[Place of chitotriosidase as a serum biomarker of sarcoidosis: A narrative review of the literature]

Abstract

Sarcoidosis is an inflammatory systemic disease characterized by epithelio-gigantocellular granulomatosis without cell necrosis. The diagnosis is pathologic. There are many biomarkers of sarcoidosis. The oldest and most widely used in routine medical practice is angiotensin-converting enzyme (ACE) since 1975. However, it is a marker of low diagnostic value. The other most frequently studied biomarkers of interest are chitotriosidase (CTO), soluble IL-2 receptor (rsIL-2), neopterin, lysozyme, and SAA protein. In this work, we propose a review of the serum biomarkers of sarcoidosis. The studies are heterogeneous, and the results are difficult to conclude. Pathology remains the gold standard for the definitive diagnosis. In the context of evolutionary follow-up and relapse, we can select a priori 3 markers of interest: ACE (sensitivity [Se]: from 22 to 77% and specificity [Sp]: from 54 to 99%), CTO (Se: from 45 to 89% and Sp from 70 to 100%), and rsIL-2 (Se: from 52 to 82% and Sp: from 57 to 94%). The most rational association for a particular disease phenotype has yet to be determined. Future advances will come from an in-depth knowledge of granuloma, its mechanisms of formation, growth, and regression in the context of a still partially unknown inflammatory and immune response. Recent substantial progress has been made through radiological examinations. Multi-omics technologies will undoubtedly complement the arsenal of physiopathological and diagnostic research that will make it possible to move away from pathological examination and ensure better monitoring of the disease.

Keywords: Angiotensin-converting enzyme; Biomarkers; Biomarqueurs; Chitotriosidase; Clinical evaluation; Enzyme de conversion de l’angiotensine; Sarcoidosis; Sarcoïdose; Évaluation clinique.