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Vidović Juras D, Ivković I, Hećimović A, Gjadrov Kuveždić K, Andabak Rogulj A, Lončar Brzak B, Brailo V, Škrinjar I, Špiljak B. Unusual parotid gland and sublingual mucosa swelling in a 48-year-old woman. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 138:339-345. [PMID: 38926043 DOI: 10.1016/j.oooo.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 05/12/2024] [Accepted: 05/17/2024] [Indexed: 06/28/2024]
Affiliation(s)
- Danica Vidović Juras
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia; Clinical Department of Oral Diseases, Dental Clinic, University Hospital Centre (UHC) Zagreb, Zagreb, Croatia
| | - Irena Ivković
- Department of Otorhinolaryngology-Head & Neck Surgery, UHC Zagreb, Zagreb, Croatia
| | - Ana Hećimović
- Clinic for Respiratory Diseases, UHC Zagreb, Zagreb, Croatia; University of Zagreb, School of Medicine, Zagreb, Croatia
| | | | - Ana Andabak Rogulj
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia; Clinical Department of Oral Diseases, Dental Clinic, University Hospital Centre (UHC) Zagreb, Zagreb, Croatia
| | - Božana Lončar Brzak
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Vlaho Brailo
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia; Clinical Department of Oral Diseases, Dental Clinic, University Hospital Centre (UHC) Zagreb, Zagreb, Croatia
| | - Ivana Škrinjar
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia; Clinical Department of Oral Diseases, Dental Clinic, University Hospital Centre (UHC) Zagreb, Zagreb, Croatia
| | - Bruno Špiljak
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
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Della Zoppa M, Bertuccio FR, Campo I, Tousa F, Crescenzi M, Lettieri S, Mariani F, Corsico AG, Piloni D, Stella GM. Phenotypes and Serum Biomarkers in Sarcoidosis. Diagnostics (Basel) 2024; 14:709. [PMID: 38611622 PMCID: PMC11011731 DOI: 10.3390/diagnostics14070709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Sarcoidosis is a multisystem disease, which is diagnosed on a compatible clinical presentation, non-necrotizing granulomatous inflammation in one or more tissue samples, and exclusion of alternative causes of granulomatous disease. Considering its heterogeneity, numerous aspects of the disease remain to be elucidated. In this context, the identification and integration of biomarkers may hold significance in clinical practice, aiding in appropriate selection of patients for targeted clinical trials. This work aims to discuss and analyze how validated biomarkers are currently integrated in disease category definitions. Future studies are mandatory to unravel the diverse contributions of genetics, socioeconomic status, environmental exposures, and other sociodemographic variables to disease severity and phenotypic presentation. Furthermore, the implementation of transcriptomics, multidisciplinary approaches, and consideration of patients' perspectives, reporting innovative insights, could be pivotal for a better understanding of disease pathogenesis and the optimization of clinical assistance.
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Affiliation(s)
- Matteo Della Zoppa
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
| | - Francesco Rocco Bertuccio
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
| | - Ilaria Campo
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
| | - Fady Tousa
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
| | - Mariachiara Crescenzi
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
| | - Sara Lettieri
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
| | - Francesca Mariani
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
| | - Angelo Guido Corsico
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
| | - Davide Piloni
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
| | - Giulia Maria Stella
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
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Abstract
At present, no biomarker exists which is truly specific for sarcoidosis and the ones available have modest sensitivity and specificity. The clinical context should dictate the choice of biomarker(s) used to address different clinical questions such as diagnosis, monitoring disease activity or monitoring response to treatment. In the future, in addition to known serum biomarkers, it seems fruitful to further explore a possible role of imaging, exhaled air and even biopsy-related biomarkers in sarcoidosis to guide clinical management.
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Affiliation(s)
- Sophie C van der Mark
- Department of Pulmonology, ILD Center of Excellence, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands; Division of Heart and Lungs, University Medical Center, Utrecht, The Netherlands
| | - Vikaash W S Bajnath
- Department of Pulmonology, ILD Center of Excellence, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands
| | - Marcel Veltkamp
- Department of Pulmonology, ILD Center of Excellence, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands; Division of Heart and Lungs, University Medical Center, Utrecht, The Netherlands.
