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Vol. 19. Issue 9.
Pages 478-481 (November 2023)
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Vol. 19. Issue 9.
Pages 478-481 (November 2023)
Original article
Increased circulating interleukin-23 level in patients with sarcoidosis
Incremento del nivel circulante de interleucina 23 en los pacientes con sarcoidosis
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Senol Kobaka,
Corresponding author
senolkobak@yahoo.com

Corresponding author.
, Huseyin Semizb, Muhittin Akyildizc, Ayse Gokdumanc, Tennur Atabayc, Huseyin Vuralc
a Istinye University Faculty of Medicine, Department of Internal Medicine and Rheumatology, WASOG Sarcoidosis Clinic, Turkey
b Ege University Faculty of Medicine, Department of Internal Medicine, Turkey
c Sifa University Faculty of Medicine, Department of Biochemistry, Turkey
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Tables (3)
Table 1. Demographic, clinical and laboratory features of patients with sarcoidosis and healthy control group.
Table 2. Mean serum IL-6, IL-12, IL-17 and IL-23 levels in patients with sarcoidosis and control group.
Table 3. Correlation between serum IL-23 with clinical findings in patients with sarcoidosis.
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Abstract
Background

Sarcoidosis is a Th1-mediated chronic inflammatory disease characterized by non-caseating granulomas. Its pathogenesis is not yet clear, but the possible role of various proinflammatory cytokines is being discussed.

Aim

This study aims to determine serum cytokine (IL-6, IL-12, IL-17, and IL-23) levels in patients with sarcoidosis, and to determine a possible correlation with clinical and laboratory findings of the disease.

Material and method

Forty-four biopsy-proven sarcoidosis patients followed up at a single centre and 41 healthy volunteers were included in the study. Demographic, clinical, laboratory, and radiological data of all patients were recorded. Serum samples from the patients and the control group were taken and IL-6, IL-12, IL-17, IL-23 were measured by ELISA method.

Results

Of the 44 sarcoidosis patients, 13(29.5%) were male and 31(70.5%) were female. Average patient age was 47.4 years, mean disease duration was 3.2 years. Twenty-one (47.7%) patients had erythema nodosum, three (6.8%) had uveitis, 40(90.9%) had arthralgia, 23(52.3%) had ankle arthritis, 15(34.1%) had enthesitis. Laboratory evaluation showed increased serum ACE levels in 24(54.5%) patients, increased serum calcium levels in 11 (25%) patients, increased serum D3 levels in 5(11.4%) patients, increased ESR and CRP levels in 22(50%) and 23(52.3%) patients, respectively. Compared with the control group higher serum IL-23 levels were found in the patients with sarcoidosis (p=.01). Serum IL-23 was associated with ankle arthritis (p=.02). Serum IL-6, IL-12, and IL-17 levels were similar in the sarcoidosis patients and the control group (p=.128, p=.212, p=.521 respectively).

Conclusion

In our study, we found increased serum IL-23 in patients with sarcoidosis, while serum IL-6, IL-12, and IL-17 were detected as normal. Although our results are somewhat contradictory to other studies in the literature, the question should still be whether sarcoidosis is a Th1/Th17 disease. Multicentre studies are needed in this regard.

Keywords:
Sarcoidosis
Serum cytokines
Increased IL-23 level
Resumen
Antecedentes

La sarcoidosis es una enfermedad inflamatoria crónica mediada por Th1, caracterizada por granulomas no caseificantes. Su patogenia no está clara todavía, aunque se está debatiendo el posible rol de las diversas citocinas proinflamatorias.

Objetivo

El objetivo de este estudio es determinar los niveles de citocinas séricas (IL-6, IL-12, IL-17 e IL-23) en los pacientes con sarcoidosis, así como establecer una posible correlación con los hallazgos clínicos y de laboratorio de la enfermedad.

Material y método

Se incluyó en el estudio a 44 pacientes con sarcoidosis verificada mediante biopsia, cuyo seguimiento se realizó en un único centro, y 41 voluntarios sanos. Se registraron los datos demográficos, clínicos, de laboratorio y radiológicos de todos los pacientes. Se tomaron muestras séricas de los pacientes y el grupo control, midiéndose los niveles de IL-6, IL-12, IL-17 e IL-23 mediante el método ELISA.

Resultados

De los 44 pacientes con sarcoidosis, 13 (29,5%) fueron varones y 31 (70,5%) fueron mujeres. La edad media de los pacientes fue de 47,4 años, y la duración media de la enfermedad fue de 3,2 años. Veintiún (47,7%) pacientes tenían eritema nudoso, 3 (6,8%) tenían uveítis, 40 (90,9%) tenían artralgia, 23 (52,3%) tenían artritis de tobillo y 15 (34,1%) tenían entesitis. La evaluación de las pruebas de laboratorio reflejó un incremento de los niveles séricos de ECA en 24 (54,5%) pacientes, de los niveles séricos de calcio en 11 (25%) pacientes, de los niveles séricos de D3 en 5 (11,4%) pacientes y de los niveles de ESR y PCR en 22 (50%) y 23 (52,3%) pacientes, respectivamente. En comparación con el grupo control, se encontraron niveles séricos de IL-23 más elevados en los pacientes con sarcoidosis (p=0,01). Los niveles séricos de IL-23 estuvieron asociados a artritis de tobillo (p=0,02). Los niveles séricos de IL-6, IL-12 e IL-17 fueron similares en los pacientes con sarcoidosis y en los sujetos del grupo control (p=0,128, p=0,212 y p=0,521, respectivamente).

Conclusión

En nuestro estudio encontramos un incremento de los niveles séricos de IL-23 en los pacientes con sarcoidosis, mientras que se detectaron niveles normales de IL-6, IL-12 e IL-17. Aunque nuestros resultados son ligeramente contradictorios con respecto a otros estudios de la literatura, persistiría la cuestión de si la sarcoidosis es una enfermedad de Th1/Th17. Son necesarios estudios multicéntricos a este respecto.

Palabras clave:
Sarcoidosis
Citocinas séricas
Incremento del nivel de IL-23

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