He Linrong, Shu Xiaoming, Liu Xia, Ge Yongpeng, Li Sizhao, Lu Xin, Wang Guochun
Department of Rheumatology, Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Yinghua East Road, Chaoyang District, Beijing 100029, China.
Mediators Inflamm. 2020 Jul 28;2020:6243019. doi: 10.1155/2020/6243019. eCollection 2020.
To investigate the role of soluble interleukin-2R (sIL-2R) in idiopathic inflammatory myopathies (IIM).
Serum sIL-2R levels were measured in 74 dermatomyositis (DM), 16 immune-mediated necrotizing myopathy (IMNM), 24 rheumatoid arthritis (RA), 20 systemic lupus erythematosus (SLE), and 20 healthy controls (HCs) by chemiluminescent immunometric assay. Clinical features and laboratory data were collected from electronic medical record. Disease activity was evaluated by using physician global disease activity and myositis disease activity assessment visual analog scale (MYOACT) on admission. 20 DM patients were followed. Serum sIL-2R levels were analyzed and compared with clinical features, laboratory data, and measures of disease activity.
Serum sIL-2R levels were significantly higher in DM patients than in IMNM patients and HCs (648.8 ± 433.1 U/ml vs. 352.3 ± 126.0 U/ml and 648.8 ± 433.1 U/ml vs. 285.8 ± 101.9 U/ml, respectively; all < 0.001), while there was no significant difference between IMNM and HCs. There were also no significant differences of sIL-2R levels in DM, SLE, and RA. Importantly, serum sIL-2R levels were significantly higher in treatment-naïve or active DM patients than those that are not (1100.9 ± 550.4 U/ml vs. 615.6 ± 330.4 U/ml, = 0.006; 808.8 ± 421.6 U/ml vs. 339.8 ± 103.4 U/ml, < 0.001). DM patients with skin ulcers had significantly higher sIL-2R levels than those without (889.3 ± 509.9 U/ml vs. 640.0 ± 368.7 U/ml, = 0.023). Cross-sectional analysis in DM showed that sIL-2R levels positively correlated with CK, ESR, CRP, ferritin, physician VAS, and MYOACT scores (rho = 0.278, rho = 0.474, rho = 0.469, rho = 0.454, = 0.646, and = 0.600, respectively; all < 0.05), negatively correlated with T cell counts and MMT8 scores ( = -0.380, = 0.002; rho = -0.394, = 0.001). Follow-up study showed that changes in sIL-2R levels after treatment correlated with changes in physician VAS and MYOACT scores ( = 0.823 and = 0.695, respectively; all < 0.01).
Serum sIL-2R levels were elevated in DM but not in IMNM. Serum sIL-2R could act as a disease activity marker and be associated with ulcerative skin lesions in DM.
探讨可溶性白细胞介素-2受体（sIL-2R）在特发性炎性肌病（IIM）中的作用。
采用化学发光免疫分析法检测74例皮肌炎（DM）、16例免疫介导坏死性肌病（IMNM）、24例类风湿关节炎（RA）、20例系统性红斑狼疮（SLE）患者及20名健康对照者（HCs）血清sIL-2R水平。从电子病历中收集临床特征和实验室数据。入院时采用医生整体疾病活动度和肌炎疾病活动度评估视觉模拟量表（MYOACT）评估疾病活动度。对20例DM患者进行随访。分析血清sIL-2R水平，并与临床特征、实验室数据及疾病活动度指标进行比较。
DM患者血清sIL-2R水平显著高于IMNM患者和HCs（分别为648.8±433.1 U/ml vs. 352.3±126.0 U/ml和648.8±433.1 U/ml vs. 285.8±101.9 U/ml；均P<0.001），而IMNM患者与HCs之间无显著差异。DM、SLE和RA患者的sIL-2R水平也无显著差异。重要的是，初治或活动期DM患者的血清sIL-2R水平显著高于非初治或非活动期患者（分别为1100.9±550.4 U/ml vs. 615.6±330.4 U/ml，P = 0.006；808.8±421.6 U/ml vs. 339.8±103.4 U/ml；P<0.001）。有皮肤溃疡的DM患者sIL-2R水平显著高于无皮肤溃疡者（889.3±509.9 U/ml vs. 640.0±368.7 U/ml，P = 0.023）。DM患者的横断面分析显示，sIL-2R水平与肌酸激酶（CK）、红细胞沉降率（ESR）、C反应蛋白（CRP）、铁蛋白、医生视觉模拟评分（VAS）及MYOACT评分呈正相关（相关系数分别为0.278、0.474、0.469、0.454、P = 0.646及P = 0.600；均P<0.05），与T细胞计数和改良医学研究委员会肌力评分（MMT8）呈负相关（P = -0.380，P = 0.002；相关系数 = -0.394，P = 0.001）。随访研究显示，治疗后sIL-2R水平的变化与医生VAS评分和MYOACT评分的变化相关（相关系数分别为0.823和0.695；均P<0.01）。
DM患者血清sIL-2R水平升高，而IMNM患者未升高。血清sIL-2R可作为DM的疾病活动度标志物，并与DM患者的溃疡性皮肤病变相关。
