Stage classification of IgG4-related dacryoadenitis and sialadenitis by the serum cytokine environment
Stage classification of IgG4-related dacryoadenitis and sialadenitis by the serum cytokine environment
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DOI：
10.1080/14397595.2018.1436029
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发表时间：
2018-02
影响因子：
2.2
通讯作者：
M. Yamamoto;K. Takano;Ryuta Kamekura;C. Suzuki;S. Ichimiya;T. Himi;H. Nakase;H. Takahashi
中科院分区：
文献类型：
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作者：
M. Yamamoto;K. Takano;Ryuta Kamekura;C. Suzuki;S. Ichimiya;T. Himi;H. Nakase;H. Takahashi
摘要目的：根据综合诊断标准(CDC)诊断的免疫球蛋白G4相关疾病(IgG4-RD)患者表现出不同的治疗反应和预后。我们假设IgG4-RD有临床分期，并通过根据病变分布分类的组的血清细胞因子水平进行了验证。方法：将确诊的IgG4相关性泪腺炎和涎腺炎(IgG4-DS)患者按疾病预防控制中心(CDC)分为局限型11例，全身型30例。检测健康对照组、过敏患者、疑似IgG4-RD患者、局灶型和全身型患者血清IL-4、IL-5、IL-6、IL-10、IL-13、IL-15、IL-21、干扰素-α、干扰素-γ、肿瘤坏死因子-α、转化生长因子-β-1、单核细胞趋化蛋白-1的水平。对各组细胞因子环境进行分析。对确诊的52例IgG4-RD患者按疗效和预后进行聚类分析，分为4组。并分析各细胞因子水平与疗效的关系。结果：正常人血清IL-5和干扰素-α水平均很低，但过敏病例、疑似病例、局灶型和全身型病例血清IL-5和干扰素-DNA浓度升高。确诊病例血清IL-5水平明显高于正常对照组。预后不良组血清IL-5水平也明显高于预后良好组。结论：IgG4-RD存在临床分期，血清IL-5参与了IgG4-RD的发病过程。
Abstract Objectives: Patients with immunoglobulin-G4 related disease (IgG4-RD) diagnosed according to the comprehensive diagnostic criteria (CDC) show varied therapeutic responses and prognoses. We assumed that there are clinical stages in IgG4-RD and have verified it using serum cytokine levels in the groups classified by lesion distribution. Methods: Definite IgG4-related dacryoadenitis and sialadenitis (IgG4-DS) cases were divided according to the CDC for IgG4-RD into 11 cases with focal type and 30 cases with systemic type. The levels of serum interleukin (IL)-4, IL-5, IL-6, IL-10, IL-13, IL-15, IL-21, interferon (IFN)-α, IFN-γ, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β1, and monocyte chemotactic protein (MCP)-1 were measured in healthy controls, allergic patients, probable IgG4-RD cases, and focal and systemic type cases. The cytokine environment was analyzed in each group. The 52 definite IgG4-RD cases were next classified into four groups with cluster analysis in terms of therapeutic responses and prognosis. The relationships between each cytokine level and therapeutic responses were also analyzed. Results: Both serum IL-5 and IFN-α concentrations were very low in healthy controls, but they increased in the allergic cases, probable cases, and focal and systemic type cases. The level of serum IL-5 was significantly higher in definite cases than in healthy controls. The serum IL-5 level was also significantly increased in the groups with a poor prognosis than in the good prognosis group. Conclusion: These results suggest that there are clinical stages in IgG4-RD, and serum IL-5 play roles in the pathogenesis of IgG4-RD.