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Israël-Biet D, Bernardinello N, Pastré J, Tana C, Spagnolo P. High-Risk Sarcoidosis: A Focus on Pulmonary, Cardiac, Hepatic and Renal Advanced Diseases, as Well as on Calcium Metabolism Abnormalities. Diagnostics (Basel) 2024; 14:395. [PMID: 38396434 PMCID: PMC10887913 DOI: 10.3390/diagnostics14040395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Although sarcoidosis is generally regarded as a benign condition, approximately 20-30% of patients will develop a chronic and progressive disease. Advanced pulmonary fibrotic sarcoidosis and cardiac involvement are the main contributors to sarcoidosis morbidity and mortality, with failure of the liver and/or kidneys representing additional life-threatening situations. In this review, we discuss diagnosis and treatment of each of these complications and highlight how the integration of clinical, pathological and radiological features may help predict the development of such high-risk situations in sarcoid patients.
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Affiliation(s)
- Dominique Israël-Biet
- Service de Pneumologie et Soins Intensifs, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
| | - Nicol Bernardinello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy;
| | - Jean Pastré
- Service de Pneumologie et Soins Intensifs, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
| | - Claudio Tana
- Geriatrics Clinic, SS Annunziata University-Hospital of Chieti, 66100 Chieti, Italy
| | - Paolo Spagnolo
- Section of Respiratory Diseases, University of Padova, 35121 Padova, Italy
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Qin D, Fan LL, Zhong Y, Shen Y, Cheng D. Diagnostic accuracy of interleukin-2 receptor in sarcoidosis: a systematic review and meta-analysis. Expert Rev Respir Med 2023; 17:495-505. [PMID: 37334768 DOI: 10.1080/17476348.2023.2225772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 06/12/2023] [Indexed: 06/20/2023]
Abstract
INTRODUCTION Soluble interleukin-2 receptor (sIL-2 R), a valuable diagnostic biomarker for sarcoidosis, has been reported with variable results. Based on the literatures currently accessible, a systematic review and meta-analysis of the diagnostic performance of serum sIL-2 R for sarcoidosis were performed. METHODS Relevant studies investigating sIL-2 R for sarcoidosis diagnosis in several databases were searched and data on sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were pooled by STATA 16.0 software. Overall test performance was assessed using summary receiver operating characteristic curves and the area under the curve (AUC). Potential publication bias was assessed by Deeks test. RESULTS We included eleven studies involving 1,424 subjects, with 1,099 cases of sarcoidosis and 325 of non-sarcoidosis. The pooled parameters of sIL-2 R in diagnosing sarcoidosis were summarized as follows: sensitivity, 0.85 (95% CI: 0.72-0.93); specificity, 0.88 (95% CI: 0.72-0.96); PLR, 7.3 (95% CI: 2.7-20.1); NLR, 0.17 (95% CI:0.08-0.36); DOR, 44 (95% CI: 8-231); and the AUC, 0.93 (95% CI: 0.90-0.95). No publication bias was identified (P = 0.64). CONCLUSIONS Evidence suggests sIL-2 R performs well in diagnosing sarcoidosis. Nevertheless, results of sIL-2 R assay should be interpreted with other diagnostic examinations.
