Lack of HLH in FMF

Abstract Background Macrophage activation syndrome (MAS) is a severe complication of systemic juvenile idiopathic arthritis (sJIA), driven by excessive activation of T cells and macrophages, resulting in a cytokine storm. IFN-γ and IL-18 play crucial roles, with monocyte and macrophage hyperresponsi...

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Main Authors: Ozge Basaran, Erdal Sag, Elif Arslanoglu Aydın, Busra Aydın, Nur Kübra Tasdemir, Elif Celikel, Yagmur Bayındır, Semanur Özdel, Yelda Bilginer, Alexei A Grom, Seza Ozen
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Pediatric Rheumatology Online Journal
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Online Access:https://doi.org/10.1186/s12969-025-01064-9
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author Ozge Basaran
Erdal Sag
Elif Arslanoglu Aydın
Busra Aydın
Nur Kübra Tasdemir
Elif Celikel
Yagmur Bayındır
Semanur Özdel
Yelda Bilginer
Alexei A Grom
Seza Ozen
author_facet Ozge Basaran
Erdal Sag
Elif Arslanoglu Aydın
Busra Aydın
Nur Kübra Tasdemir
Elif Celikel
Yagmur Bayındır
Semanur Özdel
Yelda Bilginer
Alexei A Grom
Seza Ozen
author_sort Ozge Basaran
collection DOAJ
description Abstract Background Macrophage activation syndrome (MAS) is a severe complication of systemic juvenile idiopathic arthritis (sJIA), driven by excessive activation of T cells and macrophages, resulting in a cytokine storm. IFN-γ and IL-18 play crucial roles, with monocyte and macrophage hyperresponsiveness to IFN-γ amplifying MAS-related inflammation. Familial Mediterranean Fever (FMF), an autosomal recessive disease, is characterized by recurrent fever episodes due to MEFV gene mutations. Despite intense inflammation in FMF, MAS is rare. This study aimed to compare in vitro responsiveness of peripheral blood mononuclear cells (PBMCs) to IFN-γ between sJIA/MAS and FMF patients. Methods Five sJIA/MAS and five FMF patients were included. PBMCs were stimulated in vitro with IFN-γ for 45 min. Levels of IFN-γ-induced chemokines CXCL9, CXCL10, and IL-18 in supernatants were measured using cytometric bead arrays before and after stimulation. Results PBMCs from MAS patients produced higher baseline CXCL9 levels compared to FMF patients in a flare, with differences increasing post-IFN-γ stimulation. IFN-γ stimulation also upregulated IL-18 production in MAS patients but not in FMF patients. Conclusion Enhanced responsiveness to IFN-γ distinguishes sJIA/MAS from FMF patients, which may explain the lower occurrence of MAS in FMF.
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institution Kabale University
issn 1546-0096
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publishDate 2025-02-01
publisher BMC
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series Pediatric Rheumatology Online Journal
spelling doaj-art-c3ab1c4538db4e75b2aacd03b3dd7c052025-02-09T12:17:00ZengBMCPediatric Rheumatology Online Journal1546-00962025-02-012311610.1186/s12969-025-01064-9Lack of HLH in FMFOzge Basaran0Erdal Sag1Elif Arslanoglu Aydın2Busra Aydın3Nur Kübra Tasdemir4Elif Celikel5Yagmur Bayındır6Semanur Özdel7Yelda Bilginer8Alexei A Grom9Seza Ozen10Department of Pediatric Rheumatology, Hacettepe UniversityDepartment of Pediatric Rheumatology, Hacettepe UniversityDivision of Pediatric Rheumatology, University of Health Sciences, Etlik City HospitalPediatric Rheumatology Unit, Translational Medicine Laboratories, Hacettepe UniversityPediatric Rheumatology Unit, Translational Medicine Laboratories, Hacettepe UniversityDivision of Pediatric Rheumatology, University of Health Sciences, Ankara City HospitalDepartment of Pediatric Rheumatology, Hacettepe UniversityDivision of Pediatric Rheumatology, University of Health Sciences, Etlik City HospitalDepartment of Pediatric Rheumatology, Hacettepe UniversityDivision of Rheumatology, Cincinnati Children’s Hospital Medical Center, University of CincinnatiDepartment of Pediatric Rheumatology, Hacettepe UniversityAbstract Background Macrophage activation syndrome (MAS) is a severe complication of systemic juvenile idiopathic arthritis (sJIA), driven by excessive activation of T cells and macrophages, resulting in a cytokine storm. IFN-γ and IL-18 play crucial roles, with monocyte and macrophage hyperresponsiveness to IFN-γ amplifying MAS-related inflammation. Familial Mediterranean Fever (FMF), an autosomal recessive disease, is characterized by recurrent fever episodes due to MEFV gene mutations. Despite intense inflammation in FMF, MAS is rare. This study aimed to compare in vitro responsiveness of peripheral blood mononuclear cells (PBMCs) to IFN-γ between sJIA/MAS and FMF patients. Methods Five sJIA/MAS and five FMF patients were included. PBMCs were stimulated in vitro with IFN-γ for 45 min. Levels of IFN-γ-induced chemokines CXCL9, CXCL10, and IL-18 in supernatants were measured using cytometric bead arrays before and after stimulation. Results PBMCs from MAS patients produced higher baseline CXCL9 levels compared to FMF patients in a flare, with differences increasing post-IFN-γ stimulation. IFN-γ stimulation also upregulated IL-18 production in MAS patients but not in FMF patients. Conclusion Enhanced responsiveness to IFN-γ distinguishes sJIA/MAS from FMF patients, which may explain the lower occurrence of MAS in FMF.https://doi.org/10.1186/s12969-025-01064-9CXCL-9CXCL-10Familial Mediterranean feverIL-18Macrophage activation syndrome
spellingShingle Ozge Basaran
Erdal Sag
Elif Arslanoglu Aydın
Busra Aydın
Nur Kübra Tasdemir
Elif Celikel
Yagmur Bayındır
Semanur Özdel
Yelda Bilginer
Alexei A Grom
Seza Ozen
Lack of HLH in FMF
Pediatric Rheumatology Online Journal
CXCL-9
CXCL-10
Familial Mediterranean fever
IL-18
Macrophage activation syndrome
title Lack of HLH in FMF
title_full Lack of HLH in FMF
title_fullStr Lack of HLH in FMF
title_full_unstemmed Lack of HLH in FMF
title_short Lack of HLH in FMF
title_sort lack of hlh in fmf
topic CXCL-9
CXCL-10
Familial Mediterranean fever
IL-18
Macrophage activation syndrome
url https://doi.org/10.1186/s12969-025-01064-9
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AT busraaydın lackofhlhinfmf
AT nurkubratasdemir lackofhlhinfmf
AT elifcelikel lackofhlhinfmf
AT yagmurbayındır lackofhlhinfmf
AT semanurozdel lackofhlhinfmf
AT yeldabilginer lackofhlhinfmf
AT alexeiagrom lackofhlhinfmf
AT sezaozen lackofhlhinfmf