Document Detail


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.
MedLine Citation:
PMID:  17328073     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  56     ISSN:  0004-3591     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-21     Completed Date:  2007-04-12     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  965-71     Citation Subset:  AIM; IM    
Affiliation:
Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
P01-AR-048929/AR/NIAMS NIH HHS
Chemical
Reg. No./Substance:
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:
Arthritis Rheum. 2007 Nov;56(11):3877-8   [PMID:  17968934 ]

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