Abstract

IgG4-related disease (IgG4-RD) is a multi-organ autoimmune disease characterized by elevated serum IgG4 concentration. Although serum IgG4 concentration is widely used as a biomarker for IgG4-RD and type 1 autoimmune pancreatitis (AIP), a pancreatic manifestation of IgG4-RD, a significant number of patients have normal serum IgG4 levels, even in the active phase of the disease. Recently, we reported that the development of experimental AIP and human type 1 AIP is associated with increased expression of IFN-α and IL-33 in the pancreas. In this study, we assessed the utility of serum IFN-α and IL-33 levels as biomarkers for type 1 AIP and IgG4-RD. Serum IFN-α and IL-33 concentrations in patients who met the diagnostic criteria for definite type 1 AIP and/or IgG4-RD were significantly higher than in those with chronic pancreatitis or in healthy controls. Strong correlations between serum IFN-α, IL-33, and IgG4 concentrations were observed. Diagnostic performance of serum IFN-α and IL-33 concentrations as markers of type 1 AIP and/or IgG4-RD was comparable to that of serum IgG4 concentration, as calculated by the receiver operating characteristic curve analysis. Induction of remission by prednisolone treatment markedly decreased the serum concentration of these cytokines. We conclude that serum IFN-α and IL-33 concentrations can be useful as biomarkers for type 1 AIP and IgG4-RD.

Highlights

  • IgG4-related disease (IgG4-RD) is a multi-organ autoimmune disease characterized by elevated serum IgG4 concentration

  • A total of 21 type 1 autoimmune pancreatitis (AIP)/IgG4-RD patients that fulfilled the diagnostic criteria for definite type 1 ­AIP7 and/or IgG4-RD6 were enrolled in this study

  • Consistent with the previous r­eports[4,27], serum levels of total IgG were significantly higher in patients with type 1 AIP/IgG4-RD than in chronic pancreatitis (CP) patients or healthy control (HC) (Fig. 1 and Supplementary Table S1)

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Summary

Introduction

IgG4-related disease (IgG4-RD) is a multi-organ autoimmune disease characterized by elevated serum IgG4 concentration. Serum IgG4 concentration is widely used as a biomarker for IgG4-RD and type 1 autoimmune pancreatitis (AIP), a pancreatic manifestation of IgG4-RD, a significant number of patients have normal serum IgG4 levels, even in the active phase of the disease. IgG4-related disease (IgG4-RD) is a recently discovered autoimmune disorder characterized by elevated IgG4 serum levels and by the accumulation of IgG4-expressing plasmacytes in the affected ­organs[1,2,3]. This autoimmune disorder is characterized by multiple organ ­involvement[1,2,3]. Based on our previous data, in the present study, we tested the hypothesis that serum concentrations of IFN-α and IL-33 could be useful biomarkers for type 1 AIP and IgG4-RD

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