| Title: |
IL-18 as a biomarker linking systemic juvenile idiopathic arthritis and macrophage activation syndrome |
| Authors: |
Yasin, Shima; Fall, Ndate; Brown, Rachel A; Henderlight, Maggie; Canna, Scott W; Girard-Guyonvarc’h, Charlotte; Gabay, Cem; Grom, Alexei A; Schulert, Grant S |
| Contributors: |
National Institute for Arthritis and Musculoskeletal and Skin Diseases; National Institutes of Health; Systemic JIA Foundation; NIH |
| Source: |
Rheumatology ; volume 59, issue 2, page 361-366 ; ISSN 1462-0324 1462-0332 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2019 |
| Description: |
Objectives Systemic juvenile idiopathic arthritis (sJIA) is a childhood arthritis with features of autoinflammation and high risk of macrophage activation syndrome (MAS). IL-18 has been shown to have key roles in sJIA and MAS. We aimed to examine IL-18 levels in sJIA in relation to disease activity and history of MAS and other disease biomarkers namely S100 proteins and CXCL9. Methods Total IL-18, CXCL9 and S100 proteins levels were determined in 40 sJIA patients, and IL-18 levels were compared between patients with regards to disease activity, history of MAS, and other biomarkers. Results Total IL-18 levels were significantly higher in patients with active sJIA (median 16 499 pg/ml; interquartile range (IQR) 4816–61 839), and remained persistently elevated even in the majority of patients with inactive disease (1164 pg/ml; IQR 587–3444). Patients with history of MAS had significantly higher IL-18 levels (13 380 pg/ml; IQR 4212–62 628) as compared with those without MAS history (956.5 pg/ml; IQR 276.3–4262.5). Total IL-18 performed well with area under the curve of 0.8145 and 0.84 in predicting disease activity and history of MAS, respectively. We observed moderate correlation between IL-18 and CXCL9 (R = 0.56), S100A8/A9 (R = 0.47) and S100A12 (R = 0.46). The correlation was stronger for ferritin (R = 0.74) and overall for those with active disease. Conclusion Total IL-18 levels were elevated in the majority of sJIA patients regardless of clinical features, but were higher in patients with active disease and history of MAS. Change in IL-18 may reflect increased disease activity or development of MAS. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/rheumatology/kez282 |
| Availability: |
https://doi.org/10.1093/rheumatology/kez282; http://academic.oup.com/rheumatology/article-pdf/59/2/361/36754812/kez282.pdf |
| Rights: |
https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model |
| Accession Number: |
edsbas.2FC73FB7 |
| Database: |
BASE |