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Serum HO-1 is useful to make differential diagnosis of secondary hemophagocytic syndrome from other similar hematological conditions

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Abstract

Heme oxygenase (HO)-1, a heme-degrading enzyme inducible by various stimuli, plays a key role in the regulation of inflammatory response in monocytes/macrophages. The serum HO-1 level is remarkably increased in patients with secondary hemophagocytic syndrome (HPS) or adult-onset Still’s disease. We measured serum HO-1 levels in patients with a variety of hematological diseases, including secondary HPS, by means of ELISA. Serum HO-1 levels were significantly higher in 22 patients with HPS (134.7 ± 116.2 ng/mL, P < 0.0001) at diagnosis than in 80 patients with other hematological diseases. The most effective cutoff point between HPS and other conditions was 14.5 ng/mL, with 100.0% sensitivity and 96.3% specificity. In HPS patients, the serum HO-1 levels showed the highest correlation with serum ferritin (r = 0.682, P = 0.0005), which reflects the disease activity of HPS. Moreover, both HO-1 and ferritin levels were reduced in parallel after successful treatment in patients with HPS, irrespective of underlying diseases. However, HO-1 levels were not elevated in patients with other causes of hyperferritinemia. These data demonstrate that serum HO-1 can distinguish secondary HPS from other hematological diseases, including those associated with hyperferritinemia.

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Acknowledgments

This work was supported in part by grants from Research on Specific Disease of the Health Science Research Grants from the Ministry of Health, Labor, and Welfare of Japan (Y.I.); a 2008–2010 grant-in-aid for scientific research (project no. 20591174) from the Ministry of Education, Culture, Sports, and Technology of Japan (M. Takeno); and 2007–2009 grants from the Yokohama Foundation for Advancement of Medical Science (M. Takeno). The sources of funding had no role in the writing of the report and did not participate in the decision to publish the results. We thank Dr. Shuji Murakami of the Kanagawa Cancer Center, Yokohama, for statistics advice.

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Authors and Affiliations

  1. Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan

    Takuya Miyazaki, Yohei Kirino, Mitsuhiro Takeno, Maasa Hama, Ayumi Ushihama, Reina Watanabe, Takayoshi Tachibana, Kenji Matsumoto, Masatsugu Tanaka, Satoshi Yamaji, Naoto Tomita, Hiroyuki Fujita, Atsuhisa Ueda & Yoshiaki Ishigatsubo

  2. Center for Rheumatic Diseases, Yokohama City University Medical Center, Yokohama, Japan

    Kaoru Takase, Haruko Ideguchi & Shigeru Ohno

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  1. Takuya Miyazaki
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  2. Yohei Kirino
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Correspondence to Yoshiaki Ishigatsubo.

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Miyazaki, T., Kirino, Y., Takeno, M. et al. Serum HO-1 is useful to make differential diagnosis of secondary hemophagocytic syndrome from other similar hematological conditions. Int J Hematol 91, 229–237 (2010). https://doi.org/10.1007/s12185-010-0495-y

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  • DOI: https://doi.org/10.1007/s12185-010-0495-y

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