Chialà Angela, Rotondo Cinzia, Praino Emanuela, Natuzzi Dorotea, Cacciapaglia Fabio, Iannone Florenzo
Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
J Scleroderma Relat Disord. 2018 Jun;3(2):153-158. doi: 10.1177/2397198318762893. Epub 2018 Mar 19.
Pericardial effusion is a common manifestation of systemic sclerosis, but its pathogenesis has been poorly investigated. Adipokines and interleukins may play a role in the pathophysiology of pericardial effusion. This study aimed at evaluating serum levels of adipokines and interleukins in systemic sclerosis patients with and without pericardial effusion.
A total of 87 systemic sclerosis patients (age 52.6 ± 14 years; disease duration 8.2 ± 6.7 years) were recruited in this study. Demographics, body mass index, and clinical characteristics were recorded in each patient. Pericardial effusion was considered pathologic when ≥50 mL was detected by echocardiography. Serum levels of adiponectin, leptin, resistin, visfatin, tumor necrosis factor-α, interferon-γ, interlueukin-2, interlueukin-10, and interlueukin-17 were measured using Multiplex Immunoassay (Bioplex 200 System).
In all, 11 (13%) systemic sclerosis patients had pericardial effusion. Systemic sclerosis patients with and without pericardial effusion did not differ in age, sex, and body mass index. Systemic sclerosis patients with pericardial effusion had significantly higher levels of visfatin (median/interquartile range: 1546 pg/mL (interquartile range: 8590) vs 388 pg/mL (interquartile range: 103), = 0.03) and interlueukin-17 (1.33 pg/mL (interquartile range: 3.5) vs 0.05 pg/mL (interquartile range: 0.56), = 0.04), but lower levels of adiponectin (2,845,000 pg/mL (interquartile range: 4,132,900) vs 5,272,100 pg/mL (interquartile range 8,243,600), = 0.02) than patients without pericardial effusion. Interstitial lung disease, pulmonary arterial hypertension, and "limited" or "diffuse" cutaneous subset did not correlate to adipokines or interleukin levels.
Visfatin and adiponectin may play an important role in the pathogenesis of systemic sclerosis-related pericardial effusion. Further longitudinal studies are needed to unravel a possible role of these molecules as biomarkers of pericardial effusion in systemic sclerosis patients.
心包积液是系统性硬化症的常见表现，但其发病机制尚未得到充分研究。脂肪因子和白细胞介素可能在心包积液的病理生理过程中起作用。本研究旨在评估有无心包积液的系统性硬化症患者血清中脂肪因子和白细胞介素的水平。
本研究共纳入87例系统性硬化症患者（年龄52.6±14岁；病程8.2±6.7年）。记录每位患者的人口统计学资料、体重指数和临床特征。当超声心动图检测到心包积液≥50 mL时，认为是病理性的。采用多重免疫分析法（Bioplex 200系统）检测血清脂联素、瘦素、抵抗素、内脂素、肿瘤坏死因子-α、干扰素-γ、白细胞介素-2、白细胞介素-10和白细胞介素-17的水平。
总共有11例（13%）系统性硬化症患者有心包积液。有无心包积液的系统性硬化症患者在年龄、性别和体重指数方面无差异。有心包积液的系统性硬化症患者内脂素水平显著更高（中位数/四分位间距：1546 pg/mL（四分位间距：8590）对388 pg/mL（四分位间距：103），P = 0.03），白细胞介素-17水平也显著更高（1.33 pg/mL（四分位间距：3.5）对0.05 pg/mL（四分位间距：0.56），P = 0.04），但脂联素水平低于无心包积液的患者（2,845,000 pg/mL（四分位间距：4,132,900）对5,272,100 pg/mL（四分位间距8,243,600），P = 0.02）。间质性肺疾病、肺动脉高压以及“局限性”或“弥漫性”皮肤亚型与脂肪因子或白细胞介素水平无关。
内脂素和脂联素可能在系统性硬化症相关心包积液的发病机制中起重要作用。需要进一步的纵向研究来阐明这些分子作为系统性硬化症患者心包积液生物标志物的可能作用。
