Nam Seoung Wan, Kang SuMan, Lee Jun Hyeok, Yoo Dae Hyun
Department of Rheumatology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju 26426, Korea.
Hanyang University Institute for Rheumatology Research, Seoul 04763, Korea.
J Clin Med. 2021 Feb 26;10(5):910. doi: 10.3390/jcm10050910.
The aim of this study was to evaluate the usefulness of serum interleukin (IL)-37 and IL-18 as disease activity markers of adult-onset Still's disease (AOSD) and to compare their related clinical features. Forty-five patients with a set of high and subsequent low disease activity status of AOSD were enrolled. Modified Pouchot (mPouchot) score and serologic disease activity markers including levels of IL-37 and IL-18 were compared between high and low disease activity status. The relationships between disease activity parameters and differences in levels of cytokines according to each disease manifestation were evaluated in high disease activity status. mPouchot score and all disease activity markers including IL-37 and IL-18 significantly declined after treatment. Though both cytokines positively correlated with mPouchot score, the two did not correlate with each other in high disease activity status. IL-18 positively correlated with ferritin, AST, and LDH while IL-37 correlated better with CRP. The expression level of IL-37 was related to leukocytosis while IL-18 was related to pleuritis, pneumonitis, abnormal LFT, and hyperferritinemia. In addition, patients in the IL-18 dominant group presented with higher LDH levels and required a higher mean corticosteroid dose. In conclusion, IL-37 and IL-18 are disease activity markers reflecting different aspects of AOSD that can complement each other.
本研究旨在评估血清白细胞介素（IL）-37和IL-18作为成人斯蒂尔病（AOSD）疾病活动标志物的效用，并比较其相关临床特征。纳入了45例AOSD患者，其疾病活动状态先高后低。比较了高疾病活动状态和低疾病活动状态下的改良Pouchot（mPouchot）评分以及包括IL-37和IL-18水平在内的血清学疾病活动标志物。在高疾病活动状态下，评估了疾病活动参数与每种疾病表现的细胞因子水平差异之间的关系。治疗后，mPouchot评分以及包括IL-37和IL-18在内的所有疾病活动标志物均显著下降。尽管两种细胞因子均与mPouchot评分呈正相关，但在高疾病活动状态下两者之间无相关性。IL-18与铁蛋白、谷草转氨酶（AST）和乳酸脱氢酶（LDH）呈正相关，而IL-37与C反应蛋白（CRP）的相关性更好。IL-37的表达水平与白细胞增多有关，而IL-18与胸膜炎、肺炎、肝功能异常和高铁蛋白血症有关。此外，IL-18优势组的患者LDH水平较高，平均皮质类固醇剂量需求也较高。总之，IL-37和IL-18是反映AOSD不同方面的疾病活动标志物，它们可以相互补充。
