Shinpei Kato1, Naoki Inui2, Hironao Hozumi1, Yusuke Inoue1, Hideki Yasui1, Masato Karayama1, Masato Kono1, Yuzo Suzuki1, Kazuki Furuhashi1, Noriyuki Enomoto1, Tomoyuki Fujisawa1, Yutaro Nakamura1, Hiroshi Watanabe3, Takafumi Suda1. 1. Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan. 2. Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan; Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan. Electronic address: inui@hama-med.ac.jp. 3. Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan.
Abstract
BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL) is a glycoprotein that is involved in the innate immune system and increased expression has been detected in diverse diseases. Sarcoidosis is a systemic granulomatous disorder and its clinical course and prognosis are changeable and highly divergent. This study aimed to examine the expression of NGAL in patients with sarcoidosis. In addition, we examined whether NGAL could serve as a marker of disease activity and prognosis. METHODS: Ninety-six sarcoidosis patients were studied. Serum samples collected at the time of diagnosis were examined for NGAL by cellular enzyme-linked immunosorbent assay. The level of NGAL was compared with clinical, radiological and laboratory data. RESULTS: Patients with sarcoidosis had significantly higher levels of NGAL (the median [interquartile range] was 35.1 ng/mL [23.5-60.8] in sarcoidosis patients versus 17.2 ng/mL [13.0-27.0] in the reference population, p < .0001). NGAL levels were not correlated with markers for disease activity. During the follow-up period, 26 patients (27.1%) deteriorated and received systemic corticosteroid therapy for organ dysfunction. In those patients, NGAL levels were significantly higher than in those who did not receive corticosteroid therapy (56.5 ng/mL [27.3-92.3] versus 34.3 ng/mL [23.0-53.0], p = .0201). Upon multivariate logistic regression analysis, elevated NGAL levels at diagnosis were associated with subsequent use of systemic corticosteroid therapy (hazard ratio, 1.20; 95% confidence interval, 1.09-1.31; p = .0004). CONCLUSION: NGAL may be a useful marker to predict the disease course of sarcoidosis.
BACKGROUND:Neutrophil gelatinase-associated lipocalin (NGAL) is a glycoprotein that is involved in the innate immune system and increased expression has been detected in diverse diseases. Sarcoidosis is a systemic granulomatous disorder and its clinical course and prognosis are changeable and highly divergent. This study aimed to examine the expression of NGAL in patients with sarcoidosis. In addition, we examined whether NGAL could serve as a marker of disease activity and prognosis. METHODS: Ninety-six sarcoidosispatients were studied. Serum samples collected at the time of diagnosis were examined for NGAL by cellular enzyme-linked immunosorbent assay. The level of NGAL was compared with clinical, radiological and laboratory data. RESULTS:Patients with sarcoidosis had significantly higher levels of NGAL (the median [interquartile range] was 35.1 ng/mL [23.5-60.8] in sarcoidosispatients versus 17.2 ng/mL [13.0-27.0] in the reference population, p < .0001). NGAL levels were not correlated with markers for disease activity. During the follow-up period, 26 patients (27.1%) deteriorated and received systemic corticosteroid therapy for organ dysfunction. In those patients, NGAL levels were significantly higher than in those who did not receive corticosteroid therapy (56.5 ng/mL [27.3-92.3] versus 34.3 ng/mL [23.0-53.0], p = .0201). Upon multivariate logistic regression analysis, elevated NGAL levels at diagnosis were associated with subsequent use of systemic corticosteroid therapy (hazard ratio, 1.20; 95% confidence interval, 1.09-1.31; p = .0004). CONCLUSION:NGAL may be a useful marker to predict the disease course of sarcoidosis.