title: Interleukin-18 for predicting the development of macrophage activation syndrome in systemic juvenile idiopathic arthritis.
abstract: To assess the role of IL-6/IL-18 in the pathogenesis of systemic juvenile idiopathic arthritis (s-JIA) and to investigate the clinical significance of serum IL-18 levels for predicting macrophage activation syndrome (MAS) development, we measured the serum IL-6/IL-18 levels in 76s-JIA patients, including 15 with MAS, and compared them with the clinical features. We identified 2 distinct subsets on the basis of serum IL-6/IL-18 levels. The IL-18-dominant subset had more patients who developed MAS. Serum IL-18 levels during active phase in patients with MAS were significantly higher than those without MAS. The cutoff value of serum IL-18 levels for predicting MAS development was 47750 pg/ml. The patients with IL-18 dominant subset at their disease onset were significantly more likely to develop MAS after TCZ therapy started. IL-18 might have a key role in the pathogenesis of MAS. Serum IL-18 levels >47750 pg/ml might be useful to predict MAS development.
authors.affiliation: Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8641, Japan. Electronic address: shimizum@staff.kanazawa-u.ac.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Department of Pediatric Rheumatology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Nakagishi
authors.affiliation: Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8641, Japan.
authors.forename: Natsumi
authors.initials: N
authors.lastname: Inoue
authors.affiliation: Department of Pediatric Rheumatology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan.
authors.forename: Mao
authors.initials: M
authors.lastname: Mizuta
authors.affiliation: Department of Pediatrics, School of Medicine, Kanazawa Medical University, Uchinada, Japan.
authors.forename: Giyo
authors.initials: G
authors.lastname: Ko
authors.affiliation: Department of Pediatrics, School of Medicine, Kanazawa Medical University, Uchinada, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Saikawa
authors.affiliation: Department of Pediatrics, School of Medicine, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kubota
authors.affiliation: Department of Pediatrics, School of Medicine, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamasaki
authors.affiliation: Department of Pediatrics, School of Medicine, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.
authors.forename: Syuji
authors.initials: S
authors.lastname: Takei
authors.affiliation: Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8641, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yachie
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000276:immunology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D020382:Interleukin-18 / Q000276:immunology*; D015850:Interleukin-6 / Q000276:immunology*; D008137:Longitudinal Studies; D055501:Macrophage Activation Syndrome / Q000276:immunology*; D008297:Male; D011379:Prognosis
chemical_list: C508600:IL6 protein, human; D020382:Interleukin-18; D015850:Interleukin-6
keywords: Interleukin-18 (IL-18); Prediction of macrophage activation syndrome; Systemic juvenile idiopathic arthritis