Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa.
Department of Pediatric Rheumatology, Hyogo Prefectural Kobe Children's Hospital, Kobe.
Rheumatology (Oxford). 2021 May 14;60(5):2421-2426. doi: 10.1093/rheumatology/keaa634.
To investigate the clinical significance of serum IL-18 levels for the diagnosis of systemic JIA (s-JIA) and to predict the disease course of s-JIA.
Overall, 116 patients with s-JIA, 151 with other diseases and 20 healthy controls were analysed. Serum IL-18 levels were measured longitudinally in 41 patients with s-JIA from active phase through remission phase. Serum IL-18 levels were quantified via enzyme-linked immunosorbent assay and the results were compared with clinical features and the disease course of s-JIA.
The serum IL-18 level cut-off value for differentiation of s-JIA from other diseases was 4800 pg/ml. In patients with a monocyclic course, serum IL-18 levels steadily decreased during the inactive phase and low levels were sustained during remission. In contrast, in patients with a chronic course, elevated serum IL-18 levels were sustained even during the inactive phase. In patients with a polycyclic course, serum IL-18 levels were elevated during disease flares and normalized during the inactive phase. The serum IL-18 level cut-off value for diagnosis of remission in s-JIA was 595 pg/ml.
Serum IL-18 levels of >4800 pg/ml may be useful for differentiating between s-JIA and other diseases. Monitoring of serum IL-18 levels might be useful for predicting the disease course and assessing remission in s-JIA.
探讨血清白细胞介素-18（IL-18）水平对全身幼年特发性关节炎（s-JIA）的诊断意义，并预测 s-JIA 的病程。
分析了 116 例 s-JIA 患者、151 例其他疾病患者和 20 名健康对照者的资料。对 41 例 s-JIA 患者从活动期到缓解期进行了血清 IL-18 水平的纵向检测。采用酶联免疫吸附试验定量检测血清 IL-18 水平，并与 s-JIA 的临床特征和病程进行比较。
s-JIA 与其他疾病鉴别时，血清 IL-18 水平的截断值为 4800 pg/ml。在单周期病程患者中，血清 IL-18 水平在缓解期持续下降，在缓解期持续维持低水平。相反，在慢性病程患者中，即使在缓解期，血清 IL-18 水平也持续升高。在多周期病程患者中，疾病活动期血清 IL-18 水平升高，缓解期正常。s-JIA 缓解期诊断的血清 IL-18 水平截断值为 595 pg/ml。
血清 IL-18 水平＞4800 pg/ml 可能有助于区分 s-JIA 和其他疾病。监测血清 IL-18 水平可能有助于预测 s-JIA 的病程和评估缓解。
