Serum levels of selected cytokines [interleukin (IL)-17A, IL-18, IL-23] and chemokines (RANTES, IP10) in the acute phase
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Rheumatology International https://doi.org/10.1007/s00296-019-04415-4
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Serum levels of selected cytokines [interleukin (IL)‑17A, IL‑18, IL‑23] and chemokines (RANTES, IP10) in the acute phase of immunoglobulin A vasculitis in children Majka Jaszczura1 · Elżbieta Mizgała‑Izworska2 · Elżbieta Świętochowska3 · Edyta Machura1 Received: 1 June 2019 / Accepted: 3 August 2019 © The Author(s) 2019
Abstract The pathogenesis of the immunoglobulin A vasculitis (IgAV) is still unknown. The available data shows that interleukin (IL)-17, IL-18, IL-23, regulated on activation, normal T cell expressed and secreted (CCL 5, RANTES), and interferon (IFN)-γ-inducible protein 10 (IP10) participate in the pathogenesis of IgAV by influencing the recruitment of leukocytes to the site of inflammation. The aim of this study was to analyze the serum concentration of IL-17A, IL-18, IL-23, RANTES, and IP10 in patients with acute IgAV compared to healthy children. Moreover, we wanted to assess the suitability of the levels of tested cytokines to predict the severity of the disease. All children with IgAV hospitalized in our institution between 2012 and 2017 were included in the study. Cytokines levels were determined in a serum sample secured at admission to the hospital. Basic laboratory tests have also been analyzed. IL-17A, IL-18, and IL-23 were significantly higher in whole IgAV group (52.25 pg/ml; 164.1 pg/ml and 700 pg/ml, respectively) than in the control group (27.92 pg/ml; 140.1 pg/ml and 581.5 pg/ml, respectively). The receiver operating characteristic (ROC) curve analysis revealed the largest area under the curve (AUC 0.979, p 4). This scale assesses the severity of joint, renal and gastrointestinal symptoms [17–19]. The presence of systemic involvement was defined as the occurrence of GT bleeding and/or kidneys involvement. Gastrointestinal bleeding was defined as haematemesis, melaena, hematochezia, and the positive faecal occult blood test (FOBT). The renal involvement was defined as hematuria (> 5 RBC in the field of vision), macroscopic hematuria or proteinuria (> 300 mg/24 h). We made two different IgAV patients divisions. In the first, the entire group was divided into two subgroups depending on the severity score. In the second the whole group was divided into two subgroups depending on systemic involvement. The control group consisted of 43 healthy children, selected in terms of age and gender (Table 2). Children from the control group attended the outpatient pediatric clinic for non-immunological and non-inflammatory health problems, and they needed venous puncture. At the time of the patient’s admission to the hospital (before the start of treatment), a venous blood sample (standard EDTA tubes) for laboratory tests was collected. Basic laboratory tests were performed within the first hour after admission. The following laboratory data were recorded: hemoglobin level (Hgb), white blood cell count (WBC), neutrophil and lymphocyte count, platelet count (PLT), C-reactive protein (CRP), and i
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