Insight into inflammatory cell and cytokine profiles in adult IgA vasculitis

Immunoglobulin A vasculitis (IgAV) is an immune complex, small vessel vasculitis with dominant IgA deposits in vessel walls, predominantly affecting the pediatric population. However, adults frequently have more severe gastrointestinal tract (GIT) and renal involvements as compared to children. Our...

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Bibliographic Details
Published in:Clinical rheumatology 2019-02, Vol.38 (2), p.331-338
Main Authors: Kuret, T., Lakota, K., Žigon, P., Ogrič, M., Sodin-Šemrl, Snezna, Čučnik, S., Tomšič, M., Hočevar, A.
Format: Article
Language:English
Subjects:
Amyloid
Blood donors
CD11b antigen
Children
Flow cytometry
Gastrointestinal tract
Immunoglobulin A
Inflammation
Interleukin 10
Interleukin 2
Interleukin 23
Interleukin 6
Interleukin 8
Interleukin 9
L-selectin
Leukocytes (neutrophilic)
Lymphocytes
Medicine
Medicine & Public Health
Monocytes
Neutrophils
Original Article
Rheumatology
Rheumatology in Slovenia: Clinical practice and translational research
Serum levels
Tumor necrosis factor-α
Vasculitis
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Summary:Immunoglobulin A vasculitis (IgAV) is an immune complex, small vessel vasculitis with dominant IgA deposits in vessel walls, predominantly affecting the pediatric population. However, adults frequently have more severe gastrointestinal tract (GIT) and renal involvements as compared to children. Our aim was to study serological and cellular biomarkers to support clinicians in their diagnosis and the course of IgAV in adult patients. This cross-sectional study included 62 adult IgAV patients and 53 healthy blood donors (HBDs). Demographic and clinical data, as well as routine laboratory tests, were meticulously analyzed. Serum levels of IL-1β, IL-2, IL-6, IL-8, IL-9, IL-10, IL-17A, IL-23, TNF-α and serum amyloid A (SAA) were measured. Percentages of neutrophils, lymphocytes, and monocytes with neutrophil expression of L-selectin and integrin αM were determined by flow cytometry. SAA (12-fold), IL-6 (3-fold), IL-8 (2-fold), and TNF-α (2-fold) were significantly elevated in sera of adult IgAV patients compared to HBDs. There was a 16% elevation in neutrophils in IgAV patients, with IgAV neutrophils showing significantly higher CD62L surface expression. IgAV patients with GIT involvement exhibited elevated numbers of leukocytes, neutrophils, and neutrophil/lymphocyte (NLR), but lower neutrophil CD11b expression, as compared to IgAV patients without GIT. IgAV patients exhibit a low–medium grade inflammatory, neutrophil-driven response. Patients with GIT can be distinguished by their elevated NLR.
ISSN:0770-3198
1434-9949
DOI:10.1007/s10067-018-4234-8