Serum interleukin-18 levels can improve the diagnostic performance of the PRINTO and ILAR criteria for systemic juvenile idiopathic arthritis

IF 3.7 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Cytokine Pub Date : 2024-07-30 DOI:10.1016/j.cyto.2024.156719

Shuya Kaneko , Asami Shimbo , Hitoshi Irabu , Mao Mizuta , Yasuo Nakagishi , Naomi Iwata , Koji Yokoyama , Junko Yasumura , Keiji Akamine , Kazuyuki Ueno , Shuhei Fujita , Kenichi Watanabe , Shojiro Watanabe , Hiroki Nishikawa , Junya Fujimura , Masaaki Mori , Masaki Shimizu

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Abstract

Objective

Recently, the Pediatric Rheumatology International Trials Organization (PRINTO) has proposed revisions to the current International League of Associations for Rheumatology (ILAR) criteria for systemic juvenile idiopathic arthritis (s-JIA). Interleukin (IL)-18 overproduction plays a significant role in the pathogenesis of s-JIA. This study aimed to evaluate the performance of the PRINTO criteria compared with the ILAR criteria and determine whether serum IL-18 levels improve their diagnostic performances.

Methods

Overall, 90 patients with s-JIA and 27 patients with other febrile disease controls presenting with a prolonged fever of > 14 days and arthritis and/or erythematous rash were enrolled. The ILAR and PRINTO classification criteria were applied to all patients and examined with expert diagnoses. Enzyme-linked immunosorbent assay was used for measuring serum IL-18 levels.

Results

The PRINTO criteria had higher sensitivity but lower specificity than the ILAR criteria (sensitivity: PRINTO 0.856, ILAR 0.533; specificity: PRINTO 0.259, ILAR 0.851). With the addition of serum IL-18 levels ≥ 4,800 pg/mL, the sensitivity of the ILAR criteria and specificity of the PRINTO criteria were improved to 1.000 and 1.000, respectively. PRINTO plus serum IL-18 levels ≥ 4,800 pg/mL showed the highest value in Youden’s index (sensitivity – [1 − specificity]).

Conclusion

Serum IL-18 levels could improve the diagnostic performance of the PRINTO and ILAR criteria for s-JIA. The PRINTO criteria plus serum IL-18 levels ≥ 4,800 pg/mL could be the best diagnostic performance for s-JIA.

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血清白细胞介素-18 水平可提高 PRINTO 和 ILAR 标准对全身性幼年特发性关节炎的诊断效果。

目的：最近，儿科风湿病学国际试验组织（PRINTO）建议修订目前国际风湿病学协会联盟（ILAR）关于系统性幼年特发性关节炎（s-JIA）的标准。白细胞介素（IL）-18的过度分泌在s-JIA的发病机制中起着重要作用。本研究旨在评估 PRINTO 标准与 ILAR 标准的性能比较，并确定血清 IL-18 水平是否能提高其诊断性能：方法：共招募了 90 名 s-JIA 患者和 27 名其他发热性疾病对照组患者，这些患者均表现为长期发热超过 14 天、关节炎和/或红斑皮疹。ILAR和PRINTO分类标准适用于所有患者，并与专家诊断一起进行检查。使用酶联免疫吸附试验测定血清中的IL-18水平：结果：与 ILAR 标准相比，PRINTO 标准的灵敏度更高，但特异性更低（灵敏度：PRINTO 0.856，特异性：PRINTO 0.856）：PRINTO标准的灵敏度较高，但特异性低于ILAR标准（灵敏度：PRINTO 0.856，ILAR 0.533；特异性：PRINTO 0.259，ILAR 0.533）：PRINTO为0.259，ILAR为0.851）。加上血清 IL-18 水平≥ 4,800 pg/mL，ILAR 标准的灵敏度和 PRINTO 标准的特异性分别提高到 1.000 和 1.000。PRINTO 加上血清 IL-18 水平≥ 4,800 pg/mL 显示出最高的尤登指数值（灵敏度 - [1 - 特异性]）：血清IL-18水平可提高PRINTO和ILAR标准对s-JIA的诊断效果。PRINTO标准加上血清IL-18水平≥ 4,800 pg/mL可能是s-JIA的最佳诊断标准。

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来源期刊

Cytokine 医学-免疫学

CiteScore

7.60

自引率

2.60%

发文量

262

审稿时长

48 days

期刊介绍： The journal Cytokine has an open access mirror journal Cytokine: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. * Devoted exclusively to the study of the molecular biology, genetics, biochemistry, immunology, genome-wide association studies, pathobiology, diagnostic and clinical applications of all known interleukins, hematopoietic factors, growth factors, cytotoxins, interferons, new cytokines, and chemokines, Cytokine provides comprehensive coverage of cytokines and their mechanisms of actions, 12 times a year by publishing original high quality refereed scientific papers from prominent investigators in both the academic and industrial sectors. We will publish 3 major types of manuscripts: 1) Original manuscripts describing research results. 2) Basic and clinical reviews describing cytokine actions and regulation. 3) Short commentaries/perspectives on recently published aspects of cytokines, pathogenesis and clinical results.