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Affiliation(s)
- Dan Qin
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Li-Li Fan
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Yuxia Zhong
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Yongchun Shen
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Deyun Cheng
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
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Hu X, Zou L, Wang S, Zeng T, Li P, Shen Y, Chen L. Performance of Serum Angiotensin-Converting Enzyme in Diagnosing Sarcoidosis and Predicting the Active Status of Sarcoidosis: A Meta-Analysis. Biomolecules 2022; 12:biom12101400. [PMID: 36291609 PMCID: PMC9599650 DOI: 10.3390/biom12101400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/23/2022] [Accepted: 09/28/2022] [Indexed: 11/16/2022] Open
Abstract
The usefulness of serum angiotensin-converting enzyme (sACE) for diagnosing sarcoidosis and determining the active status of sarcoidosis has been reported with varying outcomes. On the basis of the majority of published data, we conducted a meta-analysis to calculate the overall predictive accuracy of sACE in sarcoidosis disease and the active status of sarcoidosis. The inclusion of related research listed in Web of Science, PubMed, Scopus, and other literature databases was assessed. SROC curves were generated to characterize the overall test results after data on sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were combined. Publication bias was identified using Deeks’ funnel plot. Thirty-five publications with 8645 subjects met the inclusion criteria. The following are summary estimates of sACE diagnostic performance for sarcoidosis: sensitivity, 60% (95% confidence interval (CI), 52–68%); specificity, 93% (95% CI, 88–96%); PLR, 8.4 (95% CI, 5.3–13.3); NLR, 0.43 (95% CI, 0.36–0.52); and DOR, 19 (95% CI, 12–31). The area under the SROC curve (AUC) was 0.84 (95% CI, 0.80–0.87). Summary estimates for predicting the active status of sarcoidosis were as follows: sensitivity, 0.76 (95% CI, 0.61–0.87); specificity, 0.80 (95% CI, 0.64–0.90); PLR, 3.9 (95% CI, 2.1–7.3); NLR, 0.29 (95% CI, 0.17–0.49); and DOR, 13 (95% CI, 6–31). The AUC was 0.85 (95% CI, 0.82–0.88). There was no evidence of publication bias. Our meta-analysis suggests that measuring the sACE may assist in the diagnosis of sarcoidosis and predicting the active status of sarcoidosis, but the interpretation of the sACE results should be with caution. Future studies should validate our results.
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Affiliation(s)
- Xueru Hu
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China
| | - Li Zou
- Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Shuyan Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China
| | - Tingting Zeng
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China
| | - Ping Li
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China
| | - Yongchun Shen
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China
- Correspondence: (Y.S.); (L.C.); Tel.: +86-28-85422380 (Y.S. & L.C.); Fax: +86-28-85582944 (Y.S. & L.C.)
| | - Lei Chen
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China
- Correspondence: (Y.S.); (L.C.); Tel.: +86-28-85422380 (Y.S. & L.C.); Fax: +86-28-85582944 (Y.S. & L.C.)
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Abstract
PURPOSE OF REVIEW PET has emerged as method to determine the location and extent of disease activity in sarcoidosis. As most clinicians do not routinely utilize PET in the management of sarcoidosis, an understanding of the imaging technique is needed to comprehend the impact that PET abnormalities have on diagnosis, prognosis, and treatment. RECENT FINDINGS Although PET can detect inflammation because of sarcoidosis throughout the body, it is most often utilized for the diagnosis of cardiac sarcoidosis for which it may provide information about prognosis and adverse events. Whenever PET is combined with cardiac magnetic resonance (CMR), clinicians may be able to increase the diagnostic yield of imaging. Furthermore, PET abnormalities have the potential to be utilized in the reduction or augmentation of therapy based on an individual's response to treatment. Although various biomarkers are used to monitor disease activity in sarcoidosis, an established and reproducible relationship between PET and biomarkers does not exist. SUMMARY PET has the potential to improve the diagnosis of sarcoidosis and alter treatment decisions but prospective trials are needed to define the role of PET while also standardizing the performance and interpretation of the imaging modality.
