Chitotriosidase - a potential biomarker in sarkoidosis

Abstract

Introduction. Sarcoidosis is a multisystem granulomatous disease, whose unpredictable course has prompted research into biomarkers useful to predict outcome. Discussion and Review of Literature. Chitotriosidase, a chitinase produced by activated macrophages, has recently been proposed as an indicator among the potential markers of sarcoidosis. Chitotriosidase is involved in the defense against pathogens containing chitin. Increased concentrations of chitotriosidase have been observed in a number of lysosomal storage diseases, such as Gaucher?s disease, fucosidosis, galactosialidosis, atherosclerosis, ?-thalassemia, Plasmodium falciparum-induced acute malaria, visceral leishmaniasis and more recently in the cerebrospinal fluid in patients suffering from multiple sclerosis. Serum chitotriosidase activity in patients with sarcoidosis was first evaluated by Grosso et al in 2004. The idea to detect the enzyme in sarcoidosis sprang from evidence of direct involvement of activated macrophages in the pathogenesis of sarcoidosis and granuloma formation. Serum chitotriosidase was tested as a biomarker at our department in 2011, when 217 sarcoidosis patients were examined. Serum chitotriosidase has proved to differentiate active from inactive form of the disease much better than angiotensin-converting enzyme, thus adding to its role in the diagnosis and prognosis of this disease. Conclusion. Chitotriosidase is a good biomarker of sarcoidosis with good sensitivity and specificity.