Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Cairo University, Cairo, Egypt.
Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Cairo University, Cairo, Egypt.
Am J Med Sci. 2022 Oct;364(4):425-432. doi: 10.1016/j.amjms.2022.04.013. Epub 2022 Apr 22.
Interleukin 37 (IL-37) is an anti-inflammatory cytokine previously studied in Behçet's disease (BD) and atherosclerosis. However, little is known about its relation to macro and microcirculations in BD. Previous studies relied mainly on common carotid artery (CCA) intima-media thickness (IMT) and ankle brachial index (ABI) to study atherosclerosis in BD with conflicting results. This study evaluated flow parameters of CCA, ABI and nailfold videocapillaroscopy in relation to serum IL-37 in BD.
Forty BD patients and 30 healthy controls were included. IMT, peak-systolic, end-diastolic velocities, resistivity index of CCA and ABI were measured by duplex ultrasound. Capillary loop, length, diameter and morphology were recorded by nailfold videocapillaroscopy. Serum IL-37 levels were measured using enzyme-linked immunosorbent assay (ELISA).
Compared to controls, patients had higher mean CCA IMT (p < 0.0001), resistivity index (p < 0.001) and peak-systolic velocity (p=0.09) and lower mean CCA end-diastolic velocity (p=0.002), capillary loop, length, arterial, venous limbs diameter and serum IL-37 (p < 0.001). Patients with ABI ≥ 1.4 "indicating stiff arteries" had higher serum IL-37 (p < 0.05 on left, p>0.05 right sides). Serum IL-37 correlated negatively with left CCA end-diastolic velocity "denoting atherosclerosis" and positively with left posterior tibial artery ABI and CRP (p < 0.03) "denoting inflammation". Multiple regression analysis showed only association with left CCA end-diastolic velocity.
IL-37 may be related to arterial stiffness in BD and could be used as a possible marker of arteriosclerosis in the disease for further investigations. Changes of CCA peak-systolic, end-diastolic velocities, resistivity index and IMT refer to increased atherosclerosis in larger elastic arteries. In smaller muscular "crural" arteries, vasculitis with possible medial disease may be more evident.
白细胞介素 37（IL-37）是一种抗炎细胞因子，先前在白塞病（BD）和动脉粥样硬化中进行了研究。然而，关于其与 BD 中的大循环和微循环的关系知之甚少。先前的研究主要依赖于颈总动脉（CCA）内膜中层厚度（IMT）和踝臂指数（ABI）来研究 BD 中的动脉粥样硬化，但结果存在冲突。本研究评估了与 BD 中血清 IL-37 相关的 CCA、ABI 和甲襞微血管血流的血流参数。
纳入 40 例 BD 患者和 30 例健康对照者。通过双功能超声测量 CCA 的 IMT、收缩期峰值、舒张末期速度、CCA 阻力指数和 ABI。通过甲襞微血管血流记录毛细血管环、长度、直径和形态。使用酶联免疫吸附试验（ELISA）测量血清 IL-37 水平。
与对照组相比，患者的 CCA 平均 IMT 较高（p<0.0001）、阻力指数较高（p<0.001）、收缩期峰值速度较高（p=0.09），而 CCA 平均舒张末期速度较低（p=0.002）、毛细血管环、长度、动脉、静脉支直径和血清 IL-37 水平较低（p<0.001）。ABI≥1.4“提示动脉僵硬”的患者血清 IL-37 水平较高（左侧 p<0.05，右侧 p>0.05）。血清 IL-37 与左侧 CCA 舒张末期速度呈负相关，与左侧胫骨后动脉 ABI 和 CRP 呈正相关（p<0.03）“提示炎症”。多元回归分析仅显示与左侧 CCA 舒张末期速度相关。
IL-37 可能与 BD 中的动脉僵硬有关，可作为该疾病动脉粥样硬化的潜在标志物进行进一步研究。CCA 收缩期峰值、舒张末期速度、阻力指数和 IMT 的变化提示较大弹性动脉中动脉粥样硬化的增加。在较小的肌肉“小腿”动脉中，可能更明显的是血管炎伴可能的中膜疾病。
