Cytokine clusters as potential diagnostic markers of disease activity and renal involvement in systemic lupus erythematosus
JOURNAL OF INTERNATIONAL MEDICAL RESEARCH
Authors: Park, Joonhong; Jang, Woori; Park, Hye Sun; Park, Ki Hyun; Kwok, Seung-Ki; Park, Sung-Hwan; Oh, Eun-Jee
Abstract
Objective To describe interactions among cytokines and to identify subgroups of systemic lupus erythematosus (SLE) patients based on cytokine levels using principal component analysis and cluster analysis. Methods Levels of 12 cytokines were measured using sensitive multiplex bead assays and associations with SLE features including disease activity and renal involvement were assessed. Results In a group of 203 SLE patients, strong correlations were observed between interleukin (IL)6 and interferon (IFN)gamma levels (r = 0.624), IL17 and IFN gamma levels (r = 0.768), and macrophage inflammatory protein (MIP)1 alpha and MIP1 beta levels (r = 0.675). Cluster analysis revealed two distinct patient groups characterized by high levels of IL8, MIP1 alpha, and MIP1 beta (group 1) or of IL2, IL6, IL10, IL12, IFN gamma, and tumor necrosis factor alpha (group 2). Active disease was more common in group 1 (49/88, 55.7%) than in group 2 (40/115, 34.8%). More patients in group 2 had renal involvement (42/115, 36.5%) than in group 1 (22/88, 25%). Conclusions Assessment of cytokine profiles can identify distinct SLE patient subgroups and aid in understanding clinical heterogeneity and immunological phenotypes.
IL2RG hypomorphic mutation: identification of a novel pathogenic mutation in exon 8 and a review of the literature
ALLERGY ASTHMA AND CLINICAL IMMUNOLOGY
Authors: Lim, Che Kang; Abolhassani, Hassan; Appelberg, Sofia K.; Sundin, Mikael; Hammarstrom, Lennart
Abstract
BackgroundAtypicalX-linked severe combined immunodeficiency (X-SCID) is a variant of cellular immunodeficiency due to hypomorphic mutations in the interleukin 2 receptor gamma (IL2RG) gene. Due to a leaky clinical phenotype, diagnosis and appropriate treatment are challenging in these patients.Case presentationWe report a 16-year-old patient with a T-low B+ NK+ cellular immunodeficiency due to a novel nonsense mutation in exon 8 (p.R328X) of the IL2RG gene. Functional impairment of the IL2RG was confirmed by IL2-Janus kinase 3-signal transducer and activator of transcription signaling pathway investigation. In addition, the characteristics of the mutations previously described in 39 patients with an atypical phenotype were reviewed and analyzed from the literature.ConclusionThis is the first report of an atypical X-SCID phenotype due to an exon 8 mutation in the IL2RG gene. The variability in the phenotypic spectrum of classic X-SCID associated gene highlights the necessity of multi-disciplinary cooperation vigilance for a more accurate diagnostic workup.