성인형 스틸병의 주요 인자들 및 사망률과 sPD-1 혈청 농도의 상관성 연구 = Correlation of major factors and mortality with sPD-1 serum concentration in adult still disease

다국어 초록 (Multilingual Abstract)

Objective: To investigate whether serum Programmed death-1 (PD-1) levels elevate in patients with Adult-onset Still’s disease (AOSD) and determine their correlation with disease activity parameters.
Method: We enrolled 39 patients with AOSD 19 controls. Serum samples from the patients with AOSD were assayed using an enzyme-linked immunosorbent assay (ELISA). A modified Pouchot score determined comprehensive AOSD activity.
Results: Serum sPD-1 levels were significantly higher in patients with AOSD (259.6±901.1, p < 0.01) than in control subjects (44.6±76.3, p < 0.01). Also, serum sPD-L2 levels were significantly higher in patients with AOSD (698.5±438.7, p < 0.01) than those in control subjects (168.0± 79.0, p < 0.01), whereas both levels of serum sPD-1 and serum sPD-L2 were not significantly different between inactive and active AOSD subgroups.
Serum sPD-1 in all subjects were positively correlated to serum sPD-L2(r = 0.681, p < 0.0001) and were negatively correlated to age (r = -0.336, p = 0.010) levels. Serum PD-L2 in all subjects were negatively correlated to Age (r = -0.224, p = 0.070).
Serum sPD-L2 levels in AOSD were positively correlated to age (p = 0.032), levels of serum sPD-1 (p< 0.001), LDH (p = 0.002), and Ferritin (p = 0.029). However, both serum levels of sPD-1 and serum sPD-L2 did not show any correlation with the modified Pouchot score.
When we stratified AOSD patients based on the 90th percentile of controls' levels, it showed an area under the curve (AUC) with a value of 72.6%. Using the AUC, we established cutoff values for clinical application. Thus, high levels of sPD-1 are mortality predictors in AOSD.

목차 (Table of Contents)

• Abstract ⅰ
• Contents iii
• List of Tables ⅵ
• List of Figures ⅴ
• I. 서론 1
• 1.1 PD-1(programmed death protein 1) 정의 1
• 1.2 성인형 스틸병(adult onset Still’s disease; AOSD) 정의 2
• II. 재료 및 방법 5
• 2.1 검체 정보 5
• 2.2 임상평가 10
• 2.3 샘플준비 11
• 2.4 Soluble PD-1 과 Soluble PD-L2 측정 12
• 2.4.1 실험방법 13
• 2.5 통계분석 14
• III. 결과 15
• 3.1 혈청 sPD-1 및 sPD-L2의 상관관계 15
• 3.2 성인형 스틸병 환자의 혈청과 대조군에서의 수준비교 17
• 3.3 성인형 스틸병 환자의 혈청 sPD-L2의 상관관계 22
• 3.4 성인형 스틸병 환자의 혈청 sPD-1과의 사망사이의 관계 24
• Ⅵ. 고찰 31
• References 33
• 국문요약 36