Department of Medical Science, BK21 Plus Project, Yonsei University College of Medicine, Seoul, Republic of Korea.
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Mediators Inflamm. 2021 Jul 19;2021:6668884. doi: 10.1155/2021/6668884. eCollection 2021.
Serum interleukin- (IL-) 27 level has been reported to increase in patients with several autoimmune diseases; however, its significance in patients with antineutrophil cytoplasmic antibody- (ANCA-) associated vasculitis (AAV) is unknown. In this study, we investigated the associations between serum IL-27, laboratory features, and activity of AAV and evaluate the predictive ability of serum IL-27 level for disease activity. This study included 77 AAV patients, and we collected clinical and laboratory data at blood sampling. Inflammation-related variables included white blood cell, neutrophil, lymphocyte and platelet counts, serum albumin, erythrocyte sedimentation rate, and C-reactive protein levels. Serum IL-27 and IL-18 levels were measured from stored sera using Human Magnetic Luminex® assay. High disease activity of AAV was defined as the highest tertile of Birmingham vasculitis activity score (BVAS) (≥11). The mean age of the enrolled patients was 59.9 years, and 38 (49.4%) were diagnosed as microscopic polyangiitis. In the multivariable analysis, serum albumin ( = -0.419) and serum IL-27 level ( = 0.221) were significantly associated with BVAS. Furthermore, patients with renal manifestation exhibited higher serum IL-27 (mean 308.7 pg/mL vs. 105.8 pg/mL) and IL-18 levels (mean 376.7 pg/mL vs. 270.4 pg/mL) than those without. On applying the optimal cut-off of serum IL-27 level for predicting high activity, AAV patients with serum IL - 27 level ≥ 300.8 pg/mL had a significantly higher risk for having high disease activity than those with serum IL - 27 level < 300.8 pg/mL (relative risk 3.380, 95% confidence interval 1.223, 9.345, = 0.016). These results suggest that serum IL-27 level is associated with the cross-sectional activity and the presence of renal manifestation and could be used to predict high disease activity in patients with AAV.
血清白细胞介素- (IL-) 27 水平已被报道在多种自身免疫性疾病患者中升高；然而，其在抗中性粒细胞胞质抗体- (ANCA-) 相关性血管炎 (AAV) 患者中的意义尚不清楚。在这项研究中，我们研究了血清 IL-27 与 AAV 的实验室特征和活动之间的关系，并评估了血清 IL-27 水平对疾病活动的预测能力。本研究纳入了 77 例 AAV 患者，并在采血时收集了临床和实验室数据。炎症相关变量包括白细胞、中性粒细胞、淋巴细胞和血小板计数、血清白蛋白、红细胞沉降率和 C 反应蛋白水平。使用 Human Magnetic Luminex® assay 从储存的血清中测量血清 IL-27 和 IL-18 水平。高疾病活动的 AAV 定义为伯明翰血管炎活动评分 (BVAS) 的最高三分位 (≥11)。入组患者的平均年龄为 59.9 岁，38 例 (49.4%) 被诊断为显微镜下多血管炎。在多变量分析中，血清白蛋白 ( = -0.419) 和血清 IL-27 水平 ( = 0.221) 与 BVAS 显著相关。此外，有肾脏表现的患者血清 IL-27 (平均 308.7 pg/mL 比 105.8 pg/mL) 和 IL-18 水平 (平均 376.7 pg/mL 比 270.4 pg/mL) 均高于无肾脏表现的患者。应用血清 IL-27 水平预测高活动的最佳截断值，血清 IL-27 水平≥300.8 pg/mL 的 AAV 患者发生高疾病活动的风险显著高于血清 IL-27 水平<300.8 pg/mL 的患者 (相对风险 3.380，95%置信区间 1.223，9.345， = 0.016)。这些结果表明，血清 IL-27 水平与横断面活性和肾脏表现有关，可用于预测 AAV 患者的高疾病活动。
