Liu Changning
Department of Laboratory Medicine, Key Laboratory of Precision Medicine for Viral Diseases, Guangxi Health Commission Key Laboratory of Clinical Biotechnology, Liuzhou People's Hospital, Liu Zhou 545006, China.
Open Life Sci. 2024 Feb 5;19(1):20220823. doi: 10.1515/biol-2022-0823. eCollection 2024.
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of autoimmune diseases. This study aimed to investigate the clinical significance of changes in interleukin-18 (IL-18) and neutrophil/lymphocyte ratio (NLR) in the pathogenesis of AAV and the impact of NLR on the prognosis of patients. The clinical data of 52 AAV patients (AAV group) who met the conditions of hospitalization, 30 patients with mild mesangial proliferative glomerulonephritis (disease controls), and 30 healthy volunteers (normal controls) in Nephrology Department of Liuzhou People's Hospital from May 2020 to August 2022 were selected. A total of 52 AAV patients were divided into active phase (>15 points) and remission phase (≤15 points) based on the Birmingham vasculitis activity score (BVAS). Serum IL-18 level was detected by enzyme-linked immunosorbent assay in three groups. Pearson product moment correlation analysis was performed to investigate the correlation between serum IL-18 levels and clinical laboratory indicators, and receiver operating characteristic (ROC) curve analysis was performed on serum IL-18, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) levels, and NLR in AAV patients. The levels of serum creatinine, parathyroid hormone, β2-microglobulin (β2-MG), ESR, CRP, and IL-18 in active stage of AAV were significantly higher than those in remission stage of AAV. Moreover, the serum IL-18 level of active AAV patients was significantly higher than that of disease control group ( < 0.05). The levels of eGFR, hemoglobin, and complement C3 were significantly lower than those during the remission ( < 0.05). Pearson product moment correlation analysis showed that serum IL-18 level in AAV patients was positively correlated with BVAS score and ESR level. The area under the curve of serum IL-18, NLR, CRP, ESR levels evaluated by ROC curve was 0.921, 0.899, 0.83, and 0.75, respectively. Kaplan-Meier survival curve showed that the cumulative survival rate of patients in low NLR group was significantly higher than that in high NLR group (68.36 vs 42.89%), with significant difference (Log-Rank = 6.745, = 0.025 < 0.05). IL-18 may be adopted as one of the important biological markers to judge the disease of AAV, and the cumulative survival rate of patients with high NLR is low, which may be applied as an indicator to evaluate the poor prognosis of patients with AAV.
抗中性粒细胞胞浆抗体（ANCA）相关血管炎（AAV）是一组自身免疫性疾病。本研究旨在探讨白细胞介素-18（IL-18）和中性粒细胞/淋巴细胞比值（NLR）变化在AAV发病机制中的临床意义以及NLR对患者预后的影响。选取2020年5月至2022年8月柳州市人民医院肾内科符合住院条件的52例AAV患者（AAV组）、30例轻度系膜增生性肾小球肾炎患者（疾病对照组）和30例健康志愿者（正常对照组）。根据伯明翰血管炎活动评分（BVAS）将52例AAV患者分为活动期（>15分）和缓解期（≤15分）。采用酶联免疫吸附法检测三组血清IL-18水平。进行Pearson积矩相关分析以探讨血清IL-18水平与临床实验室指标之间的相关性，并对AAV患者的血清IL-18、C反应蛋白（CRP）、红细胞沉降率（ESR）水平和NLR进行受试者操作特征（ROC）曲线分析。AAV活动期患者的血清肌酐、甲状旁腺激素、β2-微球蛋白（β2-MG）、ESR、CRP和IL-18水平显著高于AAV缓解期患者。此外，活动期AAV患者的血清IL-18水平显著高于疾病对照组（<0.05）。估算肾小球滤过率（eGFR）、血红蛋白和补体C3水平显著低于缓解期（<0.05）。Pearson积矩相关分析显示，AAV患者血清IL-18水平与BVAS评分和ESR水平呈正相关。通过ROC曲线评估的血清IL-18、NLR、CRP、ESR水平的曲线下面积分别为0.921、0.899、0.83和0.75。Kaplan-Meier生存曲线显示，低NLR组患者的累积生存率显著高于高NLR组（68.36%对42.89%），差异有统计学意义（Log-Rank = 6.745，P = 0.025 < 0.05）。IL-18可作为判断AAV病情的重要生物学标志物之一，高NLR患者的累积生存率较低，可作为评估AAV患者预后不良的指标。