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Affiliation(s)
- Robert J. Vender
- Department of Thoracic Medicine & Surgery at Temple University Hospital
| | - Hamad Aldahham
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Rohit Gupta
- Department of Thoracic Medicine & Surgery, Lewis Katz School of Medicine at Temple University
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Human Tissue Angiotensin Converting Enzyme (ACE) Activity Is Regulated by Genetic Polymorphisms, Posttranslational Modifications, Endogenous Inhibitors and Secretion in the Serum, Lungs and Heart. Cells 2021; 10:cells10071708. [PMID: 34359878 PMCID: PMC8305685 DOI: 10.3390/cells10071708] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/29/2021] [Accepted: 07/01/2021] [Indexed: 12/22/2022] Open
Abstract
Objective: Inhibitors of the angiotensin converting enzyme (ACE) are the primarily chosen drugs to treat heart failure and hypertension. Moreover, an imbalance in tissue ACE/ACE2 activity is implicated in COVID-19. In the present study, we tested the relationships between circulating and tissue (lung and heart) ACE levels in men. Methods: Serum, lung (n = 91) and heart (n = 72) tissue samples were collected from Caucasian patients undergoing lung surgery or heart transplantation. ACE I/D genotype, ACE concentration and ACE activity were determined from serum and tissue samples. Clinical parameters were also recorded. Results: A protocol for ACE extraction was developed for tissue ACE measurements. Extraction of tissue-localized ACE was optimal in a 0.3% Triton-X-100 containing buffer, resulting in 260 ± 12% higher ACE activity over detergent-free conditions. SDS or higher Triton-X-100 concentrations inhibited the ACE activity. Serum ACE concentration correlated with ACE I/D genotype (II: 166 ± 143 ng/mL, n = 19, ID: 198 ± 113 ng/mL, n = 44 and DD: 258 ± 109 ng/mL, n = 28, p < 0.05) as expected. In contrast, ACE expression levels in the lung tissue were approximately the same irrespective of the ACE I/D genotype (II: 1423 ± 1276 ng/mg, ID: 1040 ± 712 ng/mg and DD: 930 ± 1273 ng/mg, p > 0.05) in the same patients (values are in median ± IQR). Moreover, no correlations were found between circulating and lung tissue ACE concentrations and activities (Spearman’s p > 0.05). In contrast, a significant correlation was identified between ACE activities in serum and heart tissues (Spearman’s Rho = 0.32, p < 0.01). Finally, ACE activities in lung and the serum were endogenously inhibited to similar degrees (i.e., to 69 ± 1% and 53 ± 2%, respectively). Conclusion: Our data suggest that circulating ACE activity correlates with left ventricular ACE, but not with lung ACE in human. More specifically, ACE activity is tightly coordinated by genotype-dependent expression, endogenous inhibition and secretion mechanisms.
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Sorić Hosman I, Kos I, Lamot L. Serum Amyloid A in Inflammatory Rheumatic Diseases: A Compendious Review of a Renowned Biomarker. Front Immunol 2021; 11:631299. [PMID: 33679725 PMCID: PMC7933664 DOI: 10.3389/fimmu.2020.631299] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/31/2020] [Indexed: 12/13/2022] Open
Abstract
Serum amyloid A (SAA) is an acute phase protein with a significant importance for patients with inflammatory rheumatic diseases (IRD). The central role of SAA in pathogenesis of IRD has been confirmed by recent discoveries, including its involvement in the activation of the inflammasome cascade and recruitment of interleukin 17 producing T helper cells. Clinical utility of SAA in IRD was originally evaluated nearly half a century ago. From the first findings, it was clear that SAA could be used for evaluating disease severity and monitoring disease activity in patients with rheumatoid arthritis and secondary amyloidosis. However, cost-effective and more easily applicable markers, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), overwhelmed its use in clinical practice. In the light of emerging evidences, SAA has been discerned as a more sensitive biomarker in a wide spectrum of IRD, especially in case of subclinical inflammation. Furthermore, a growing number of studies are confirming the advantages of SAA over many other biomarkers in predicting and monitoring response to biological immunotherapy in IRD patients. Arising scientific discoveries regarding the role of SAA, as well as delineating SAA and its isoforms as the most sensitive biomarkers in various IRD by recently developing proteomic techniques are encouraging the revival of its clinical use. Finally, the most recent findings have shown that SAA is a biomarker of severe Coronavirus disease 2019 (COVID-19). The aim of this review is to discuss the SAA-involving immune system network with emphasis on mechanisms relevant for IRD, as well as usefulness of SAA as a biomarker in various IRD. Therefore, over a hundred original papers were collected through an extensive PubMed and Scopus databases search. These recently arising insights will hopefully lead to a better management of IRD patients and might even inspire the development of new therapeutic strategies with SAA as a target.
