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Ali AA, Yousef RN, Elsheikh MS, Salamah AR, Wu LL, Alnaggar AR, Khalil NM, Behiry ME. YKL-40 in serum: a promising biomarker of juvenile SLE and strongly correlated with disease duration. Ir J Med Sci 2024; 193:1403-1409. [PMID: 37874503 PMCID: PMC11128401 DOI: 10.1007/s11845-023-03545-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/03/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND The biological function of YKL-40 is not well determined in different inflammatory and autoimmune diseases; however, some data highlighted its possible connection with disease activity. AIM We investigated the diagnostic utility of serum YKL-40 in patients with SLE and examined its correlation with disease activity. Additionally, we examined any differences in serum YKL-40 levels between juvenile and adult SLE patients. METHODS We included 78 female patients with SLE and 42 controls. The level of YKL-40 in serum was measured by ELISA. RESULTS The serum YKL-40 level in SLE patients was significantly higher compared to the control group (9 (3) ng/mL vs. 5.5 (0.1) ng/mL; p < 0.001). YKL-40 showed excellent diagnostic utility with an AUC of 1 (p < 0.001) and a cutoff point of 5.6, providing sensitivity and specificity of 100%. YKL-40 was higher in adolescents and those with a positive family history of SLE (p = 0.01 for both) and positively correlated with disease duration (r = 0.45, p < 0.001). YKL-40 level was significantly higher in patients with photosensitivity, fever, vasculitis, blood disorders, positive anti-dsDNA, and APL ab (p < 0.05 for all). Conversely, patients with skin manifestations had a significantly lower YKL-40 (p = 0.004). In juvenile SLE, the AUC was 0.65 and a p-value of 0.01, and at a cutoff value of (8.7) ng/mL, the sensitivity and specificity were 72% and 60%, respectively. CONCLUSION YKL-40 in serum could be a promising biomarker in patients with SLE, especially in adolescent-onset cases. It is independently influenced by disease duration, anemia, thrombocytopenia, positive anti-dsDNA, and APL ab features.
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Affiliation(s)
- Asmaa A Ali
- Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, 212013, P. R., Zhenjiang, China
| | - Rasha N Yousef
- Department of Clinical and Chemical Pathology, Medical Research and Clinical Studies Institute, National Research Center, Giza, Egypt.
| | - Mai S Elsheikh
- Department of Complementary Medicine, Medical Research and Clinical Studies Institute, National Research Center, Giza, Egypt
| | - Abeer R Salamah
- Department of Molecular Genetics and Enzymology, Human Genetics and Genomic Research Institute, National Research Center, Giza, Egypt
| | - Liang L Wu
- Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, 212013, P. R., Zhenjiang, China
| | - Alshaimaa R Alnaggar
- Internal Medicine Department, Rheumatology and Clinical Immunology Unit, KasrAlainy School of Medicine, Cairo University, Cairo, Egypt
| | - Noha M Khalil
- Internal Medicine Department, Rheumatology and Clinical Immunology Unit, KasrAlainy School of Medicine, Cairo University, Cairo, Egypt
| | - Mervat E Behiry
- Internal Medicine Department, Rheumatology and Clinical Immunology Unit, KasrAlainy School of Medicine, Cairo University, Cairo, Egypt
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Noguchi K, Furukawa T, Tatsumi Y, Kasama S, Yoshikawa T, Hashimoto T, Azuma N, Hirota S, Kimura T, Matsui K. Involvement of YKL-40-positive macrophages commonly identified in polymyositis and dermatomyositis in the pathogenesis of myositis: a retrospective study. Immunol Med 2024; 47:37-44. [PMID: 37817562 DOI: 10.1080/25785826.2023.2264007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/23/2023] [Indexed: 10/12/2023] Open
Abstract
YKL-40 is implicated in inflammation and tissue repair, but no reports have investigated its involvement in myositis in polymyositis (PM) and dermatomyositis (DM). Therefore, we aimed to investigate the relationship between YKL-40 and PM/DM. We retrospectively enrolled 35 patients diagnosed with PM/DM along with 26 healthy controls (HCs). Both PM and DM were diagnosed according to Bohan and Peter's criteria. Serum YKL-40 levels were measured, age-corrected to YKL-40 percentile values, and compared to HCs. Patients with myositis without interstitial lung disease were also enrolled and compared to HCs. Immunofluorescence staining was performed to identify YKL-40-positive inflammatory cells in muscle biopsy samples from two patients each with PM and DM. Age-corrected serum YKL-40 levels were significantly higher in patients with PM/DM compared to HCs with and without lung disease; however, these levels decreased significantly after treatment. Immunohistochemical analysis showed infiltration of YKL-40-positive inflammatory cells into the intramuscular sheath and perimuscular membrane. Immunofluorescence staining showed CD68 expression in YKL-40-positive inflammatory cells, suggesting that these cells were macrophages. To the best of our knowledge, this is the first study to demonstrate that YKL-40-positive macrophages are present in PM and DM, indicating that YKL-40 may be involved in PM/DM.
