Markedly increased IL-18 liver expression in adult-onset Still's disease-related hepatitis

Priori, R., Barone, F., Alessandri, C., Colafrancesco, S., McInnes, I. B. , Pitzalis, C., Valesini, G. and Bombardieri, M. (2011) Markedly increased IL-18 liver expression in adult-onset Still's disease-related hepatitis. Rheumatology, 50(4), pp. 776-780. (doi: 10.1093/rheumatology/keq397) (PMID:21149398)

Abstract

Objectives. First, to investigate the prevalence of liver involvement in adult-onset Still’s disease (AOSD) Italian patients; secondly, to measure serum IL-18 concentration and correlate its level to other inflammatory markers and disease activity; and thirdly to characterize the expression level and the cellular source of IL-18 in the liver of a patient with AOSD with hepatitis. Methods. The clinical charts of 41 consecutive Italian AOSD patients were evaluated with special attention to liver involvement. Serum levels of IL-18 were measured in 21 patients. Finally, the case of a 33-year-old woman with hepatitis where a liver biopsy was obtained and sections stained with antibodies against IL-18 and CD68 is described in detail. Results. Of the 41 AOSD patients, 32 and 39% displayed increased AST level or ALT level, respectively, generally normalizing with steroid treatment, while 41% had evidence of hepatosplenomegaly. Circulating IL-18 levels were significantly higher in those with active disease compared with 85 controls. A correlation was observed between IL-18 serum level and disease activity, serum ferritin level and neutrophil count. IL-18 concentration was markedly increased in the patient with active hepatitis. Intense IL-18 expression was detected within the liver parenchyma and double staining with IL-18 and CD68 clearly showed colocalization of the cytokine with the macrophage marker. Conclusion. Macrophage-derived IL-18 might play a central role in the pathogenesis of AOSD. IL-18 serum level is higher in patients with active AOSD and its local, rather than systemic, expression may be responsible for tissue damage in some target organs, such as liver.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McInnes, Professor Iain
• Authors: Priori, R., Barone, F., Alessandri, C., Colafrancesco, S., McInnes, I. B., Pitzalis, C., Valesini, G., and Bombardieri, M.
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Journal Name: Rheumatology
• Publisher: Oxford University Press
• ISSN: 1462-0324
• ISSN (Online): 1462-0332