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Affiliation(s)
- Iva Sorić Hosman
- Department of Pediatrics, Zadar General Hospital, Zadar, Croatia
| | - Ivanka Kos
- Division of Nephrology, Dialysis and Transplantation, Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Lovro Lamot
- Division of Nephrology, Dialysis and Transplantation, Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia.,Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia
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Csongrádi A, Altorjay IT, Fülöp GÁ, Enyedi A, Enyedi EE, Hajnal P, Takács I, Tóth A, Papp Z, Fagyas M. Chitotriosidase gene polymorphisms and mutations limit the determination of chitotriosidase expression in sarcoidosis. Clin Chim Acta 2020; 513:50-56. [PMID: 33307063 DOI: 10.1016/j.cca.2020.11.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/12/2020] [Accepted: 11/27/2020] [Indexed: 12/20/2022]
Abstract
Serum chitotriosidase (CTO) activity was proposed as a biomarker in sarcoidosis being potentially useful in diagnostics. Nevertheless, a common duplication polymorphism (c.1049_1072dup24, Dup24) of the CTO gene influences CTO activity and thereby compromises its use in sarcoidosis. Here we aimed to substitute CTO activity with CTO concentration to prevent the confounding effect of Dup24. CTO activity, concentration and genetic backgrounds were determined in 80 histopathology proven sarcoidosis patients and 133 healthy individuals. CTO activities were lower in healthy individuals and sarcoidosis patients heterozygous for Dup24 mutation (472 ± 367 mU/L, n = 49; 2300 ± 2105 mU/L, n = 29) than in homozygous wild types (838 ± 856 mU/L, n = 81; 5125 ± 4802 mU/L, n = 48; p < 0.001, respectively). Sera of Dup24 homozygous individuals had no CTO activity. CTO concentrations were also lower in healthy individuals and sarcoidosis patients heterozygous for Dup24 mutation (7.2 ± 1.9 µg/L, n = 11; 63.16 ± 56.5 µg/L, n = 29) than in homozygous wild types (18.9 ± 13.0 µg/L, n = 36; 157.1 ± 132.4 µg/L, n = 47, p < 0.001, respectively) suggestive for an interaction between Dup24 mutation and CTO concentration determinations. We also identified a healthy Hungarian male subject without CTO activity carrying a rare mutation (c.(965_993)del), which mutation has been considered unique for Cypriot population to date. Taken together, CTO concentration determination does not add to the CTO activity measurement when CTO is used as a biomarker in sarcoidosis. Therefore, genotyping of CTO gene should be involved in the interpretation of laboratory findings.
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Affiliation(s)
- Alexandra Csongrádi
- Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, 22 Móricz Zsigmond str., H-4032 Debrecen, Hungary; University of Debrecen, Kálmán Laki Doctoral School of Biomedical and Clinical Sciences, Hungary
| | - István T Altorjay
- University of Debrecen, Kálmán Laki Doctoral School of Biomedical and Clinical Sciences, Hungary; Department of Cardiology, Faculty of Medicine, University of Debrecen, 22 Móricz Zsigmond str., H-4032 Debrecen, Hungary
| | - Gábor Á Fülöp
- Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, 22 Móricz Zsigmond str., H-4032 Debrecen, Hungary; University of Debrecen, Kálmán Laki Doctoral School of Biomedical and Clinical Sciences, Hungary
| | - Attila Enyedi
- Department of Surgery, Faculty of Medicine, University of Debrecen, 22 Móricz Zsigmond str., H-4032 Debrecen, Hungary; University of Debrecen, Doctoral School of Clinical Medicine, Hungary
| | - Enikő E Enyedi
- Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, 22 Móricz Zsigmond str., H-4032 Debrecen, Hungary
| | - Péter Hajnal
- Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, 22 Móricz Zsigmond str., H-4032 Debrecen, Hungary; University of Debrecen, Kálmán Laki Doctoral School of Biomedical and Clinical Sciences, Hungary
| | - István Takács
- Department of Surgery, Faculty of Medicine, University of Debrecen, 22 Móricz Zsigmond str., H-4032 Debrecen, Hungary
| | - Attila Tóth
- Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, 22 Móricz Zsigmond str., H-4032 Debrecen, Hungary; HAS-UD Vascular Biology and Myocardial Pathophysiology Research Group, Hungarian Academy of Sciences, Budapest, Hungary
| | - Zoltán Papp
- Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, 22 Móricz Zsigmond str., H-4032 Debrecen, Hungary; HAS-UD Vascular Biology and Myocardial Pathophysiology Research Group, Hungarian Academy of Sciences, Budapest, Hungary
| | - Miklós Fagyas
- Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, 22 Móricz Zsigmond str., H-4032 Debrecen, Hungary.
