血清白介素-18水平在涉及pyrin炎性体的自身炎症性疾病中特异性升高：一项516例患者的研究

IF 5.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Internal Medicine Pub Date : 2025-06-01 DOI:10.1016/j.ejim.2025.04.002

Inès Elhani , Laure Calas , Farah Bejar , Bruno Fautrel , Laurence Pieroni , Véronique Hentgen , Philippe Mertz , Stéphane Mitrovic , Marion Delplanque , Léa Savey , Sophie Georgin-Lavialle

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引用次数: 0

摘要

自身炎症性疾病（AIDs）的特点是先天免疫过度激活。目前的生物标志物，如c反应蛋白（CRP）和血清淀粉样蛋白A (SAA)，不是疾病特异性的，不能反映疾病的严重程度。白细胞介素-18 （IL-18）是IL-1超家族中的一种促炎细胞因子，最近被研究为艾滋病的生物标志物；本研究旨在评估来自法国成人艾滋病国家参考中心的一大批艾滋病患者的血清IL-18水平。我们对516例患者的708个IL-18测量值进行了回顾性分析。在涉及pyrin炎性体的疾病中观察到最高的IL-18水平，如家族性地中海热、甲羟戊酸激酶缺乏症、cdc42相关AID和pstpip1相关AID。受试者工作特征（ROC）曲线分析显示，IL-18鉴别pyrin炎性小体相关疾病与其他单基因炎性疾病的AUC为0.87，灵敏度为83.4%，特异性为76.2%（临界值为412 pg/mL）。我们的研究结果表明，血清总IL-18作为诊断工具的效用，特别是对于pyrin炎症小体相关的艾滋病，可以在未来帮助个性化治疗策略。

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Serum interleukin-18 levels are specifically elevated in auto-inflammatory diseases involving the pyrin inflammasome: A study on 516 patients

Auto-inflammatory diseases (AIDs) are characterized by excessive activation of innate immunity. Current biomarkers, such as C-reactive protein (CRP) and serum Amyloid A (SAA), are not disease-specific and cannot reflect disease severity. Interleukin-18 (IL-18), a pro-inflammatory cytokine of the IL-1 superfamily, has been recently studied as, biomarker for AIDs; This study aims to evaluate total serum IL-18 levels in a large cohort of AID patients from the adult French national reference center for AID. We conducted a retrospective analysis of 708 IL-18 measurements from 516 patients. The highest IL-18 levels were observed in diseases involving the pyrin inflammasome, such as Familial Mediterranean fever, mevalonate kinase deficiency, CDC42-associated AID and PSTPIP1-associated AID. Receiver operating characteristic (ROC) curve analysis demonstrated an AUC of 0.87 for IL-18, with a sensitivity of 83.4 % and specificity of 76.2 % at a cut-off value of 412 pg/mL, in differentiating pyrin inflammasome-related diseases from other monogenic inflammatory diseases. Our findings suggest the utility of total serum IL-18 as a diagnostic tool, particularly for pyrin inflammasome-related AIDs, that could in the future help to personalized treatment strategies.

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来源期刊

European Journal of Internal Medicine 医学-医学：内科

CiteScore

9.60

自引率

6.20%

发文量

364

审稿时长

20 days

期刊介绍： The European Journal of Internal Medicine serves as the official journal of the European Federation of Internal Medicine and is the primary scientific reference for European academic and non-academic internists. It is dedicated to advancing science and practice in internal medicine across Europe. The journal publishes original articles, editorials, reviews, internal medicine flashcards, and other relevant information in the field. Both translational medicine and clinical studies are emphasized. EJIM aspires to be a leading platform for excellent clinical studies, with a focus on enhancing the quality of healthcare in European hospitals.