期刊
ANNALS OF THE RHEUMATIC DISEASES
卷 71, 期 6, 页码 974-980出版社
B M J PUBLISHING GROUP
DOI: 10.1136/annrheumdis-2011-200598
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资金
- Interdisciplinary Centre for Clinical Research at the University of Muenster [Foe2/005/06, Ro2/004/10]
- Deutsche Forschungsgemeinschaft (DFG) [FO 354/2-2]
- Innovative Medizinische Forschung (IMF) [WI 120733]
- Bundesministerium fur Bildung und Forschung (AID-NET) [01GM08100]
- FP7 programme (Pharmachild) [GA-No 260353]
- SPARKS-UK [08ICH09]
- Big Lottery Fund UK [RG/1/010135231]
- Sparks Charity [08ICH09] Funding Source: researchfish
Background Analysis of myeloid-related protein 8 and 14 complex (MRP8/14) serum concentrations is a potential new tool to support the diagnosis of systemic-onset juvenile idiopathic arthritis (SJIA) in the presence of fever of unknown origin. Objective To test the ability of MRP8/14 serum concentrations to monitor disease activity in patients with SJIA and stratify patients at risk of relapse. Methods Serum concentrations of MRP8/14 in 52 patients with SJIA were determined by a sandwich ELISA. The monitoring of therapeutic regimens targeting interleukin 1 and tumour necrosis factor a, and methotrexate treatment was analysed and diagnostic power to predict flares was tested. Results MRP8/14 levels were clearly raised in active disease and decreased significantly in response to successful treatments. Serum concentrations of MRP8/14 increased significantly (p<0.001) (mean +/- 95% CI 12.030 +/- 3.090 ng/ml) during disease flares compared with patients with inactive disease (864 +/- 86 ng/ml). During clinical remission MRP8/14 serum levels of >740 ng/ml predicted disease flares accurately (sensitivity 92%, specificity 88%). MRP8/14 levels correlated well with clinical disease activity, as assessed by physician's global assessment of disease activity (r=0.62), Childhood Health Assessment Questionnaire (r=0.56), active joint count (r=0.46) and with C-reactive protein (r=0.71) and erythrocyte sedimentation rate (r=0.72) (for all p<0.001). Conclusion MRP8/14 serum concentrations correlate closely with response to drug treatment and disease activity and therefore might be an additional measurement for monitoring anti-inflammatory treatment of individual patients with SJIA. MRP8/14 serum concentrations are the first predictive biomarker indicating subclinical disease activity and stratifying patients at risk of relapse during times of clinically inactive disease.
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