Journal of Diagnostics Concepts & Practice >

2019 , Vol. 18 >Issue 03: 329 - 333

DOI: https://doi.org/10.16150/j.1671-2870.2019.03.016

Original articles

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

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  • Department of Clinical Laboratory, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China

Received date: 2019-01-10

  Online published: 2019-06-25

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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

Cite this article

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 . DOI: 10.16150/j.1671-2870.2019.03.016

References

[1] Kamisawa T, Zen Y, Pillai S, et al. IgG4-related disease[J]. Lancet, 2015, 385(9976):1460-1471.
[2] Wallace ZS, Deshpande V, Mattoo H, et al. IgG4-Related Disease: Clinical and Laboratory Features in One Hundred Twenty-Five Patients[J]. Arthritis Rheumatol, 2015, 67(9):2466-2475.
[3] Ohta N, Kurakami K, Ishida A, et al. Roles of TGF-beta and periostin in fibrosclerosis in patients with IgG4-rela-ted diseases[J]. Acta Otolaryngol, 2013, 133(12):1322-1327.
[4] Tanaka A, Moriyama M, Nakashima H, et al. Th2 and regulatory immune reactions contribute to IgG4 production and the initiation of Mikulicz disease[J]. Arthritis Rheum, 2012, 64(1):254-263.
[5] Akiyama M, Yasuoka H, Yoshimoto K, et al. CC-chemokine ligand 18 is a useful biomarker associated with disease activity in IgG4-related disease[J]. Ann Rheum Dis, 2018, 77(9):1386-1387.
[6] Parkes J, Roderick P, Harris S, et al. Enhanced liver fibrosis test can predict clinical outcomes in patients with chronic liver disease[J]. Gut, 2010, 59(9):1245-1251.
[7] Della-Torre E, Feeney E, Deshpande V, et al. B-cell depletion attenuates serological biomarkers of fibrosis and myofibroblast activation in IgG4-related disease[J]. Ann Rheum Dis, 2015, 74(12):2236-2243.
[8] Abignano G, Cuomo G, Buch MH, et al. The enhanced liver fibrosis test: a clinical grade, validated serum test, biomarker of overall fibrosis in systemic sclerosis[J]. Ann Rheum Dis, 2014, 73(2):420-427.
[9] Wu M, Baron M, Pedroza C, et al. CCL2 in the Circulation Predicts Long-Term Progression of Interstitial Lung Disease in Patients With Early Systemic Sclerosis: Data From Two Independent Cohorts[J]. Arthritis Rheumatol, 2017, 69(9):1871-1878.
[10] Yalçinkaya Y, Çinar S, Artim-Esen B, et al. The relationship between vascular biomarkers and disease characteristics in systemic sclerosis: elevated MCP-1 is predomi-nantly associated with fibrotic manifestations[J]. Clin Exp Rheumatol, 2016, 34 Suppl 100(5):110-114.
[11] Umehara H, Okazaki K, Masaki Y, et al. Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011[J]. Mod Rheumatol, 2012, 22(1):21-30.
[12] Umehara H, Okazaki K, Nakamura T, et al. Current approach to the diagnosis of IgG4-related disease - Combination of comprehensive diagnostic and organ-specific criteria[J]. Mod Rheumatol, 2017, 27(3):381-391.
[13] Ohara H, Okazaki K, Tsubouchi H, et al. Clinical diagnostic criteria of IgG4-related sclerosing cholangitis 2012[J]. J Hepatobiliary Pancreat Sci, 2012, 19(5):536-542.
[14] Goto H, Takahira M, Azumi A, et al. Diagnostic criteria for IgG4-related ophthalmic disease[J]. Jpn J Ophthalmol, 2015, 59(1):1-7.
[15] Matsui S, Yamamoto H, Minamoto S, et al. Proposed diagnostic criteria for IgG4-related respiratory disease[J]. Respir Investig, 2016, 54(2):130-132.
[16] Lichtinghagen R, Pietsch D, Bantel H, et al. The Enhanced Liver Fibrosis (ELF) score: normal values, influe-nce factors and proposed cut-off values[J]. J Hepatol, 2013, 59(2):236-242.
[17] de Jager SC, Bermúdez B, Bot I, et al. Growth differentiation factor 15 deficiency protects against atherosclerosis by attenuating CCR2-mediated macrophage chemotaxis[J]. J Exp Med, 2011, 208(2):217-225.
[18] Sierra-Filardi E, Nieto C, Domínguez-Soto A, et al. CCL2 shapes macrophage polarization by GM-CSF and M-CSF: identification of CCL2/CCR2-dependent gene expression profile[J]. J Immunol, 2014, 192(8):3858-3867.
[19] Furukawa S, Moriyama M, Tanaka A, et al. Preferential M2 macrophages contribute to fibrosis in IgG4-related dacryoadenitis and sialoadenitis, so-called Mikulicz's di-sease[J]. Clin Immunol, 2015, 156(1):9-18.
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