Serum levels of selected cytokines [interleukin (IL)-17A, IL-18, IL-23] and chemokines (RANTES, IP10) in the acute phase of immunoglobulin A vasculitis in children.

The pathogenesis of the immunoglobulin A vasculitis (IgAV) is still unknown. The available data shows that interleukin (IL)-17, IL-18, IL-23, regulated on activation, normal T cell expressed and secreted (CCL 5, RANTES), and interferon (IFN)-γ-inducible protein 10 (IP10) participate in the pathogenesis of IgAV by influencing the recruitment of leukocytes to the site of inflammation. The aim of this study was to analyze the serum concentration of IL-17A, IL-18, IL-23, RANTES, and IP10 in patients with acute IgAV compared to healthy children. Moreover, we wanted to assess the suitability of the levels of tested cytokines to predict the severity of the disease. All children with IgAV hospitalized in our institution between 2012 and 2017 were included in the study. Cytokines levels were determined in a serum sample secured at admission to the hospital. Basic laboratory tests have also been analyzed. IL-17A, IL-18, and IL-23 were significantly higher in whole IgAV group (52.25 pg/ml; 164.1 pg/ml and 700 pg/ml, respectively) than in the control group (27.92 pg/ml; 140.1 pg/ml and 581.5 pg/ml, respectively). The receiver operating characteristic (ROC) curve analysis revealed the largest area under the curve (AUC 0.979, p < 0.001) for the IL-17A with 95.1% sensitivity and 91.7% specificity. There were no significant differences in cytokine levels depending on the severity of the IgAV. Although the serum levels of the IL-17A, IL-18, and IL-23 increase significantly in the acute phase of the IgAV, they cannot be used as indicators of predicting the course of the disease. IL-17A seems to be a good predictor of IgAV occurrences.

[The new adipokine zinc-α2-glycoprotein (ZAG) as a link between adipose tissue and kidney? [Czy nowa adipocytokina cynkowa α2-glikoproteina (ZAG) stanowi ogniwo miedzy tkanka tluszczowa a nerkami?]].

Adipose tissue is currently considered not only as an energy store but also as an organ of internal secretion. Numerous adipocytokines regulating a number of human body processes are important in many disease processes, including chronic kidney disease (CKD). Nowadays, the role of zinc α2-glycoprotein (ZAG) is being sought as a potential link between these two organs. ZAG, through its lipolytic effect, contributes to progressive malnutrition in patients undergoing dialysis, and this significantly increases their mortality. It seems that ZAG may be a new potential biomarker of kidney damage, and the specific pharmacotherapy will significantly reduce the progressive process of cachexia.

Analysis of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and mean platelet volume to platelet count ratio in children with acute stage of immunoglobulin A vasculitis and assessment of their suitability for predicting the course of the disease.

Immunoglobulin A vasculitis (IgAV) is the most common systemic vasculitis in developmental age. The disease is most often characterized by a self-limiting course and good prognosis, but sometimes serious complications, like gastrointestinal bleeding or glomerulonephritis, may develop. The neutrophil to lymphocyte (NLR) and the platelet to lymphocyte (PLR) ratios are indicators related to clinical outcome in various inflammatory diseases. The mean platelet volume to platelet count ratio (MPR) has not been evaluated in patients with IgAV. The aim of this study was to analyze the values of the NLR, PLR and MPR in patients with an acute stage of IgAV compared to healthy children and to assess their suitability for predicting the severity of the disease. All children with IgAV hospitalized in our institution between 2012 and 2017 were reviewed retrospectively. The selected laboratory data were recorded before starting the treatment; these results allowed for NLR, PLR, and MPR calculation. The study involved 71 IgAV children. 57.7% of patients revealed signs of systemic involvement (including GT bleeding and/or glomerulonephritis) and 42.3% were nonsystemic (presenting skin and joint symptoms). 83% of patients were classified as mild and 17% as severe course of the disease. The NLR and the PLR were significantly higher in all IgAV children and in the systemic involvement group in comparison with non-systemic. The MPR was significantly lower in all IgAV group with the exception of children without systemic involvement. The NLR is a more valuable indicator than the PLR to identify patients at higher risk of systemic involvement in the course of IgAV. Clinical usefulness of the MPR requires further research.