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Diffuse Lung Disease |

Efficacy of Serum Inflammatory Markers C Reactive Protein (hsCRP), Tissue Necrosis Factor Alpha (TNF α), and Soluble Interleukin 2 Receptor (sIL2R) in Assessing Disease Activity and Response to Treatment in Sarcoidosis

Randeep Guleria, DM; Pawan Tiwari, MD; Anant Mohan, MD; Naveet Wig, MD; Kalpana Luthra, MD; Sneh Arora, PhD; Jaya Kumar, MD
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All India Institute of Medical Sciences Department of Pulmonary Medicine and Sleep Disorders, New Delhi, India


Chest. 2013;144(4_MeetingAbstracts):459A. doi:10.1378/chest.1703681
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Abstract

SESSION TITLE: Biomarkers in ILD

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Tuesday, October 29, 2013 at 04:30 PM - 05:30 PM

PURPOSE: Various parameters have been evaluated for grading severity, prognosis and response to treatment in sarcoidosis. We evaluated efficacy of serum inflammatory markers C Reactive Protein (hsCRP), Tissue Necrosis Factor alpha (TNF α) and soluble Interleukin 2 receptor (sIL2R) in assessing disease activity and response to treatment in sarcoidosis.

METHODS: In this prospective study, 31 patients with sarcoidosis were evaluated at baseline and after 6 months of treatment as per ATS guidelines. All patients underwent clinical evaluation including ESR, ACE levels, Respiratory Functional Impairment on Pulmonary Function Tests (RFI), HRCT Chest, along with serum sIL2R, TNFα and hsCRP. sIL2R, TNFα and hsCRP were compared with conventional serum markers ACE & ESR, RFI and HRCT Chest at baseline and after 6 months.

RESULTS: Stage II disease was present in 19 patients (61%); stage I and stage III disease was present in 5 (16%) and 7 patients (23%) respectively. 22 patients (71%) had partial radiologic response to treatment. 6 patients (19%) had complete response; 3 patients (10%) had no response or worsening. Hs CRP and sIL2R were significantly associated with RFI at baseline, with an area under curve (AUC) of 0.79 (SE 0.083, 95% CI 0.62-0.92) and 0.77 (SE 0.114, 95% CI 0.586-0.902) respectively. sIL2R was significantly associated with presence of infiltrates on HRCT at baseline, with AUC of 0.89 (SE 0.06, 95% CI 0.726-0.974). sIL2R significantly correlated with presence of RFI after treatment with AUC of 0.72 (SE 0.097, 95% CI 0.527-0.863). Elevated sIL2R levels at baseline were significantly associated with partial response to treatment.

CONCLUSIONS: Serum sIL2R and hsCRP were associated with severity and activity of pulmonary sarcoidosis at baseline. Elevated sIL2R at baseline was significantly associated with partial response to treatment. sIL2R was also associated with disease severity after treatment.

CLINICAL IMPLICATIONS: hsCRP and sIL2R along with conventional parameters may be useful for assessing disease severity and predicting response to treatment in sarcoidosis.

DISCLOSURE: The following authors have nothing to disclose: Randeep Guleria, Pawan Tiwari, Anant Mohan, Naveet Wig, Kalpana Luthra, Sneh Arora, Jaya Kumar

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