Original Articles
Vol. 11 No. 1 (2019): Review Articles, Original Articles, Scientific Letters, Case Reports, Letters to Editor.
https://doi.org/10.4084/mjhid.2019.008

SOLUBLE ST2 AND CD163 AS POTENTIALBIOMARKERS TO DIFFERENTIATE PRIMARY HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS FROM MACROPHAGE ACTIVATION SYNDROME

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Received: August 7, 2018
Accepted: November 26, 2018
Published: January 1, 2019
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Authors

Zhuo Gao
Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China, China.
Yini Wang
Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China, .
Jingshi Wang
Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China, .
Jia Zhang
Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China, .
Zhao Wang
wangzhao@ccmu.edu.cn
Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China, .

Abstract

Background and Objective: The differentiation of primary haemophagocytic lymphohistiocytosis (pHLH) and macrophage activation syndrome (MAS) poses a challenge to hematologists. The aim of this study was (1) to compare the levels of soluble ST2 (sST2), sCD163, IL-10, IFN-?, TNF-? and IL-18 in patients with pHLH and MAS and (2) to investigate whether they can help differentiate the two diseases.

Methods: A total of 54 participants were recruited in this study, including 12 pHLH patients, 22 MAS patients and 20 healthy subjects. We measured the levels of sST2 and sCD163 in serum by ELISA. The serum levels of IL-10, IFN-?, TNF-? and IL-18 were detected using a Luminex 200 instrument.

Results: The serum levels of sST2 and sCD163 in MAS patients were markedly higher than that in pHLH patients (363.13 ± 307.24 ng/ml vs 80.75 ± 87.04 ng/ml, P = 0.004; 3532.72 ± 2479.68 ng/ml vs 1731.96 ± 1262.07 ng/ml, P = 0.046). There was no significant difference in the expression of IFN-? (306.89 ± 281.60 pg/ml vs 562.43 ± 399.86 pg/ml), IL-10 (20.40 ± 30.49 pg/ml vs 8.3 ± 13.14 pg/ml), IL-18 (463.33 ± 597.04 pg/ml vs 1247.82 ± 1318.58 pg/ml) and TNF-? (61.48 ± 84.69 pg/ml vs 106.10 ±77.21 pg/ml) between pHLH and MAS.

Conclusion: Patients with pHLH and MAS show some differences in cytokine profiles. The elevated levels of IFN-?, IL-10, IL-18 and TNF-? can contribute to the diagnosis of HLH, but may not discriminate pHLH from MAS. Levels of sST2 and sCD163 may serve as markers to distinguish pHLH from MAS.

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“SOLUBLE ST2 AND CD163 AS POTENTIALBIOMARKERS TO DIFFERENTIATE PRIMARY HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS FROM MACROPHAGE ACTIVATION SYNDROME” (2019) Mediterranean Journal of Hematology and Infectious Diseases, 11(1), p. e2019008. doi:10.4084/mjhid.2019.008.