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Affiliation(s)
- Kazuteru Noguchi
- Department of Diabetes Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Tetsuya Furukawa
- Department of Diabetes Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Yoshiki Tatsumi
- Department of Neurology, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Shuhei Kasama
- Department of Neurology, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Takahiro Yoshikawa
- Department of Diabetes Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Teppei Hashimoto
- Department of Diabetes Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Naoto Azuma
- Department of Diabetes Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Seiichi Hirota
- Department of Surgical Pathology, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Takashi Kimura
- Department of Neurology, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Kiyoshi Matsui
- Department of Diabetes Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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Vázquez-Del Mercado M, Pérez-Vázquez F, Márquez-Aguirre AL, Martínez-García EA, Chavarria-Avila E, Ramos-Becerra CG, Aguilar-Vázquez A, Godínez-Rubí M, Martín-Márquez BT, Gómez-Limón L, Márquez-De-La-Paz G, Rubio-Arellano ED, Pizano-Martinez O. YKL-40 serum levels are predicted by inflammatory state, age and diagnosis of idiopathic inflammatory myopathies. Sci Rep 2023; 13:19172. [PMID: 37932407 PMCID: PMC10628093 DOI: 10.1038/s41598-023-46491-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/01/2023] [Indexed: 11/08/2023] Open
Abstract
YKL-40 increase according to the aging process, and its functions have been associated with tissue remodeling and systemic inflammation. In Rheumatoid Arthritis (RA) it has been proposed as a possible biomarker of activity and severity, however; in the field of idiopathic inflammatory myopathies (IIM) the role of YKL-40 in IIM is not clear. Thus, we aimed to evaluate if there is an association between the serum levels and muscle tissue expression of YKL-40 with age, IIM phenotype, muscle strength and myositis disease activity. The main finding was that age is the most important variable that affects the YKL-40 serum levels. In muscle biopsy, we observed that YKL-40 is mainly expressed in infiltrating lymphoid cells than in muscle tissue. Using ANCOVA according to the b-coefficients, YKL-40 serum levels are predicted by inflammatory state, age, and IIM diagnosis.
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Affiliation(s)
- Mónica Vázquez-Del Mercado
- Departamento de Biología Molecular y Genómica, Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada No. 950, Puerta 7, Edificio P, Planta Baja. CP 44340, Colonia Independencia, Guadalajara, Jalisco, Mexico
- Servicio de Reumatología SNP 004086 CONAHCyT, División de Medicina Interna del Hospital Civil Dr. Juan I. Menchaca, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
- Cuerpo Académico Inmunología y Reumatología UDG-CA-703, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Felipe Pérez-Vázquez
- Departamento de Disciplinas Filosófico, Metodológicas e Instrumentales, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Ana L Márquez-Aguirre
- Unidad de Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco (CIATEJ), A.C., Guadalajara, Jalisco, Mexico
| | - Erika-Aurora Martínez-García
- Departamento de Biología Molecular y Genómica, Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada No. 950, Puerta 7, Edificio P, Planta Baja. CP 44340, Colonia Independencia, Guadalajara, Jalisco, Mexico
- Cuerpo Académico Inmunología y Reumatología UDG-CA-703, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Efrain Chavarria-Avila
- Departamento de Biología Molecular y Genómica, Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada No. 950, Puerta 7, Edificio P, Planta Baja. CP 44340, Colonia Independencia, Guadalajara, Jalisco, Mexico
- Departamento de Disciplinas Filosófico, Metodológicas e Instrumentales, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Carlos G Ramos-Becerra
- Laboratorio de Mecánica Vascular, Departamento de Fisiología, Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Andrea Aguilar-Vázquez
- Departamento de Biología Molecular y Genómica, Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada No. 950, Puerta 7, Edificio P, Planta Baja. CP 44340, Colonia Independencia, Guadalajara, Jalisco, Mexico
- Doctorado en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Marisol Godínez-Rubí
