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Human Chitotriosidase: a Sensitive Biomarker of Sarcoidosis

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Abstract

Background

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. No suitable biomarkers are available to evaluate the evolution of this disease, which still has an unpredictable clinical course. Some years ago our research group proposed chitotriosidase as a potential biomarker with prognostic value, that however needed to be validated.

Aims and methods

The aims of this study were to evaluate the sensitivity and specificity of chitotriosidase in a population of 232 sarcoidosis patients under the observation of our Sarcoidosis Regional Referral Centre in Siena and to analyse enzyme concentrations in different disease phenotypes (as defined by the recently published COS classification) to define its prognostic value.

Results

Serum chitotriosidase concentrations were significantly higher in patients than in healthy controls (p < 0.0001) and were directly correlated with ACE levels (r = 0.25, p < 0.0001). ROC curve analysis revealed 88.6 % sensitivity and 92.8 % specificity. Enzyme concentrations were significantly higher in stage 3 sarcoidosis than in stage 0 (p = 0.02). The lowest concentrations of chitotriosidase were found in untreated patients in remission (COS-1), while the highest enzyme concentrations were found in symptomatic patients with persistent disease on steroids and with functional deterioration in the last year (COS-9). In COS-9 subgroup, chitotriosidase decreased significantly after the increasing of steroid dose or the introduction of a new immunosuppressant therapy (p < 0.01).

Conclusion

Chitotriosidase proved to be a biomarker with good sensitivity and specificity that is easily detected in serum. It can be proposed in clinical practice to identify progressive patients requiring close follow-up, to detect relapses and to evaluate the effects of therapy.

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Abbreviations

BAL:

bronchoalveolar lavage

ACE:

angiotensin converting enzyme

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Authors and Affiliations

  1. Department of Clinical Medicine and Immunology, Respiratory Disease Section, Siena, Italy

    Elena Bargagli, David Bennett, Claudia Maggiorelli, Pasquale Di Sipio & Paola Rottoli

  2. Department of Paediatrics, Siena University, Siena, Italy

    Maria Margollicci

  3. Department of Environmental Sciences, Siena University, Siena, Italy

    Nicola Bianchi

  4. Sezione di Malattie Respiratorie, Dipartimento di Medicina Clinica e Scienze Immunologiche, Policlinico Le Scotte, Viale Bracci, 53100, Siena, Italy

    Elena Bargagli

Authors
  1. Elena Bargagli
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  2. David Bennett
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  3. Claudia Maggiorelli
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  4. Pasquale Di Sipio
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  5. Maria Margollicci
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Correspondence to Elena Bargagli.

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All the authors have no conflict of interest to declare

The present work was performed at Department of Clinical Medicine and Immunology Respiratory Disease Section, no funding sponsors to declare.

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Bargagli, E., Bennett, D., Maggiorelli, C. et al. Human Chitotriosidase: a Sensitive Biomarker of Sarcoidosis. J Clin Immunol 33, 264–270 (2013). https://doi.org/10.1007/s10875-012-9754-4

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  • DOI: https://doi.org/10.1007/s10875-012-9754-4

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