J Korean Med Sci.  2013 Aug;28(8):1145-1153. 10.3346/jkms.2013.28.8.1145.

Serum Level of Interleukin-33 and Soluble ST2 and Their Association with Disease Activity in Patients with Behcet's Disease

• Kim DJ
• Baek SY
• Park MK
• Park KS
• Lee JH
• Park SH
• Kim HY
• Kwok SK

• KMID: 1793018
• DOI: http://doi.org/10.3346/jkms.2013.28.8.1145

Abstract

Interleukin (IL)-33 is an important mediator of innate immunity. Behcet's disease (BD) is an autoinflammatory disorder characterized by hyperactivity of the innate immune response. We measured serum levels of IL-33 and its receptor soluble ST2 (sST2) in patients with BD to investigate their association with disease activity. Serum levels of both IL-33 and sST2 were higher in patients with BD compared with those in normal controls (IL-33: 594.48+/-175.04 pg/mL in BD and 224.23+/-56.64 pg/mL in normal controls [P=0.048], sST2: 99.01+/-15.92 pg/mL in BD and 23.56+/-3.25 pg/mL in normal controls [P<0.001]). IL-33 and sST2 expression in skin tissue, as shown by immunohistochemistry, was higher in patients with BD compared with that in the normal controls. Serum sST2 level correlated significantly with the BD currently active form (BDCAF), Iranian BD dynamic activity measure (IBDDAM), erythrocyte sedimentation rate and C-reactive protein. Multiple linear regression showed that serum sST2 was an independent factor associated with IBBDAM (regression coefficient, 0.374; P=0.004), and BDCAF (regression coefficient, 0.236; P=0.047). These results demonstrate that IL-33 and sST2 are highly expressed in patients with BD and that serum sST2 is an independent factor associated with IBDDAM and BDCAF, suggesting a potential role for sST2 as a surrogate marker of disease activity in patients with BD.

Keyword

Interleukin-33; soluble ST2; Behcet Syndrome

MeSH Terms

Adult
Behcet Syndrome/blood/*pathology
Blood Sedimentation
C-Reactive Protein/analysis
Female
Humans
Immunohistochemistry
Interleukins/*blood/metabolism
Male
Middle Aged
Receptors, Cell Surface/*blood/metabolism
Severity of Illness Index
Skin/metabolism/pathology
C-Reactive Protein
Interleukins
Receptors, Cell Surface

Figure

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  Fig. 1 Serum levels of interleukin (IL)-33 and receptor soluble ST2 (sST2) between patients with BD and NC. Serum levels of IL-33 and sST2 were significantly higher in patients with BD than those in the NC. BD, Behcet's disease; NC, Normal control.

• 

  Fig. 2 IL-33 and sST2 expression in the skin (dermis). (A, B) H&E stain. Septal panniculitis existed in the skin of patients with Behcet's disease (BD). (C-F) IHC stain. IL-33 and sST2 were highly expressed in the dermis of skin from patients with BD. H&E, hematoxylin & eosin; IHC, immunohistochemical.

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  Fig. 3 IL-33 and sST2 expression in the skin (epidermis). (A-D) IHC stain. IL-33 and sST2 were highly expressed in the epidermis of skin from patients with BD. IHC, immunohistochemical.

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  Fig. 4 Correlation between receptor soluble ST2 (sST2) and disease activity parameters in patients with Behcet's disease (BD). sST2 was correlated significantly with acute phase reactant (erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP]) (ESR: r=0.389, P=0.004; CRP: r=0.445, P=0.002). sST2 was correlated significantly with Behcet's disease activity score (BD currently active form [BDCAF] and Iranian BD dynamic activity measure [IBDDAM]) (BDCAF: r=0.453, P=0.001; IBDDAM: r=0.514, P<0.001).

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