- Laboratorio de Patología Diagnóstica e Inmunohistoquímica, Centro de Investigación y Diagnóstico en Patología, Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
- Departamento de Morfología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Beatriz-Teresita Martín-Márquez
- Departamento de Biología Molecular y Genómica, Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada No. 950, Puerta 7, Edificio P, Planta Baja. CP 44340, Colonia Independencia, Guadalajara, Jalisco, Mexico
- Cuerpo Académico Inmunología y Reumatología UDG-CA-703, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Livier Gómez-Limón
- Departamento de Biología Molecular y Genómica, Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada No. 950, Puerta 7, Edificio P, Planta Baja. CP 44340, Colonia Independencia, Guadalajara, Jalisco, Mexico
- Servicio de Reumatología SNP 004086 CONAHCyT, División de Medicina Interna del Hospital Civil Dr. Juan I. Menchaca, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Guillermo Márquez-De-La-Paz
- Departamento de Biología Molecular y Genómica, Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada No. 950, Puerta 7, Edificio P, Planta Baja. CP 44340, Colonia Independencia, Guadalajara, Jalisco, Mexico
| | - Edy-David Rubio-Arellano
- Departamento de Fisiología, Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Oscar Pizano-Martinez
- Departamento de Biología Molecular y Genómica, Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada No. 950, Puerta 7, Edificio P, Planta Baja. CP 44340, Colonia Independencia, Guadalajara, Jalisco, Mexico.
- Cuerpo Académico Inmunología y Reumatología UDG-CA-703, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.
- Departamento de Morfología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.
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Cui B, Chen Y, Luo F, Lin S, Liu H, Huang Y, Zhou Y, Tian Y, Yin G, Xie Q. Clinical value of YKL-40 in patients with polymyositis/dermatomyositis: A cross-sectional study and a systematic review. J Clin Lab Anal 2022; 36:e24605. [PMID: 35837962 PMCID: PMC9459284 DOI: 10.1002/jcla.24605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/03/2022] [Accepted: 07/03/2022] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION We performed a cross-sectional study to investigate the clinical usefulness of YKL-40 in patients with dermatomyositis (DM) and conducted a systematic review to summarize the clinical value of YKL-40 in patients with polymyositis (PM)/DM. MATERIALS AND METHODS A cross-sectional study and a systematic review were performed to study the clinical value of YKL-40 in patients with PM/DM. Serum YKL-40 level was detected using enzyme-linked immunosorbent assay, and its association with clinical and laboratory parameters was analyzed. In the systematic review, electronic databases of OVID Embase, OVID Medline, and web of science were searched to collect studies that reported clinical use of YKL-40 in patients with PM/DM. RESULTS In the cross-sectional study, serum YKL-40 level was higher in patients with DM than in healthy controls (median [interquartile range]: 84.09 [52.72-176.4] ng/ml versus 27.37 [12.30-53.58] ng/ml, p < 0.0001). Serum levels of YKL-40 were associated with the course of DM (r = -0.469, p < 0.001), CRP (r = 0.303, p = 0.043), CK (r = 0.263, p = 0.037), and global disease activity (r = 0.628, p < 0.001). The area under the ROC curve was 0.835 (95% confidence interval 0.751-0.920). In the systematic review, a total of four studies were included with moderate to high quality. Serum level of YKL-40 has the possibility for diagnosing PM/DM, identifying PM/DM patients with interstitial lung disease (ILD) or rapid progress ILD, and predicting death. CONCLUSION Serum YKL-40 level is a possible useful biomarker for PM/DM diagnosis and may be used to predict prognosis.
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Affiliation(s)
- Beibei Cui
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuehong Chen
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Fengming Luo
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Sang Lin
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Huan Liu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Yupeng Huang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Yueyuan Zhou
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Yunru Tian
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Geng Yin
- Department of General Practice, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qibing Xie
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
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