Stage classification of IgG4-related dacryoadenitis and sialadenitis by the serum cytokine environment. Issue 6 (2nd November 2018)

• Record Type: Journal Article
• Authors: Yamamoto, Motohisa; Takano, Kenichi; Kamekura, Ryuta; Suzuki, Chisako; Ichimiya, Shingo; Himi, Tetsuo; Nakase, Hiroshi; Takahashi, Hiroki
• Is Part Of: Modern rheumatology. Volume 28:Issue 6(2018)
• Page Start: 1004
• Page End: 1008
• Publication Date: 2018-11-02
• Subjects: IgG4-related disease -- interferon-α -- interleukin-5 -- staging classification; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1080/14397595.2018.1436029
• Languages: English
• ISSNs: 1439-7595

Abstract

Abstract: Objectives: Patients with immunoglobulin-G4 related disease (IgG4-RD) diagnosed according to the comprehensive diagnostic criteria (CDC) show varied therapeutic responses and prognoses. We assumed that there are clinical stages in IgG4-RD and have verified it using serum cytokine levels in the groups classified by lesion distribution. Methods: Definite IgG4-related dacryoadenitis and sialadenitis (IgG4-DS) cases were divided according to the CDC for IgG4-RD into 11 cases with focal type and 30 cases with systemic type. The levels of serum interleukin (IL)-4, IL-5, IL-6, IL-10, IL-13, IL-15, IL-21, interferon (IFN)-α, IFN-γ, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β1, and monocyte chemotactic protein (MCP)-1 were measured in healthy controls, allergic patients, probable IgG4-RD cases, and focal and systemic type cases. The cytokine environment was analyzed in each group. The 52 definite IgG4-RD cases were next classified into four groups with cluster analysis in terms of therapeutic responses and prognosis. The relationships between each cytokine level and therapeutic responses were also analyzed. Results: Both serum IL-5 and IFN-α concentrations were very low in healthy controls, but they increased in the allergic cases, probable cases, and focal and systemic type cases. The level of serum IL-5 was significantly higher in definite cases than in healthy controls. The serum IL-5 level was also significantly increased in the groups with a poor prognosis than in the good prognosis group. Conclusion: These results suggest that there are clinical stages in IgG4-RD, and serum IL-5 play roles in the pathogenesis of IgG4-RD.