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Sustained elevation of serum interleukin-18 and its association with hemophagocytic lymphohistiocytosis in XIAP deficiency

2013; Elsevier BV; Volume: 65; Issue: 1 Linguagem: Inglês

10.1016/j.cyto.2013.09.007

1096-0023

Taizo Wada, Hirokazu Kanegane, Kazuhide Ohta, Fumiyo Katoh, Toshihiko Imamura, Yozo Nakazawa, Ritsuko Miyashita, Junichi Hara, Kazuko Hamamoto, Xi Yang, Alexandra H. Filipovich, Rebecca Marsh, Akihiro Yachie,

Family and Disability Support Research

X-linked lymphoproliferative syndrome (XLP) is a rare primary immunodeficiency characterized by increased vulnerability to Epstein–Barr virus infection. XLP type 1 is caused by mutations in SH2D1A, whereas X-linked inhibitor of apoptosis (XIAP) encoded by XIAP/BIRC4 is mutated in XLP type 2. In XIAP deficiency, hemophagocytic lymphohistiocytosis (HLH) occurs more frequently and recurrence is common. However, the underlying mechanisms remain mostly unknown. We describe the characteristics of the cytokine profiles of serum samples from 10 XIAP-deficient patients. The concentration of interleukin (IL)-18 was strikingly elevated in the patients presented with HLH, and remained high after the recovery from HLH although levels of other pro-inflammatory cytokines approached the normal range. Longitudinal examination of two patients demonstrated marked exacerbation of IL-18 levels during every occasion of HLH. These findings may suggest the association between HLH susceptibility and high serum IL-18 levels in XIAP deficiency.