Value of serum soluble interleukin-2 receptor as a diagnostic and predictive biomarker in sarcoidosis

Schimmelpennink, Milou C.; Quanjel, Marian J.R.; Vorselaars, Adm; Wiertz, Ivo A.; Veltkamp, Marcel; Moorsel, Chm Van; Grutters, Jan C.

doi:10.1080/17476348.2020.1751614

Cited by 27 publications

(16 citation statements)

References 43 publications

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“…The sIL-2R comprises of α (CD25), β (CD122), and common γ (CD132) chains expressing on the surface of T cells and is released by T cells in a soluble form as sIL-2R. 15,16 Furthermore, sIL-2R is present in vivo, at low levels in the sera of healthy individuals, but are further increased in patients during the acute or aggravated phase of the disease and decreased during the convalescence period or after treatment, 17,18 such as in patients with cancer; 19 inflammatory bowel disease; 17 IgG4-related disease; 20 autoimmune inflammation, including rheumatoid arthritis; 21 systemic lupus erythematosus; 22 sarcoidosis; 23 and severe asthma. 24 Cigarette smoke exposure is a significant risk factor for the occurrence and development of a variety of airway diseases.…”

Section: Discussionmentioning

confidence: 99%

Increased Serum Soluble Interleukin-2 Receptor Associated with Severity of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Zhang¹,

Ren²,

Sun³

et al. 2021

COPD

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Background: This study aimed to reveal the correlation between serum soluble interleukin-2 receptor (sIL-2R) and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: A total of 315 patients diagnosed with AECOPD between December 2017 and June 2020 were enrolled. The patients were divided into the good and adverse groups based on the outcomes. An adverse outcome in COPD exacerbation was defined by the presence of at least one of the following: (1) death from a respiratory cause during hospitalisation or within 1 month of follow-up; (2) intensive care unit admission; (3) invasive or non-invasive mechanical ventilation; and (4) COPD-related emergency visit or readmission within 1 month of follow-up. A good outcome was considered as the absence of all the aforementioned issues. The patients underwent lung function (spirometry) assessment, and clinical and inflammatory profiles were collected. Univariate and multivariate analyses were performed to identify the correlation between serum sIL-2R concentration and other variables related to adverse outcomes of AECOPD. The receiver operating characteristic curve was used to show the predictive ability of sIL-2R for adverse outcomes of AECOPD. Results: We enrolled 315 patients, of whom 161 and 154 had good and adverse outcomes, respectively. We demonstrated that patients with adverse outcomes of AECOPD had a higher concentration of serum sIL-2R than patients with good outcomes (p < 0.001). The increased serum sIL-2R was positively associated with mMRC scores (p < 0.001), GLOD grades (p < 0.001), frequent exacerbation (p < 0.001), and smoking (p < 0.001) in patients with AECOPD and negatively correlated with pulmonary function (p < 0.001). An elevated sIL-2R level was a predictor for the risk of adverse outcomes in AECOPD with a cut-off value of 860 U/mL. Conclusion: Increased serum sIL-2R concentration correlated with the risk of the adverse outcomes in AECOPD, indicating that it can be a predictive factor contributing to the diagnosis and assessment of adverse outcomes in patients with AECOPD.

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Section: Discussionmentioning

confidence: 99%

Increased Serum Soluble Interleukin-2 Receptor Associated with Severity of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Zhang¹,

Ren²,

Sun³

et al. 2021

COPD

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“…sIL-2R is released by activated mononuclear cells and sIL2R levels correlate with disease activity, particularly in patients with extrapulmonary disease. In addition, sIL2R is more sensitive than serum ACE and lysozyme levels for a diagnosis of sarcoidosis [ 68 ], although sIL-2R levels can also be elevated in hematologic malignancy, autoimmune disorders and idiopathic pulmonary fibrosis [ 69 ]. A more recent study in patients with suspected sarcoidosis demonstrated a sensitivity of 88% and a specificity of 85% [ 70 ].…”

