Baseline IL-2 and the AIH score can predict the response to standard therapy in paediatric autoimmune hepatitis

被引:17
|
作者
Diestelhorst, Jana [1 ,2 ]
Junge, Norman [2 ]
Jonigk, Danny [3 ]
Schlue, Jerome [3 ]
Falk, Christine S. [4 ]
Manns, Michael P. [1 ]
Baumann, Ulrich [2 ]
Jaeckel, Elmar [1 ,5 ]
Taubert, Richard [1 ,5 ]
机构
[1] Hannover Med Sch, Dept Gastroenterol Hepatol & Endocrinol, Hannover, Germany
[2] Hannover Med Sch, Dept Paediat Kidney Liver & Metab Dis, Pediat Gastroenterol & Hepatol, Hannover, Germany
[3] Hannover Med Sch, Inst Pathol, Hannover, Germany
[4] Hannover Med Sch, Inst Transplant Immunol, Integrated Res & Treatment Ctr Transplantat IFB Tx, Hannover, Germany
[5] Hannover Med Sch, Integrated Res & Treatment Ctr Transplantat IFB Tx, Hannover, Germany
来源
SCIENTIFIC REPORTS | 2018年 / 8卷
关键词
REGULATORY T-CELLS; LOW-DOSE INTERLEUKIN-2; CORTICOSTEROID-THERAPY; REMISSION; CHILDREN; DIAGNOSIS; FERRITIN; BUDESONIDE; PREDNISONE; CRITERIA;
D O I
10.1038/s41598-017-18818-5
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Although autoimmune hepatitis (AIH) can be treated with corticosteroid-based first-line therapy, incomplete remission is associated with progressive liver fibrosis. So far accepted predictors of the subsequent treatment response of AIH patients are lacking. Therefore, we analysed baseline parameters, including iron homeostasis and cytokine levels, in 60 children with paediatric AIH (pAIH). In contrast to adults, elevated serum markers indicating iron overload were not commonly found in children. Therefore, ferritin was not predictive of the treatment response in pAIH. Although baseline immunoglobulins were lower in pAIH children with subsequent complete biochemical remission (BR) upon standard first-line therapy, only lower AIH scores (<= 16 points) could predict BR upon standard therapy in our training and validation cohorts. Additionally, higher baseline IL-2 and MCP-1/CCL2 levels were associated with BR in a sub-cohort. A combined score of IL-2 level and a simplified AIH score predicted treatment response more precisely than both parameter alone in this sub-cohort. In conclusion, the baseline AIH score could be validated as a predictor of treatment response in pAIH. Additionally, low baseline IL-2 may help identify children who need salvage therapy. This could be important because the use of low-dose IL-2 therapies is being tested in various autoimmune diseases.
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页数:9
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