Serum tenascin-C discriminates patients with active SLE from inactive patients and healthy controls and predicts the need to escalate immunosuppressive therapy: a cohort study

Autor: Jiří Vencovský, Hana Ciferska, R. Svobodova, M. Olejarova, Marketa Husakova, Jakub Zavada, Ladislav Šenolt, Hana Hulejová, Michal Uher, Michal Tomcik
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Adult
Male
medicine.medical_specialty
Immunology
SLE
Enzyme-Linked Immunosorbent Assay
Tenascin-C
Gastroenterology
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Rheumatology
Predictive Value of Tests
Internal medicine
medicine
Immunology and Allergy
Humans
Lupus Erythematosus
Systemic
Disease activity
Prospective Studies
Prospective cohort study
skin and connective tissue diseases
030304 developmental biology
030203 arthritis & rheumatology
0303 health sciences
Systemic lupus erythematosus
biology
business.industry
Tenascin C
Hazard ratio
Tenascin
Biomarker
Middle Aged
medicine.disease
musculoskeletal system
3. Good health
Cross-Sectional Studies
Predictive value of tests
biology.protein
Biomarker (medicine)
Female
business
Flare
Biomarkers
Immunosuppressive Agents
Cohort study
Research Article
Zdroj: Arthritis Research & Therapy
ISSN: 1478-6362
1478-6354
Popis: Introduction The aim of this study was to examine whether circulating levels of the proinflammatory glycoprotein tenascin-C (TNC) are useful as an activity-specific or predictive biomarker in systemic lupus erythematosus (SLE). Methods Serum TNC levels were determined by enzyme-linked immunosorbent assay at inception visit in a prospective cohort of 59 SLE patients, and in 65 healthy controls (HC). SLE patients were followed for a mean of 11 months, disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K) and British Isles Lupus Assessment Group disease activity index (BILAG-2004), clinical and laboratory data were recorded every 3–6 months, and changes in glucocorticoids (GC) and immunosuppressants (IS) were recorded serially. We examined cross-sectionally the relationships between serum concentrations of TNC and SLE status, SLEDAI-2 K scores, strata of disease activity, and levels of conventional biomarkers [anti–double-stranded DNA (dsDNA), anti-nucleosome antibodies, C3 and C4]. We also explored the utility of TNC levels for predicting disease flares, defined as (i) new/increased GC, (ii) new/increased GC or IS, and (iii) increase in SLEDAI by ≥3 or (iv) BILAG A or B flare. Results There was no significant difference in the mean levels of TNC between the SLE patients and HC. However, in SLE patients with active disease (SLEDAI ≥6), the TNC levels were significantly higher than in the HC (p = 0.004) or in patients with no/low disease activity (p = 0.004). In SLE patients, TNC levels were significantly associated with positivity of anti-dsDNA (p = 0.03) and anti-nucleosome antibodies (p = 0.008). Flares defined by a need to escalate immunosuppressive therapy were captured more frequently and earlier than flares defined by standard activity indices. Higher baseline levels of serum TNC presented a significantly greater risk of flare (i) [hazard ratio (HR) 1.39, 95 % confidence interval (CI) 1.11–1.73] or (ii) (HR 1.25, 95 % CI 1.02–1.52) but not of flares (iii) or (iv). The baseline serum TNC level was the single most important independent predictor of flare (i) compared with conventional biomarkers. Conclusions TNC is not disease-specific, but it seems to indicate the activity of SLE and may predict the need to escalate immunosuppressive therapy. TNC levels may thus serve as a useful activity-specific and predictive biomarker in SLE. Electronic supplementary material The online version of this article (doi:10.1186/s13075-015-0862-4) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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