Assessing sarcoidosis activity: Is serum chitotriosidase a reliable marker? Study of 430 patients and 264 healthy controls

Background Sarcoidosis is a multisystem granulomatous disease of unknown etiology and unpredictable course. Assessing sarcoidosis activity it is a difficult multitask effort due to many faces this mysterious disease might have. The aims of this study were to evaluate the sensitivity and specificity of two already used biomarkers of sarcoidosis activity (serum angiotensin converting enzyme – ACE and serum chitotriosidase in a population of 430 sarcoidosis patients. The two markers were also analyzed in a group of 264 healthy controls. Methods 430 biopsy positive sarcoidosis patients were divided according to the disease activity at the time of the investigation into a group of active and inactive disease, also a group with acute or chronic disease. The enzyme concentrations were analyzed in different disease phenotypes (as defined by the recently published COS classification). Results Serum chitotriosidase levels were almost 6 times higher in patients with active sarcoidosis than in healthy controls and inactive disease.(p Serum levels of chitotriosidase of 100 nmol/mL/h has the sensitivity of 82.5% ( to confirm active sarcoidosis) and specificity of 70.0% ( to exclude active sarcoidosis). Serum levels of ACE ( cut off 32.0 U/L) has the sensitivity of 66.0% and the specificity of 54%. The serum levels of chitotriosidase significantly correlated with the disease duration. (p Conclusion Serum chitotriosidase proved to be a reliable biomarker of sarcoidosis activity and also disease chronicity.