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Rao D, Fu M, Chen Y, Liu Q, Xiao L, Zhang X, Li Z, Li H, He Y, Chen Y, Chen J, Hu J, Huang Y. A combination of two ELISA tests for nasopharyngeal carcinoma screening in endemic areas based on a case-control study. PeerJ 2020; 8:e10254. [PMID: 33240616 PMCID: PMC7666820 DOI: 10.7717/peerj.10254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/06/2020] [Indexed: 11/20/2022] Open
Abstract
For populations with a high risk of nasopharyngeal carcinoma (NPC) in Guangdong province in southern China, mass screening is the first choice to prevent death from NPC. To improve the performance of NPC screening, we used a combination based on the IgA antibody against the Epstein-Barr virus (EBV) capsid antigen (VCA-IgA) and the IgA antibody against Epstein-Barr virus nuclear antigen 1 (EBNA1-IgA) to NPC screening by enzyme-linked immunosorbent assay (ELISA). A multiplication model was applied to measure the level of the combination. We evaluated the NPC screening effect of the markers.A case-control study was performed to assess the NPC screening effect of the markers. A total of 10,894 serum specimens were collected, including 554 samples from NPC patients and 10,340 samples from healthy controls. In the training stage, 640 subjects were randomly selected, including 320 NPC cases and 320 healthy controls. In the verification stage, 10,254 subjects were used to verify the NPC screening effect of the combination. Receiver operating characteristic (ROC) analysis was performed. In the verification stage, the combination achieved an sensitivity of 91.45%, a specificity of 93.45%, and an area under the ROC curve (AUC) of 0.978 (95% CI [0.968–0.987]). Compared with VCA-IgA and EBNA1-IgA individually, the combination had an improved screening performance. A probability (PROB) calculated by logistic regression model based on VCA-IgA and EBNA1-IgA was applied to NPC screening by ELISA in China. The AUC of the combination was a little bit larger than the PROB. There was a slight increase (3.13%) in the sensitivity of the combination compared to the sensitivity of the PROB, while the specificity was lower for the combination (92.50%) than for the PROB (95.94%). We successfully applied a combination of two ELISA tests based on VCA-IgA and EBNA1-IgA for NPC screening by using a multiplication model. The results suggested that the combination was effective and can be an option for NPC screening.
