Abstract: Serum Cytokine Profiles in Patients with Adult Onset Still's Disease

Serum Cytokine Profiles in Patients with Adult Onset Still's Disease

JEONG-HEE CHOI, CHANG-HEE SUH, YOUNG-MOK LEE, YU-JIN SUH, SOO-KEOL LEE, SUN-SIN KIM, DONG-HO NAHM and HAE-SIM PARK

ABSTRACT.

Objective. Adult onset Still's disease (AOSD) is a systemic inflammatory disorder characterized by fever, arthritis, and rash. Although the pathogenesis is not known, immunologically mediated inflammation occurs in active AOSD. To evaluate the pathogenesis and disease activity of AOSD, we measured serial serum concentrations of several cytokines in patients with active and inactive disease.

Methods. Seventeen patients diagnosed as having AOSD were enrolled. We analyzed clinical and laboratory findings retrospectively. Serial serum samples were obtained from 14 patients with active and inactive AOSD. Interleukin 18 (IL-18), soluble IL-2 receptor (sIL-2R), IL-6, interferon-g (IFN-g), and IL-8 were determined by ELISA.

Results. Serum levels of IL-18, IFN-g, and IL-8 were significantly higher in patients with AOSD than in healthy controls (p < 0.01), but there were no significant differences between patients with active and inactive AOSD. Serum sIL-2R levels tended to be higher in the active state than in healthy controls, but there was no statistically significant difference between the 2 groups. Serum sIL-2R levels decreased significantly with antiinflammatory therapy (p < 0.05). Serum IL-18 and sIL-2R levels correlated significantly with serum ferritin levels in the active AOSD group (p < 0.05).

Conclusion. Overproduction of IL-18 may contribute to the pathogenic mechanism of AOSD, and serum sIL-2R levels may be used as a marker for monitoring disease activity in AOSD. (J Rheumatol 2003;30:2422-7)

Key Indexing Terms:

ADULT ONSET STILL'S DISEASE
CYTOKINE
INTERLEUKIN 18
SOLUBLE IL-2 RECEPTOR

From the Department of Allergy and Rheumatology, Ajou University School of Medicine, Suwon, Korea.

Supported by Korea Research Foundation Grant KRF-2001-041-F00155.

J-H. Choi, MD; C-H. Suh, MD, PhD; Y-M. Lee, MD; Y-J. Suh, MD; S-K. Lee, MD, PhD; S-S. Kim, MD, PhD; D-H. Nahm, MD, PhD; H-S. Park, MD, PhD.

Address reprint requests to Dr. H-S. Park, Department of Allergy and Rheumatology, Ajou University School of Medicine, Paldalgu Woncheondong San-5, Suwon, Korea 442-749. E-mail: hspark@madang.ajou.ac.kr

Submitted June 23, 2002; revision accepted March 28, 2003.