Soluble ST2 and CD163 as Potential Biomarkers to Differentiate Primary Hemophagocytic Lymphohistiocytosis from Macrophage Activation Syndrome
Soluble ST2 and CD163 as Potential Biomarkers to Differentiate Primary Hemophagocytic Lymphohistiocytosis from Macrophage Activation Syndrome
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DOI：
10.4084/mjhid.2019.008
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发表时间：
2019-01-01
影响因子：
3.2
通讯作者：
Wang, Zhao
中科院分区：
文献类型：
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作者：
Gao, Zhuo;Wang, Yini;Wang, Zhao
原发性噬血细胞性淋巴组织细胞增生症（pHLH）和巨噬细胞活化综合征（MAS）的鉴别诊断是血液学家面临的一个挑战。本研究的目的是：（1）比较pHLH和MAS患者血清可溶性ST 2（sST 2）、sCD 163、IFN-γ、IL-10、IL-18、TNF-α和血清可溶性白细胞介素2受体（sCD 25）的水平;（2）探讨它们是否有助于鉴别这两种疾病。本研究共招募了52名参与者，包括12名pHLH患者，20名MAS患者和20名健康受试者。ELISA法检测血清sST 2、sCD 163、sCD 25水平。使用Luminex 200仪器检测IFN-γ、IL-10、IL-18和TNF-α的血清水平。MAS患者血清sST 2和sCD 163水平明显高于pHLH患者（363.13 ± 307.24 ng/ml vs 80.75 ± 87.04 ng/ml，P = 0.004; 3532.72 ± 2479.68 ng/ml vs 1731.96 ± 1262.07 ng/ml，P = 0.046）。IFN-γ的表达无显著差异（306.89 +/- 281.60 pg/ml vs 562.43 +/- 399.86 pg/ml），IL-10（20.40 +/- 30.49 pg/ml vs 8.3 +/- 13.14 pg/ml），IL-18（463.33 +/- 597.04 pg/ml vs 1247.82 +/- 1318.58 pg/ml），TNF-α（61.48 +/- 84.69 pg/ml vs 106.10 +/- 77.21 pg/ml）和sCD 25（21062.1 +/- 18515.26 pg/ml vs 11074.78 +/- 11149.96 pg/ml）。pHLH和MAS患者的细胞因子谱存在一定差异。IFN-γ、IL- 10、TNF-α、IL-18和sCD 25水平升高有助于HLH的诊断，但不能区分pHLH和MAS。sST 2和sCD 163可作为pHLH与MAS的鉴别标志。
The differentiation of primary hemophagocytic lymphohistiocytosis (pHLH) and macrophage activation syndrome (MAS) poses a challenge to hematologists. The aim of this study was (1) to compare the levels of soluble ST2 (sST2), sCD163, IFN-gamma, IL-10, IL-18, TNF-alpha and Serum soluble interleukin-2 receptor (sCD25) in patients with pHLH and MAS and (2) to investigate whether they can help differentiate the two diseases. A total of 52 participants were recruited in this study, including 12 pHLH patients, 20 MAS patients, and 20 healthy subjects. We measured the levels of sST2, sCD163 and sCD25 in serum by ELISA. The serum levels of IFN-gamma, IL-10, IL-18, and TNF-alpha were detected using a Luminex 200 instrument. The serum levels of sST2 and sCD163 in MAS patients were markedly higher than that in pHLH patients (363.13 +/- 307.24 ng/ml vs 80.75 +/- 87.04 ng/ml, P = 0.004; 3532.72 +/- 2479.68 ng/ml vs 1731.96 +/- 1262.07 ng/ml, P = 0.046). There was no significant difference in the expression of IFN-gamma (306.89 +/- 281.60 pg/ml vs 562.43 +/- 399.86 pg/ml), IL-10 (20.40 +/- 30.49 pg/ml vs 8.3 +/- 13.14 pg/ml), IL-18 (463.33 +/- 597.04 pg/ml vs 1247.82 +/- 1318.58 pg/ml), TNF-alpha (61.48 +/- 84.69 pg/ml vs 106.10 +/- 77.21 pg/ml), and sCD25 (21062.1 +/- 18515.26 pg/ml vs 11074.78 +/- 11149.96 pg/ml) between pHLH and MAS. Patients with pHLH and MAS show some differences in cytokine profiles. The elevated levels of IFN-gamma, IL- 10, TNF-alpha, IL-18, and sCD25 can contribute to the diagnosis of HLH, but may not discriminate pHLH from MAS. Levels of sST2 and sCD163 may serve as markers to distinguish pHLH from MAS.