Article
Identification of active sarcoidosis using chitotriosidase and angiotensin-converting enzyme
Registro en:
LOPES, Mariana Carneiro et al. Identification of active sarcoidosis using chitotriosidase and angiotensin-converting enzyme. Lung, p. 1-8, Mar. 2019.
0341-2040
10.1007/s00408-019-00219-2
1432-1750
Autor
Lopes, Mariana Carneiro
Amadeu, Thaís Porto
Ribeiro-Alves, Marcelo
Costa, Claudia Henrique
Rodrigues, Luciana Silva
Bessa, Elisabeth Jauhar Cardoso
Bruno, Leonardo Palermo
Lopes, Agnaldo José
Rufino, Rogerio
Resumen
Purpose: Activity/remission differentiation is a great challenge in the follow-up and treatment of sarcoidosis patients. Angiotensin-converting enzyme (ACE) and high sensitivity C-reactive protein (hs-CRP) were proposed as sarcoidosis biomarkers. More recently, chitotriosidase (CHITO) has been described as a better alternative. This study has the aim to evaluate the association of CHITO activity, ACE, hs-CRP or a combination of these biomarkers and to construct a clinical algorithm to differentiate between sarcoidosis activity/remission status. Methods: Forty-six patients with either active sarcoidosis or sarcoidosis in remission and 21 healthy individuals were included. ACE, hs-CRP, and CHITO were evaluated in serum samples. Comparisons of the laboratory variable means among groups were performed by linear models. The cutoff points of the biomarkers for activity/remission differentiation were calculated using the Youden’s index. Biomarker cutoff points and decision tree classifier (DTC) performance were estimated by their leave-one-out cross-validation (LOOCV) accuracy (Acc), sensitivity (Se), and specificity (Sp). Results A 55% mean Se and a 100% mean Sp were found for CHITO, while an 88% Se and a 47% Sp were found for ACE, and a 66% Se and a 68% Sp for hs-CRP cutoff points for activity/remission differentiation. The DTC algorithm with CHITO, hs-CRP, and ACE information had an LOOCV mean Acc of 82%, Se of 78%, and Sp of 89% for sarcoidosis activity/remission differentiation. Conclusions: The algorithm involving CHITO, hs-CRP, and ACE could be a suitable strategy for differentiation between sarcoidosis activity/remission status. 2020-04-15