC相比，AOSD患者皮肤病变中表达IL-33和ST2的炎症细胞数量增加，但与湿疹或银屑病皮肤病变中的炎症细胞数量无差异。
我们发现活动期AOSD患者血清IL-33和可溶性ST2水平显著升高。结果表明，IL-33/ST2信号通路可能在与AOSD相关的急性炎症和皮肤表现的发病机制中起作用。