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Affiliation(s)
- Dongping Rao
- Department of Medical Records, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong, China
| | - Meiqin Fu
- Clinical Laboratory, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong, China
| | - Yingjie Chen
- Clinical Laboratory, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong, China
| | - Qing Liu
- Department of Preventive Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Lin Xiao
- Department of Radiotherapy, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong, China
| | - Xin Zhang
- Clinical Experimental Center, Jiangmen Key Laboratory of Clinical Biobanks and Translational Research, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong, China
| | - Zhongxiao Li
- Clinical Laboratory, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong, China
| | - Haitao Li
- Clinical Laboratory, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong, China
| | - Yongyi He
- Department of Medical Records, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong, China
| | - Yongxing Chen
- Department of Ear-Nose-Throat, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong, China
| | - Jieying Chen
- Clinical Laboratory, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong, China
| | - Jin Hu
- Clinical Laboratory, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong, China
| | - Yanming Huang
- Department of Respiratory Medicine, Clinical Experimental Center, Jiangmen Key Laboratory of Clinical Biobanks and Translational Research, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong, China
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Abstract
PURPOSE OF REVIEW Ocular sarcoidosis is one of the most common causes of uveitis worldwide. The diagnosis and treatment of patients with ocular sarcoidosis remains challenging in some cases. It is important for clinicians to keep up to date with new diagnostic and treatment tools for this disease. RECENT FINDINGS The International Workshop on Ocular Sarcoidosis diagnostic criteria were first proposed in 2009 and revised in 2017. The new criteria contained two parts: ocular presentation and systemic investigation. The diagnostic value of liver enzymes was reduced in the new criteria, whereas the value placed of lymphopenia and the CD4/CD8 ratio in bronchoalveolar lavage fluid were increased. Despite not being included in the criteria, recent studies have also highlighted the diagnostic value of serum soluble interleukin-2 receptors. Recent ophthalmologic imaging also provides useful insights for the differential diagnosis.Many new treatments for ocular sarcoidosis have been developed in recent years. The introduction of biological immunomodulatory agents for uveitis treatment represents a big improvement. Antitumor necrosis factor-alpha antibodies, including adalimumab, have been proven to be effective for treating ocular sarcoidosis. Many studies have also suggested that other biological agents could be effective and well tolerated. Newer intravitreal dexamethasone and fluocinolone implants have been developed. Patients treated with these implants have experienced good and sustained control of their intraocular inflammation. SUMMARY Diagnosis and treatment options for ocular sarcoidosis have changed over time. However, challenges still exist in some difficult patients. Future studies should focus on finding more sensitive biomarkers and developing more effective immunomodulatory treatments with longer efficacy and less side effects.
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Affiliation(s)
- De-Kuang Hwang
- Department of Ophthalmology, Taipei Veterans General Hospital, and National Yang-Ming University, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shwu-Jiuan Sheu
- Department of Ophthalmology, Kaohsiung Medical University Hospital
- Department of Ophthalmology, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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13
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Bergantini L, d'Alessandro M, Vietri L, Rana GD, Cameli P, Acerra S, Sestini P, Bargagli E. Utility of serological biomarker' panels for diagnostic accuracy of interstitial lung diseases. Immunol Res 2020; 68:414-421. [PMID: 33089426 PMCID: PMC7674352 DOI: 10.1007/s12026-020-09158-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/08/2020] [Indexed: 02/07/2023]
Abstract
Interstitial lung diseases (ILD) are a heterogeneous group of illnesses of known and unknown aetiology. Differential diagnosis among the three disorders is often challenging. Specific biomarkers with good sensitivity and specificity are therefore needed to predict clinical outcome and guide clinical decisions. The aim of this study was to investigate inflammatory/fibrotic biomarkers, to determine whether single mediators or panels of mediators could be useful to stratify patients into three distinct domains: sarcoidosis, idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis (cHP). A total of 163 ILD patients monitored at Siena Referral Centre for Sarcoidosis and other Interstitial Lung Diseases were enrolled in the study. Clinical data, pulmonary function tests and biochemical analytes were retrospectively collected. SAA levels were detected by ELISA kit and Krebs von den Lungen 6 (KL-6) were measured by CLEIA method, for sarcoidosis, cHP and IPF patients. Multiple comparison analysis showed significant differences in C reactive protein (CRP), white blood cell count (WBC) and creatinine levels between the three groups. In the logistic regression model, KL-6, CRP and WBC showed areas under curves (AUC) 0.86, for sarcoidosis diagnosis. The logistic regression model KL-6 and SAA showed the best performance with an AUC 0.81 for discriminating IPF than cHP and sarcoidosis. For differential diagnosis of IPF and cHP, KL-6 and SAA were considered in the logistic regression model, showed an AUC 0.79. The combination of serum biomarkers proposed here offers insights into the pathobiology of ILDs. These panels of bioindicators will improve diagnostic accuracy and will be useful in the clinical management of ILDs.
