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. 2012:2012:156890.
doi: 10.1155/2012/156890. Epub 2012 Jun 18.

IL-18 Serum Level in Adult Onset Still's Disease: A Marker of Disease Activity

Serena Colafrancesco  1 , Roberta Priori, Cristiano Alessandri, Carlo Perricone, Monica Pendolino, Giovanna Picarelli, Guido Valesini
Affiliations

IL-18 Serum Level in Adult Onset Still's Disease: A Marker of Disease Activity

Serena Colafrancesco et al. Int J Inflam. 2012.

Abstract

Introduction. Immunological factors seem to play a pivotal role in Adult Onset Still's Disease (AOSD). Among all, IL-18 cytokine is overexpressed and drives the inflammatory process. Objective. We aimed to investigate the levels of IL-18 in sera of Italian patients with AOSD and to assess its possible role as a marker of disease activity. Methods. IL-18 serum levels were determined by ELISA in 26 Italian patients with AOSD. Disease activity was assessed using Pouchot's criteria. As controls, 21 patients with Rheumatoid Arthritis (RA), 21 patients with Sjogren's Syndrome (SS), 20 patients with Systemic Lupus Erythematosus (SLE), and 21 healthy subjects (normal human sera, NHS) were evaluated. Results. IL-18 serum levels were significantly higher in patients with active AOSD than in non-active (P = 0.001) and control groups (RA P = 0.0070, SS P = 0.0029, SLE P = 0.0032, NHS P = 0.0004). A significant correlation between IL-18 serum levels and disease activity (P < 0.0001), and laboratory parameters as ferritin (P = 0.0127) and C-reactive protein (P = 0.0032) was demonstrated. Conclusions. Higher levels of IL-18 are detected in active AODS patients and correlate with disease activity and inflammatory laboratory features. ROC-AUC analysis of the serum concentration of IL-18 suggests that it can be considered a diagnostic marker of AOSD. This paper supports the targeting of this cytokine as a possible therapeutic option in AOSD.

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Figures

Figure 1
Figure 1
Box-and-whisker plot of IL-18 serum levels in patients with active AOSD (n = 16) and non-active AOSD (n = 10).
Figure 2
Figure 2
Box-and-whisker plot of IL-18 serum levels in patients with AOSD (n = 26), RA (n = 21) SS (n = 21), SLE (n = 20), and NHS (n = 21). Median, quartiles, range, and possibly extreme values are shown.
Figure 3
Figure 3
Area under the receiver operating characteristic curves for detection of AOSD by reference to the level of serum IL-18. (a) AOSD versus NHS; (b) AOSD versus RA; (c) AOSD versus SS; (d)AOSD versus SLE.
Figure 4
Figure 4
Correlation between disease activity and IL-18 serum levels.
Figure 5
Figure 5
(a) Correlation between CRP serum levels and IL-18 serum levels. (b) Correlation between serum ferritin levels and IL-18 serum levels.
See this image and copyright information in PMC

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