| The diagnostic significance of soluble CD163 and soluble interleukin-2 receptor alpha-chain in macrophage activation syndrome and untreated new-onset systemic juvenile idiopathic arthritis. | |
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MedLine Citation:
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PMID: 17328073 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Macrophage activation syndrome is characterized by an overwhelming inflammatory reaction driven by excessive expansion of T cells and hemophagocytic macrophages. Levels of soluble interleukin-2 receptor alpha (sIL-2Ralpha) and soluble CD163 (sCD163) may reflect the degree of activation and expansion of T cells and macrophages, respectively. This study was undertaken to assess the value of serum sIL-2Ralpha and sCD163 in diagnosing acute macrophage activation syndrome complicating systemic juvenile idiopathic arthritis (JIA). METHODS: Enzyme-linked immunosorbent assay was used to assess sIL-2Ralpha and sCD163 levels in sera from 7 patients with acute macrophage activation syndrome complicating systemic JIA and 16 patients with untreated new-onset systemic JIA. The results were correlated with clinical features of established macrophage activation syndrome, including ferritin levels. RESULTS: The median level of sIL-2Ralpha in the patients with macrophage activation syndrome was 19,646 pg/ml (interquartile range [IQR] 18,128), compared with 3,787 pg/ml (IQR 3,762) in patients with systemic JIA (P = 0.003). Similarly, the median level of sCD163 in patients with macrophage activation syndrome was 23,000 ng/ml (IQR 14,191), compared with 5,480 ng/ml (IQR 2,635) in patients with systemic JIA (P = 0.017). In 5 of 16 patients with systemic JIA, serum levels of sIL-2Ralpha or sCD163 were comparable with those in patients with acute macrophage activation syndrome. These patients had high inflammatory activity associated with a trend toward lower hemoglobin levels (P = 0.11), lower platelet counts, and significantly higher ferritin levels (P = 0.02). Two of these 5 patients developed overt macrophage activation syndrome several months later. CONCLUSION: Levels of sIL-2Ralpha and sCD163 are promising diagnostic markers for macrophage activation syndrome. They may also help identify patients with subclinical macrophage activation syndrome. |
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Authors:
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Jack Bleesing; Anne Prada; David M Siegel; Joyce Villanueva; Judyann Olson; Norman T Ilowite; Hermine I Brunner; Thomas Griffin; Thomas B Graham; David D Sherry; Murray H Passo; Athimalaipet V Ramanan; Alexandra Filipovich; Alexei A Grom |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Arthritis and rheumatism Volume: 56 ISSN: 0004-3591 ISO Abbreviation: Arthritis Rheum. Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-03-21 Completed Date: 2007-04-12 Revised Date: 2007-12-03 |
Medline Journal Info:
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Nlm Unique ID: 0370605 Medline TA: Arthritis Rheum Country: United States |
Other Details:
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Languages: eng Pagination: 965-71 Citation Subset: AIM; IM |
Affiliation:
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Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Antigens, CD / blood* Antigens, Differentiation, Myelomonocytic / blood* Arthritis, Juvenile Rheumatoid / blood, complications*, diagnosis* Cell Proliferation Child Child, Preschool Female Ferritins / blood Humans Interleukin-2 Receptor alpha Subunit / blood* Macrophage Activation* Macrophages / pathology Male Prospective Studies Receptors, Cell Surface / blood* Syndrome T-Lymphocytes / pathology |
| Grant Support | |
ID/Acronym/Agency:
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P01-AR-048929/AR/NIAMS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antigens, CD; 0/Antigens, Differentiation, Myelomonocytic; 0/CD163 antigen; 0/Interleukin-2 Receptor alpha Subunit; 0/Receptors, Cell Surface; 9007-73-2/Ferritins |
| Comments/Corrections | |
Comment In:
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Arthritis Rheum. 2007 Nov;56(11):3877-8
[PMID:
17968934
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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