ILD Center of Excellence, Department of Pulmonology, St Antonius Hospital , Nieuwegein, the Netherlands.
Division of Heart and Lungs, University Medical Centre , Utrecht, the Netherlands.
Expert Rev Respir Med. 2020 Jul;14(7):749-756. doi: 10.1080/17476348.2020.1751614. Epub 2020 Apr 12.
Differentiating between interstitial lung diseases (ILD) is challenging. Serum soluble interleukin 2 receptor (sIL-2R) is used as a diagnostic marker in sarcoidosis, but its diagnostic value has not yet been studied in other ILDs like Idiopathic Pulmonary Fibrosis (IPF) or Hypersensitivity Pneumonitis (HP). Also, the prognostic value of sIL-2R in sarcoidosis remains unknown.
This retrospective cohort study included 121 patients with sarcoidosis, 35 with cHP, 62 with IPF (idiopathic pulmonary fibrosis) and 70 healthy controls. Serum sIL-2R levels were determined at diagnosis. Follow-up data were available for patients with chronic sarcoidosis (n = 64) and patients with non-chronic sarcoidosis (n = 29).
Patients with sarcoidosis had higher sIL-2R levels (median 5418 pg/mL) than patients with cHP (median 4015 pg/mL, = 0.002) and IPF (median 4192 pg/mL, = 0.034). No differences were found between patients with cHP and IPF. Logistic regression revealed that sIL-2R at diagnosis is a significant predictor of the development of chronic sarcoidosis (OR = 2.1, = 0.032).
High levels of sIL-2R are suggestive of sarcoidosis, although a broad overlap exists in sIL-2R levels across sarcoidosis, cHP, and IPF. High levels of sIL-2R might serve as a prognostic biomarker for chronicity.
间质性肺疾病(ILD)的鉴别具有挑战性。血清可溶性白细胞介素 2 受体(sIL-2R)在结节病中被用作诊断标志物,但尚未在特发性肺纤维化(IPF)或过敏性肺炎(HP)等其他ILD 中研究其诊断价值。此外,sIL-2R 在结节病中的预后价值尚不清楚。
这项回顾性队列研究纳入了 121 例结节病患者、35 例慢性 HP 患者、62 例 IPF 患者和 70 例健康对照者。在诊断时测定血清 sIL-2R 水平。对慢性结节病患者(n=64)和非慢性结节病患者(n=29)进行了随访。
与慢性 HP 患者(中位数 4015pg/mL, =0.002)和 IPF 患者(中位数 4192pg/mL, =0.034)相比,结节病患者的 sIL-2R 水平更高(中位数 5418pg/mL)。慢性 HP 患者和 IPF 患者之间未发现差异。Logistic 回归显示,诊断时的 sIL-2R 是慢性结节病发展的显著预测因子(OR=2.1, =0.032)。
高水平的 sIL-2R 提示结节病,但在结节病、慢性 HP 和 IPF 中,sIL-2R 水平存在广泛重叠。高水平的 sIL-2R 可能是慢性的预后生物标志物。