Serum levels of alpha-1 acid glycoprotein and pentraxin 3 in patients with Behçet's disease and relationship with disease activity

Association between blood Pentraxin-3 concentrations and rheumatic diseases: A systematic review and meta-analysis

BACKGROUND

Among the Pentraxins, the long Pentraxin-3 (PTX-3) is associated with several processes, particularly in the earliest phases of the innate humoral response. Increased blood PTX-3 concentrations have been observed in a wide range of conditions, from infectious to cardiovascular disorders. Since its increase is more rapid than C-reactive protein (CRP), PTX-3 can be useful to detect and monitor early inflammation. To dissect its pathophysiological role in rheumatic diseases (RD), we conducted a systematic review and meta-analysis comparing blood PTX-3 concentrations in RD patients and healthy individuals and investigating possible associations with clinical, demographic, and study characteristics.

METHODS

We performed a search of published evidence until April 2024 in PubMed, Web of Science and Scopus, which led to the selection of 60 relevant manuscripts from a total of 1072 records.

RESULTS

Our synthesis revealed a statistically significant difference in PTX-3 concentrations between RD patients and controls (standard mean difference, SMD = 1.02, 95% CI 0.77-1.26, p < .001), that correlated with CRP concentrations. The effect size was associated with geographical region of study conduction, RD type, with a reduction of the observed heterogeneity in patients with low LDL-cholesterol and triglycerides concentrations.

CONCLUSIONS

Our study has shown a significant increase in blood PTX-3 concentrations in RD patients, which was associated with specific patient characteristics. Nevertheless, additional studies are needed to better define the utility of measuring PTX-3 in the early phase of RD. Our study was conducted in compliance with the PRISMA 2020 statement (study protocol available at PROSPERO CRD42024516600).

Serum calprotectin and ischemia modified albumin levels as markers of disease activity in Behçet's disease

Introduction

Behçet’s disease (BD) is a complex multisystemic inflammatory disorder which is characterized by recurrent attacks of acute inflammation. As there is no universally recognized pathognomonic laboratory marker of BD, its diagnosis is still based on clinical findings.

Aim

To evaluate the role of calprotectin and ischemia modified albumin (IMA) as biomarkers in the assessment of disease activity of BD.

Material and methods

A total of 93 patients with BD and 62 age- and gender-matched healthy controls were included in the study. Disease activity was assessed with the BD Current Activity Form (BDCAF) score. Serum levels of calprotectin, high-sensitivity C-reactive protein (hsCRP) and IMA were measured in the patient and control groups.

Results

Serum levels of calprotectin, IMA and hsCRP in patients with BD were higher than those of the healthy control group (p < 0.001 for all). No correlations between calprotectin and IMA, hsCRP, erythrocyte sedimentation rate, CRP, or BDCAF score were found.

Conclusions

As the calprotectin level are increased in BD patients, it could be a candidate biomarker which plays a role in BD pathogenesis.

Update on the role of Pentraxin 3 in atherosclerosis and cardiovascular diseases

Pentraxin 3 (PTX3) is an acute-phase protein that was recently demonstrated to play pleiotropic activities in cardiovascular (CV) diseases. Tumor necrosis factor and interleukins up-regulates PTX3 transcription in different cell types (i.e. endothelial cells, phagocytes, smooth muscle cells, fibroblasts and glial cells) involved in atherogenesis. By interacting with numerous ligands, PTX3 acts as a modulatory molecule of complement system, inflammatory response, angiogenesis, and vascular/tissue remodeling. Experimental data point to a beneficial role of PTX3 in atherosclerotic plaque development and vulnerability. Animal studies indicated a protective role of PTX3 signaling in ischemic/reperfusion injury and failing heart. Clinical studies have so far provided contrasting results, highlighting a debated role of PTX3 as an active mediator of endothelial dysfunction, atherosclerotic plaque vulnerability and worse outcome after ischemic events. Therefore, substantial evidence suggests a dual role of PTX3 as modulator or amplifiers of the innate immune response. The final result of PTX3 activation might be determined by a fine tuning of time, space and environmental signals. The aim of this review is to provide an overview of biological properties of PTX3 in CV diseases and to discuss the ability of PTX3 to act as a crossroad between pro- and anti-inflammatory pathways.

