Inflammatory Biomarkers in MAS

Elevated biomarkers of inflammation associated with MAS

Certain biomarkers of inflammation can measure key disease pathways. These often become elevated during macrophage activation syndrome (MAS) episodes, and their specificity may be helpful in identifying MAS.1 See below for a table containing key biomarkers to assess in patients with suspected MAS, and their relation to the underlying pathology.

 

Inflammatory
biomarkers

Biology

STANDARD LAB ASSESSMENTS1

STANDARD LAB ASSESSMENTS1

CRP

Hepatic release in response to systemic inflammation (IL-6)

ESR

Initially elevated due to systemic inflammation but may later decline due to fibrinogen consumption

Ferritin

Macrophage/hepatocyte activation

LDH

General marker of cellular death

SPECIALIZED LAB ASSESSMENTS1-3

SPECIALIZED LAB ASSESSMENTS1-3

sCD163

Macrophage activation

CXCL9

Chemokine induced by IFNγ;
marker for IFNγ activity

IL-18

Inflammasome activated; induces IFNγ

Neopterin 
(macrophage)

Metabolite of GTP, induced by IFNγ

sCD25

Marker of T-cell activation

CD=cluster of differentiation; CRP=C-reactive protein; CXCL9=chemokine (C-X-C motif) ligand 9; ESR=erythrocyte sedimentation rate; GTP=guanosine triphosphate; IFNγ=interferon gamma; IL=interleukin; LDH=lactate dehydrogenase; sCD25=soluble cluster of differentiation 25.

CXCL9 is a recognized marker for IFNγ activity4

IFNγ is a key driver of the hyperinflammatory response in MAS in Still's disease and selectively induces CXCL9.4

CXCL9 is5:

  • Stable and easily measurable in serum compared to IFNγ, which has a short half-life and is often stored in peripheral tissues
  • Reflective of IFNγ production and activation of IFNγ-induced signaling pathways
  • Useful as both an ancillary diagnostic tool and an emerging marker of treatment response
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Icon of magnifying glass

CXCL9 overview

Learn more about the importance of CXCL9 in MAS.

Learn more about CXCL9