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Brachat A, Feist E, Behrens F, Blank N, Nirmala NR, Specker C, Witt M, Zernicke J, Martini A, Junge G. Genes responding to Canakinumab therapy in SJIA are -inversely - disregulated in adult onset Still's disease. Pediatr Rheumatol Online J 2015. [PMCID: PMC4597022 DOI: 10.1186/1546-0096-13-s1-p4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Nirmala N, Brachat A, Feist E, Blank N, Specker C, Witt M, Zernicke J, Martini A, Junge G. Gene-expression analysis of adult-onset Still's disease and systemic juvenile idiopathic arthritis is consistent with a continuum of a single disease entity. Pediatr Rheumatol Online J 2015; 13:50. [PMID: 26589963 PMCID: PMC4654831 DOI: 10.1186/s12969-015-0047-3] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 11/06/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Adult-onset Still's disease (AOSD), a rare autoinflammatory disorder, resembles systemic juvenile idiopathic arthritis (SJIA). The superimposable systemic clinical features of AOSD and SJIA suggest both clinical phenotypes represent the same disease continuum with different ages of onset. To further characterize the similarity between AOSD and SJIA at the molecular level, 2 previously identified response gene sets in SJIA were used to investigate how genes that respond to interleukin (IL)-1β inhibition with canakinumab in SJIA patients behave in AOSD patients with active disease prior to IL-1β targeting therapy, relative to healthy subjects. FINDINGS All genes downregulated in SJIA patients following canakinumab treatment were upregulated in most patients with active AOSD prior to canakinumab treatment, relative to healthy subjects. A few patients with milder AOSD had expectedly gene-expression patterns that resembled those in healthy subjects. Comparison of the gene-expression patterns with neutrophil counts showed a correlation between elevated neutrophil numbers and upregulation of canakinumab-responsive genes. Correspondingly, most genes upregulated following canakinumab treatment in patients with SJIA patients were downregulated in the majority of AOSD patients. CONCLUSIONS These results further support the concept of a Still's disease continuum that includes both a pediatric/juvenile onset (SJIA) and adult onset (AOSD) form.
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Affiliation(s)
- Nanguneri Nirmala
- Novartis Institutes for BioMedical Research, Inc., 45 Sidney Street, Cambridge, MA, 02139, USA.
| | - Arndt Brachat
- Novartis Institutes for Biomedical Research, CH-4002, Basel, Switzerland.
| | - Eugen Feist
- Department of Rheumatology and Clinical Immunology, Charité- Universitätsmedizin, Chariteplatz 1, 10117, Berlin, Germany.
| | - Norbert Blank
- Division of Rheumatology, Department of Medicine, University of Heidelberg, Im Neuenheimer Feld 410, D-69120, Heidelberg, Germany.
| | - Christof Specker
- Klinik für Rheumatologie & Klinische Immunologie, SJK - University Hospital Essen, Propsteistrasse 2, 45239, Essen, Germany.
| | - Matthias Witt
- Division of Rheumatology and Clinical Immunology, Med. Klinik and Poliklinik IV, University of Munich, Pettenkoferstrasse 8a, 80336, Munich, Germany.
| | - Jan Zernicke
- Department of Rheumatology and Clinical Immunology, Charité- Universitätsmedizin, Chariteplatz 1, 10117, Berlin, Germany.
| | - Alberto Martini
- University of Genoa and G Gaslini Institute, Head Pediatria II, Reumatologia, IRCCS G. Gaslini, Largo G. Gaslini 5, 616147, Genoa, Italy.
| | - Guido Junge
- Novartis Pharma AG, CH-4002, Basel, Switzerland.
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