Value of new-type serum fibrosis-related biomarkers level in diagnosing IgG4-related disease

doi:10.16150/j.1671-2870.2019.03.016

Abstract

Abstract:

Objective: To explore serological biomarkers which can be used for diagnosing IgG4-related diseases (IgG4-RD) and to analyze its correlation with involvement of IgG4-RD and patients' response to corticosteroid therapy. Methods: Seventy-two patients with untreated IgG4-RD from January 2015 to January 2019 were enrolled. The serum concentrations of growth differentiation factor 15 (GDF-15), CC chemokine ligand 2 (CCL2), hyaluronic acid (HA), amino-terminal propeptide of type Ⅲ procollagen (PⅢNP), and tissue inhibitor of metalloproteinases 1 (TIMP-1) were measured by enzyme-linked immunosorbent assay. The enhanced liver fibrosis (ELF) score was calculated from the TIMP-1, PⅢNP and HA values. The value of these biomarkers in reflecting the degree of tissue fibrosis and extent of organ involvement was assessed. Results: Compared with healthy controls, patients with IgG4-RD had significantly elevated serum concentrati-ons of GDF-15, HA, PⅢNP, and TIMP-1; the average concentrations of CCL2, HA, PⅢNP and TIMP-1 were 1 121 pg/mL, 398 pg/mL, 87.2 ng/mL and 211 ng/mL, respectively. The ELF score of IgG4-RD patients was also significantly elevated (11.2). Among them, serum GDF-15 of 666 pg/mL distinguished most efficiently patients with IgG4-RD from healthy controls (area under ROC 0.92, sensitivity 77.8%, specificity 100%). Conclusions: New-type serological biomarker GDF-15 and CCL2 have substantial clinical value in diagnosis of IgG4-RD but can not reflect the severity of organ involvement and degree of fibrosis, or cannot be served as criteria of outcome of corticosteroid treatment.

Key words: IgG4-related disease, Fibrosis, Growth differentiation factor 15, CC chemokine ligand 2

CLC Number:

R539.3

ZHOU Xinyun, CHEN Hui, SHEN Lisong. Value of new-type serum fibrosis-related biomarkers level in diagnosing IgG4-related disease[J]. Journal of Diagnostics Concepts & Practice, 2019, 18(03): 329-333.

Figures/Tables 4

References 19

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项目	中位数（四分位数间距）
年龄（岁）	64（57~74）
性别（男/女）	51（70.8%）/21（29.2%）
病程持续时间（月）	10（4~33）
实验室数据
总IgG（mg/dL）	1 885（1 380~2 460）
IgG4（mg/dL）	457（260~705）
IgG4≥135 mg/dL的比例	68/72（94.4%）
IgE（U/mL）	408（125~774）
C₃（mg/dL）	78.9（69.6~101.9）
C₄（mg/dL）	20.8（13.3~29.2）
sIL-2R（U/mL）	788（485~1 123）

指标	IgG4-RD（n=72）	健康对照组（n=50）	P值
GDF-15（pg/mL）	1 121（645~2033）	286（133~325）	<0.000 1
CCL2（pg/mL）	398（231~475）	309（207~350）	0.014 0
TIMP-1（ng/mL）	211（138~279）	135（103~159）	<0.000 1
HA（ng/mL）	87.2（46.3~132）	20.9（10.8~41.7）	<0.000 1
PⅢNP（ng/mL）	26.1（13.6~50.1）	5.2（0.7~19.9）	<0.000 1
ELF评分（分）	11.2（8.8~13.9）	6.6（4.1~8.9）	<0.000 1

项目	Spearman相关系数	P值
GDF-15	0.08	0.490 0
CCL2	0.04	0.770 0
TIMP-1	0.09	0.450 0
HA	0.16	0.160 0
PⅢNP	-0.16	0.190 0
ELF评分	-0.05	0.850 0
总IgG	0.50	0.000 3
IgG4	0.68	<0.000 1
C₃	-0.31	0.016 0
C₄	-0.47	0.003 7
sIL-2R	0.55	<0.000 1

参数	治疗前	治疗后	P值
IgG4（mg/dL）	248（191~504）	91（59~163）	0.000 5
GDF-15（pg/mL）	989（571~1537）	1 158（872~1743）	0.034 0
CCL2（pg/mL）	310（248~392）	359（297~434）	0.033 0
TIMP-1（ng/mL）	220（172~245）	246（207~280）	0.019 0
HA（ng/mL）	70.6（51.4~86.6）	70.8（55.4~91.0）	0.970 0
PⅢNP（ng/mL）	20.4（5.7~76.8）	35.6（28.2~57.4）	0.860 0
ELF评分	10.3（9.4~10.9）	10.8（10.5~11.4）	0.250 0