From the Guidelines
Monitoring soluble Interleukin-2 (IL-2) levels is not a recommended tool for assessing sarcoidosis disease activity and treatment response, as the provided evidence does not support its use in clinical practice. The European Respiratory Journal's clinical practice guidelines on treatment of sarcoidosis, published in 2021 1, do not mention the use of soluble IL-2 levels in monitoring sarcoidosis. Instead, the guidelines recommend assessing disease activity and treatment response through a combination of clinical parameters, including pulmonary function tests, chest imaging, and symptom assessment.
The guidelines provide recommendations for the treatment of various manifestations of sarcoidosis, including pulmonary, cutaneous, cardiac, and neurologic manifestations, as well as sarcoidosis-associated fatigue and small-fibre neuropathy 1. However, they do not discuss the role of soluble IL-2 levels in monitoring disease activity or treatment response.
In clinical practice, it is essential to prioritize morbidity, mortality, and quality of life when making treatment decisions for patients with sarcoidosis. The provided evidence suggests that a comprehensive approach to monitoring disease activity and treatment response, including regular clinical assessments and imaging studies, is more effective than relying on a single biomarker like soluble IL-2 levels.
Key points to consider when monitoring patients with sarcoidosis include:
- Regular clinical assessments to evaluate disease activity and treatment response
- Pulmonary function tests to assess lung function
- Chest imaging to evaluate lung involvement
- Symptom assessment to evaluate the impact of disease on quality of life
- Adjusting treatment frequency and intensity based on clinical response and disease activity.
Overall, while soluble IL-2 levels may have some theoretical relevance to sarcoidosis, the current evidence does not support their use in clinical practice, and a more comprehensive approach to monitoring disease activity and treatment response is recommended.
From the Research
Role of Soluble Interleukin-2 (IL-2) in Monitoring Sarcoidosis
- Soluble interleukin-2 receptor (sIL-2R) has been studied as a potential biomarker for monitoring sarcoidosis, with some studies suggesting its usefulness in assessing disease activity and treatment response 2, 3, 4, 5, 6.
- A study published in 2020 found that sIL-2R was detectable in exhaled breath condensate, but its levels did not correlate with disease activity or pulmonary function tests 2.
- In contrast, a 2003 study found that serum sIL-2R levels correlated with disease activity and were higher in patients with extrapulmonary disease 3.
- Another study published in 2015 found that baseline and serial serum ACE and sIL-2R levels correlated with lung function improvement during methotrexate treatment 4.
- A 2003 study found that sIL-2R had the largest area under the curve and the highest sensitivity and specificity for assessing disease severity in untreated patients with sarcoidosis 5.
- A 2019 study found that serum sIL-2R had a sensitivity of 88% and a specificity of 85% for diagnosing sarcoidosis, and was superior to ACE in establishing the diagnosis 6.
Key Findings
- sIL-2R may be a useful biomarker for monitoring disease activity and treatment response in sarcoidosis.
- Serum sIL-2R levels may correlate with disease severity and lung function improvement.
- sIL-2R may be superior to ACE in establishing the diagnosis of sarcoidosis.