Section: Confirmation Of the Diagnosismentioning

confidence: 99%

Pulmonary Sarcoidosis: Diagnosis and Differential Diagnosis

et al. 2021

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Sarcoidosis is a multisystem disorder of unknown origin and poorly understood pathogenesis that predominantly affects lungs and intrathoracic lymph nodes and is characterized by the presence of noncaseating granulomatous inflammation in involved organs. The disease is highly heterogeneous and can mimic a plethora of other disorders, making diagnosis a challenge even for experienced physicians. The evolution and severity of sarcoidosis are highly variable: many patients are asymptomatic and their disease course is generally benign with spontaneous resolution. However, up to one-third of patients develop chronic or progressive disease mainly due to pulmonary or cardiovascular complications that require long-term therapy. The diagnosis of sarcoidosis requires histopathological evidence of noncaseating granulomatous inflammation in one or more organs coupled with compatible clinical and radiological features and the exclusion of other causes of granulomatous inflammation; however, in the presence of typical disease manifestations such as Löfgren’s syndrome, Heerfordt’s syndrome, lupus pernio and asymptomatic bilateral and symmetrical hilar lymphadenopathy, the diagnosis can be established with high level of certainty on clinical grounds alone. This review critically examines the diagnostic approach to sarcoidosis and emphasizes the importance of a careful exclusion of alternative diagnoses.

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“…Heerfordt's is acute uveitis, parotitis, fevers and facial nerve palsy [1,37]. The Angiotensin Enzyme Inhibitor (ACE) has sensitivities ranging from 41-70 % (mean 58%) and a specificities of 70-80%, the latter depending on the magnitude of elevation beyond the normal range [39][40][41] Likewise, other serum biomarkers, IL-2, chitotriosidase, Lysozyme and KL-6 have not proven to be of sufficient accuracy to make a diagnosis [42,43].…”

Section: Diagnosismentioning

confidence: 99%

Sarcoidosis: Review of Diagnosis and Treatment

Shoor¹

2021

austinjorthopaderheumatol

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Background: Sarcoidosis is a systemic heterogenous granulomatous disease of unknown etiology that results in inflammation of pulmonary and extrapulmonary sites. In a minority of patients it can result in fibrosis and permanent organ damage. Most commonly mentioned causes of sarcoidosis include atypical mycobacterium, proprionobacterium and inorganic dusts. Once exposed to an organic or inorganic, an Antigen Presenting Cell (APC) prepares and presents the antigen to a T cell and its respective HLA locus. In a susceptible person, this provides cytokine production, differentiation into T helper cells and provokes an immune response that in its early stages is allayed by corticosteroids or other immunomodulatory agents. In the majority of patients appropriate immunomodulatory therapy will control the disease and prevent progression. However, in 20-25 % the disease can progress and lead to organ damage or compromise and fibrosis. Sarcoidosis is a relatively common disease with an incidence of 2.3-17.8 per 100,000. It is 2-4 times more common in African Americans than Caucasian Americans with the mean age of onset of 45-50 years of age. Unlike autoimmune rheumatic disease the disease occurs almost as commonly in men than women. Sources: A Medline, Pub Med review from 1999-2021. Spectrum of Disease: Sarcoidosis occurs in 90-98 % of patients during the course of their disease. Eleven to twenty two percent of patients have involvement of either the liver, Skin, ocular (uveitis), Lymph nodes and spleen. The upper airway, liver, CNS and heart comprise <10% of cases each and the bone, joints/ muscle, and hypercalcemia < 5%. Diagnosis: With the exception of Lofgren’s and Heerfordt’syndromes the presence of non-caseating/necrotizing granuloma must be present on biopsy of at least one site and mycobacterial or fungal infections or malignancy must be ruled out. If clinically suspicious, Skin and peripheral lymph nodes are the least invasive areas for biopsy and if hilar or mediastinal nodes are suggestive, an EBUS approach is recommended. In organs such as the heart and CNS where biopsy is either insensitive or invasive, a Cardiologist and Neurologist in concert with a Rheumatologist can make a probable diagnosis based on clinical presentation, PET or MRI and exclusion of alternative diseases.

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Value of serum soluble interleukin-2 receptor as a diagnostic and predictive biomarker in sarcoidosis

Cited by 27 publications

References 43 publications

Increased Serum Soluble Interleukin-2 Receptor Associated with Severity of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Increased Serum Soluble Interleukin-2 Receptor Associated with Severity of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Pulmonary Sarcoidosis: Diagnosis and Differential Diagnosis

Sarcoidosis: Review of Diagnosis and Treatment

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