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Affiliation(s)
- Laura Bergantini
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Miriana d'Alessandro
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Lucia Vietri
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Giuseppe Domenico Rana
- Internal Medicine Unit, Department of Internal Medicine, Geriatrics and Rare Diseases Unit, Bari University, Bari, Italy
| | - Paolo Cameli
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Silvia Acerra
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Piersante Sestini
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Elena Bargagli
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
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14
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Kraaijvanger R, Janssen Bonás M, Vorselaars ADM, Veltkamp M. Biomarkers in the Diagnosis and Prognosis of Sarcoidosis: Current Use and Future Prospects. Front Immunol 2020; 11:1443. [PMID: 32760396 PMCID: PMC7372102 DOI: 10.3389/fimmu.2020.01443] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 06/03/2020] [Indexed: 12/15/2022] Open
Abstract
Sarcoidosis is a heterogeneous disease in terms of presentation, duration, and severity. Due to this heterogeneity, it is difficult to align treatment decisions. Biomarkers have proved to be useful for the diagnosis and prognosis of many diseases, and over the years, many biomarkers have been proposed to facilitate diagnosis, prognosis, and treatment decisions. Unfortunately, the ideal biomarker for sarcoidosis has not yet been discovered. The most commonly used biomarkers are serum and bronchoalveolar lavage biomarkers, but these lack the necessary specificity and sensitivity. In sarcoidosis, therefore, a combination of these biomarkers is often used to establish a proper diagnosis or detect possible progression. Other potential biomarkers include imaging tools and cell signaling pathways. Fluor-18-deoxyglucose positron emission tomography and high-resolution computed tomography have been proven to be more sensitive for the diagnosis and prognosis of both pulmonary and cardiac sarcoidosis than the serum biomarkers ACE and sIL-2R. There is an upcoming role for exploration of signaling pathways in sarcoidosis pathogenesis. The JAK/STAT and mTOR pathways in particular have been investigated because of their role in granuloma formation. The activation of these signaling pathways also proved to be a specific biomarker for the prognosis of sarcoidosis. Furthermore, both imaging and cell signaling biomarkers also enable patients who might benefit from a particular type of treatment to be distinguished from those who will not. In conclusion, the diagnostic and prognostic path of sarcoidosis involves many different types of existing and new biomarker. Research addressing biomarkers and disease pathology is ongoing in order to find the ideal sensitive and specific biomarker for this disease.
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Affiliation(s)
- Raisa Kraaijvanger
- Department of Pulmonology, ILD Center of Excellence, St. Antonius Hospital, Nieuwegein, Netherlands
| | - Montse Janssen Bonás
- Department of Pulmonology, ILD Center of Excellence, St. Antonius Hospital, Nieuwegein, Netherlands
| | - Adriane D. M. Vorselaars
- Department of Pulmonology, ILD Center of Excellence, St. Antonius Hospital, Nieuwegein, Netherlands
| | - Marcel Veltkamp
- Department of Pulmonology, ILD Center of Excellence, St. Antonius Hospital, Nieuwegein, Netherlands
- Department of Pulmonology, University Medical Center, Utrecht, Netherlands
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15
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Schimmelpennink MC, Quanjel M, Vorselaars ADM, Wiertz I, Veltkamp M, Van Moorsel CHM, Grutters JC. Value of serum soluble interleukin-2 receptor as a diagnostic and predictive biomarker in sarcoidosis. Expert Rev Respir Med 2020; 14:749-756. [DOI: 10.1080/17476348.2020.1751614] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- MC Schimmelpennink
- ILD Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, the Netherlands
| | - M Quanjel
- ILD Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, the Netherlands
| | - ADM Vorselaars
- ILD Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, the Netherlands
| | - I Wiertz
- ILD Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, the Netherlands
| | - M Veltkamp
- ILD Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, the Netherlands
- Division of Heart and Lungs, University Medical Centre, Utrecht, the Netherlands
| | - CHM Van Moorsel
- ILD Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, the Netherlands
- Division of Heart and Lungs, University Medical Centre, Utrecht, the Netherlands
| | - JC Grutters
- ILD Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, the Netherlands
- Division of Heart and Lungs, University Medical Centre, Utrecht, the Netherlands
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