Serum Biomarkers of Disease Activity in Longitudinal Assessment of Patients with ANCA-Associated Vasculitis.

Autor: Monach PA; Boston University, Boston, Massachusetts.; VA Boston Healthcare System, Brigham and Women's Hospital, Boston, Massachusetts., Warner RL; University of Michigan, Ann Arbor, Michigan., Lew R; Boston University, Boston, Massachusetts., Tómasson G; University Hospital, Reykjavik, Iceland., Specks U; Mayo Clinic, Rochester, Minnesota., Stone JH; Massachusetts General Hospital, Boston, Massachusetts., Fervenza FC; Mayo Clinic, Rochester, Minnesota., Hoffman GS; Cleveland Clinic, Cleveland, Ohio., Kallenberg CGM; University Medical Center, Groningen, The Netherlands., Langford CA; University Medical Center, Groningen, The Netherlands., Seo P; Johns Hopkins University, Baltimore, Maryland., St Clair EW; Duke University, Durham, North Carolina., Spiera R; Hospital for Special Surgery, New York, New York., Johnson KJ; University of Michigan, Ann Arbor, Michigan., Merkel PA; University of Pennsylvania, Philadelphia.
Jazyk: angličtina
Zdroj: ACR open rheumatology [ACR Open Rheumatol] 2022 Feb; Vol. 4 (2), pp. 168-176. Date of Electronic Publication: 2021 Nov 18.
DOI: 10.1002/acr2.11366
Abstrakt: Objective: Improved biomarkers of current disease activity and prediction of relapse are needed in antineutrophil cytoplasmic antibody-associated vasculitis (AAV). For clinical relevance, biomarkers must perform well longitudinally in patients on treatment and in patients with nonsevere flares.
Methods: Twenty-two proteins were measured in 347 serum samples from 74 patients with AAV enrolled in a clinical trial. Samples were collected at Month 6 after remission induction, then every 3 months until Month 18, or at the time of flare. Associations of protein concentrations with concurrent disease activity and with future flare were analyzed using mixed-effects models, Cox proportional hazards models, and conditional logistic regression.
Results: Forty-two patients had flares during the 12-month follow-up period, and 32 remained in remission. Twenty-two patients had severe flares. Six experimental markers (CXCL13, IL-6, IL-8, IL-15, IL-18BP, and matrix metalloproteinase-3 [MMP-3]) and ESR were associated with disease activity using all three methods (P < 0.05, with P < 0.01 in at least one method). A rise in IL-8, IL-15, or IL-18BP was associated temporally with flare. Combining C-reactive protein (CRP), IL-18BP, neutrophil gelatinase-associated lipocalin (NGAL), and sIL-2Rα improved association with active AAV. CXCL13 and MMP-3 were increased during treatment with prednisone, independent of disease activity. Marker concentrations during remission were not predictive of future flare.
Conclusion: Serum biomarkers of inflammation and tissue damage and repair have been previously shown to be strongly associated with severe active AAV were less strongly associated with active AAV in a longitudinal study that included mild flares and varying treatment. Markers rising contemporaneously with flare or with an improved association in combination merit further study.
(© 2021 The Authors. ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.)
Databáze: MEDLINE
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