Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Clin Exp Rheumatol. 2018 May-Jun;36 Suppl 112(3):157-164. Epub 2018 Feb 15.
To identify biomarkers for disease activity in IgG4-related disease (IgG4-RD) and primary Sjögren's syndrome (pSS).
Forty-three consecutive treatment-naïve patients with IgG4-RD, 62 patients with pSS, and 5 patients with sicca syndrome were enrolled. IgG4-RD and pSS disease activity was assessed based on the IgG4-RD responder index (IgG4-RD RI) and EULAR Sjögren's Syndrome Disease Activity Index (ES- SDAI), respectively. The associations of biomarkers with disease activity were examined.
Comparison of the three dis- eases identified the serum levels of IgG, IgG4, IgG4/IgG ratio, IgE, and soluble interleukin-2 receptor (sIL-2R) for IgG4-RD and the serum levels of IgM and sIL-2R and lymphocyte counts for pSS as potential biomarkers of disease activity. Among these, serum sIL-2R levels correlate with baseline IgG4-RD RI scores and the number of affected organs in IgG4-RD (ρ=0.74, p<0.0001 and ρ=0.75, p<0.0001, respectively). Serum sIL-2R levels also correlate with ESSDAI scores and the number of af- fected organs in pSS (ρ=0.67, p<0.0001 and ρ=0.41, p<0.0001, respectively). Receiver operating characteristic curve analysis suggested serum sIL-2R levels as an efficient biomarker to distinguish the presence of extra-dacryosialadenitis involvements in IgG4-RD with a cut-off value of 424 U/mL (AUC=0.93, p<0.0001), and in pSS with 452 U/mL (AUC=0.89, p<0.0001). Serum sIL-2R levels decreased significantly after treatment in patients with IgG4-RD and pSS.
Serum sIL-2R levels are a potentially valuable biomarker for evaluating disease activity and treatment response in IgG4-RD and pSS.
鉴定 IgG4 相关疾病(IgG4-RD)和原发性干燥综合征(pSS)的疾病活动生物标志物。
纳入 43 例初治 IgG4-RD 患者、62 例 pSS 患者和 5 例干燥综合征患者。根据 IgG4-RD 应答指数(IgG4-RD RI)和 EULAR 干燥综合征疾病活动指数(ES-SDAI)评估 IgG4-RD 和 pSS 的疾病活动度。检查生物标志物与疾病活动度的相关性。
对三种疾病的比较确定了 IgG、IgG4、IgG4/IgG 比值、IgE 和可溶性白细胞介素-2 受体(sIL-2R)为 IgG4-RD 的疾病活动潜在生物标志物,以及 IgM 和 sIL-2R 和淋巴细胞计数为 pSS 的疾病活动潜在生物标志物。其中,血清 sIL-2R 水平与 IgG4-RD 基线 RI 评分和 IgG4-RD 受累器官数量呈正相关(ρ=0.74,p<0.0001 和 ρ=0.75,p<0.0001)。血清 sIL-2R 水平也与 pSS 的 ESSDAI 评分和受累器官数量呈正相关(ρ=0.67,p<0.0001 和 ρ=0.41,p<0.0001)。受试者工作特征曲线分析表明,血清 sIL-2R 水平可作为一种有效的生物标志物,用于区分 IgG4-RD 中是否存在额外的泪腺外腺炎受累,截断值为 424 U/mL(AUC=0.93,p<0.0001),在 pSS 中为 452 U/mL(AUC=0.89,p<0.0001)。IgG4-RD 和 pSS 患者经治疗后血清 sIL-2R 水平显著下降。
血清 sIL-2R 水平是评估 IgG4-RD 和 pSS 疾病活动度和治疗反应的潜在有价值的生物标志物。