Department of Paediatrics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. 3-go Maja 13-15, 41-800, Zabrze, Poland.
Department of Family Medicine, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland.
Rheumatol Int. 2019 Nov;39(11):1945-1953. doi: 10.1007/s00296-019-04415-4. Epub 2019 Aug 29.
The pathogenesis of the immunoglobulin A vasculitis (IgAV) is still unknown. The available data shows that interleukin (IL)-17, IL-18, IL-23, regulated on activation, normal T cell expressed and secreted (CCL 5, RANTES), and interferon (IFN)-γ-inducible protein 10 (IP10) participate in the pathogenesis of IgAV by influencing the recruitment of leukocytes to the site of inflammation. The aim of this study was to analyze the serum concentration of IL-17A, IL-18, IL-23, RANTES, and IP10 in patients with acute IgAV compared to healthy children. Moreover, we wanted to assess the suitability of the levels of tested cytokines to predict the severity of the disease. All children with IgAV hospitalized in our institution between 2012 and 2017 were included in the study. Cytokines levels were determined in a serum sample secured at admission to the hospital. Basic laboratory tests have also been analyzed. IL-17A, IL-18, and IL-23 were significantly higher in whole IgAV group (52.25 pg/ml; 164.1 pg/ml and 700 pg/ml, respectively) than in the control group (27.92 pg/ml; 140.1 pg/ml and 581.5 pg/ml, respectively). The receiver operating characteristic (ROC) curve analysis revealed the largest area under the curve (AUC 0.979, p < 0.001) for the IL-17A with 95.1% sensitivity and 91.7% specificity. There were no significant differences in cytokine levels depending on the severity of the IgAV. Although the serum levels of the IL-17A, IL-18, and IL-23 increase significantly in the acute phase of the IgAV, they cannot be used as indicators of predicting the course of the disease. IL-17A seems to be a good predictor of IgAV occurrences.
IgAV 的发病机制尚不清楚。现有数据表明，白细胞介素（IL）-17、IL-18、IL-23、调节激活正常 T 细胞表达和分泌（CCL5、RANTES）和干扰素（IFN）-γ诱导蛋白 10（IP10）通过影响白细胞向炎症部位募集参与 IgAV 的发病机制。本研究旨在分析与健康儿童相比，急性 IgAV 患者血清中 IL-17A、IL-18、IL-23、RANTES 和 IP10 的浓度。此外，我们还评估了检测细胞因子的水平是否适合预测疾病的严重程度。我们机构于 2012 年至 2017 年期间收治的所有 IgAV 患儿均纳入本研究。在入院时采集血清样本以确定细胞因子水平。还分析了基本实验室检查。与对照组（27.92pg/ml；140.1pg/ml 和 581.5pg/ml）相比，整个 IgAV 组（52.25pg/ml；164.1pg/ml 和 700pg/ml）中 IL-17A、IL-18 和 IL-23 的水平明显升高。受试者工作特征（ROC）曲线分析显示，IL-17A 的曲线下面积（AUC 0.979，p<0.001）最大，其灵敏度为 95.1%，特异性为 91.7%。IL-17A、IL-18 和 IL-23 的血清水平与 IgAV 的严重程度无关。尽管 IgAV 急性期 IL-17A、IL-18 和 IL-23 的血清水平显著升高，但不能作为预测疾病过程的指标。IL-17A 似乎是 IgAV 发生的一个很好的预测指标。