Serum PLR and LMR in Behçet's disease: Can they show the disease activity?

The aim of this study is to determine platelet to lymphocyte ratio (PLR) and lymphocytes to monocytes ratio (LMR) levels in Behçet's disease (BD) and to investigate their relationships with disease activity.Hematological and inflammatory parameters including high-sensitivity C-reactive proteins (hs-CRP), erythrocyte sedimentation rate (ESR), PLR, and LMR were examined in BD and healthy controls.Data from 140 patients with BD (108 with active and 32 with inactive disease) and 107 controls were enrolled. PLR (153.21 ± 65.44, 106.20 ± 28.91, P <.001, respectively) was remarkably higher, whereas LMR (5.37 ± 5.47, 8.95 ± 5.84, P <.001, respectively) was significantly lower in BD than in controls. Active BD patients had significantly higher PLR (159.20 vs 131.14, P = .037), ESR (38.30 vs 24.55, P = .017), and hs-CRP (30.20 vs 17.21, P = .027) than those with inactive BD. However, no significant difference in LMR was found between the groups. Moreover, PLR was positively correlated with BDCAF (r = 0.193, P <.05), hs-CRP (r = 0.402, P <.01), and ESR (r = 0.284, P <.01), whereas LMR was negatively correlated with BDCAF (r = -0.175, P <.05), hs-CPR (r = -0.263, P <.01), and ESR (r = -0.175, P <.05). Additionally, both PLR and LMR were shown to be independent factors for BD by multivariate logistic regression analysis. Furthermore, a PLR level of 124.63 was determined as the best cut-off value by ROC analysis (sensitivity 64.3%, specificity 78.0%, and the area under the ROC curve 0. 753).PLR was elevated in active BD as compared to inactive BD. PLR may be a reliable, cost-effective, and novel potential parameter to help evaluate disease activity in BD.

Can Pentraxin-3 be a Candidate Marker in the Follow-Up of the Patients With Behçet's Disease?

Objectives

This study aims to assess the level of pentraxin-3 (PTX-3) as an inflammatory marker and compare it with C-reactive protein (CRP) levels in patients with Behçet's disease (BD).

Patients and methods

Forty-two patients with BD (15 males, 27 females; mean age 39.7±8.6 years; range 20 to 64 years) and 42 age- and sex- matched healthy controls (14 males, 28 females; mean age 40.8±8.2 year; range 25 to 60 years) were included in the study. Serum CRP and plasma PTX-3 levels were measured. Subgroup analyses were performed according to clinical manifestations of patients with BD.

Results

Both PTX-3 and CRP levels were significantly higher in patients with BD than controls (1.33±0.29 vs 0.85±0.12, p<0.05 for PTX-3 and 0.71±0.13 vs 0.27±0.03, p<0.001 for CRP, respectively). Area under the curve was 0.633±0.062 vs 0.729±0.05, respectively. Mean PTX-3 and CRP levels were 1.1 vs 1.5, p=0.5; 0.5 vs 0.9, p=0.5; respectively, in patients with mucocutaneous involvement alone and with other involvements, whereas they were 0.9 vs 1.6, p=0.1; 0.5 vs 0.8, p=0.3; respectively, in patients with and without peripheral arthritis, and were 1.7 vs 0.9, p=0.06; 1.0 vs 0.5, p=0.07; respectively, in patients with and without uveitis.

Conclusion

Although PTX-3 levels were higher in patients with BD than healthy controls, sensitivity and specificity of PTX-3 was not different than CRP in patients with BD.