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Zinellu A, Mangoni AA. The potential role of serum amyloid A as biomarker of rheumatic diseases: a systematic review and meta-analysis. Clin Exp Med 2024; 24:141. [PMID: 38951267 PMCID: PMC11217051 DOI: 10.1007/s10238-024-01413-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 06/19/2024] [Indexed: 07/03/2024]
Abstract
The identification of novel, robust biomarkers for the diagnosis of rheumatic diseases (RDs) and the presence of active disease might facilitate early treatment and the achievement of favourable long-term outcomes. We conducted a systematic review and meta-analysis of studies investigating the acute phase reactant, serum amyloid A (SAA), in RD patients and healthy controls to appraise its potential as diagnostic biomarker. We searched PubMed, Scopus, and Web of Science from inception to 10 April 2024 for relevant studies. We evaluated the risk of bias and the certainty of evidence using the JBI Critical Appraisal Checklist and GRADE, respectively (PROSPERO registration number: CRD42024537418). In 32 studies selected for analysis, SAA concentrations were significantly higher in RD patients compared to controls (SMD = 1.61, 95% CI 1.24-1.98, p < 0.001) and in RD patients with active disease compared to those in remission (SMD = 2.17, 95% CI 1.21-3.13, p < 0.001). Summary receiving characteristics curve analysis showed a good diagnostic accuracy of SAA for the presence of RDs (area under the curve = 0.81, 95% CI 0.78-0.84). The effect size of the differences in SAA concentrations between RD patients and controls was significantly associated with sex, body mass index, type of RD, and study country. Pending the conduct of prospective studies in different types of RDs, the results of this systematic review and meta-analysis suggest that SAA is a promising biomarker for the diagnosis of RDs and active disease.
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Affiliation(s)
- Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, SA, 5042, Australia.
- Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, Australia.
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Barakat L, Echchilali K, Moudatir M, El Kabli H, Ettagmouti Y, Haboub M, Arous S, Benouna MG, Drighil A, Habbal R, Azim M, Mazti A, Regragui M, Bennani Guebessi N, Karkouri M. A rare clinical case of systemic AA amyloidosis with cardiac involvement complicating ankylosing spondylitis: a case report. Egypt Heart J 2024; 76:40. [PMID: 38546927 PMCID: PMC10978558 DOI: 10.1186/s43044-024-00471-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/20/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Ankylosing spondylitis (AS) is a type of chronic inflammation that is most prevalent in young adults and is characterized by an inflammatory enthesiopathy that gradually develops toward ossification and ankylosis. If inflammation is left unchecked, it can potentially lead to complications such as secondary amyloidosis, also known as AA amyloidosis, involving the deposition of amyloid serum A protein. Our case presents with a thyroid localization of AA amyloidosis which is secondary to this AS. Such a case has been described in only four cases in the literature. Cardiac localization of AA amyloidosis has been exceptionally described in the literature. CASE PRESENTATION We report the case of a young patient with severe AS complicated by secondary amyloidosis with thyroid, cardiac, and probably renal localization. He was treated with anti-TNF therapy, and his condition improved significantly. CONCLUSIONS Our case presents several localizations of AA amyloidosis secondary to this AS. Although cardiac involvement is rare in secondary AA amyloidosis, it should always be screened for, even in a cardiacly asymptomatic patient.
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Affiliation(s)
- Leïla Barakat
- Department of Internal Medicine, CHU Ibn Rochd, Casablanca, Morocco.
| | | | - Mina Moudatir
- Department of Internal Medicine, CHU Ibn Rochd, Casablanca, Morocco
| | - Hassan El Kabli
- Department of Internal Medicine, CHU Ibn Rochd, Casablanca, Morocco
| | - Yassine Ettagmouti
- Cardiology Department, Ibn Rochd University Hospital, Casablanca, Morocco
| | - Mériem Haboub
- Cardiology Department, Ibn Rochd University Hospital, Casablanca, Morocco
| | - Salim Arous
- Cardiology Department, Ibn Rochd University Hospital, Casablanca, Morocco
| | | | - Abdenasser Drighil
- Cardiology Department, Ibn Rochd University Hospital, Casablanca, Morocco
| | - Rachida Habbal
- Cardiology Department, Ibn Rochd University Hospital, Casablanca, Morocco
| | - Meryame Azim
- Laboratory of Pathological Anatomy, CHU Ibn Rochd, Casablanca, Morocco
| | - Asmae Mazti
- Laboratory of Pathological Anatomy, CHU Ibn Rochd, Casablanca, Morocco
| | - Meriem Regragui
- Laboratory of Pathological Anatomy, CHU Ibn Rochd, Casablanca, Morocco
| | | | - Mehdi Karkouri
- Laboratory of Pathological Anatomy, CHU Ibn Rochd, Casablanca, Morocco
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3
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El Kosaier MA, Shaat RM, El.Arman MM, Afifi AEMA. Serum amyloid a level and musculoskeletal ultrasound in assessment of disease activity in rheumatoid arthritis patients. THE EGYPTIAN RHEUMATOLOGIST 2023. [DOI: 10.1016/j.ejr.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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4
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Lee YH, Huang SW, Chen CK, Hong JP, Chen YW, Lin HW. Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs and the Risk of Vascular Dementia in Patients with Spondyloarthritis: A Database Cohort Study. J Clin Med 2023; 12:jcm12030950. [PMID: 36769598 PMCID: PMC9917485 DOI: 10.3390/jcm12030950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 01/20/2023] [Accepted: 01/22/2023] [Indexed: 01/28/2023] Open
Abstract
Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease that mainly affects the axial bones, and dementia is characterized by a decline in cognitive function, leading to dependence in everyday activity. Although the association between dementia and ankylosing spondylitis has been investigated, the influence of axSpA medication on dementia risk is unclear. The aim of this study was to investigate the risk of dementia among axSpA patients and if the conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) can reduce the risk of dementia. Patients with axSpA whose data were recorded during 2004-2008 and who were followed up until the end of 2010 were recruited. A control cohort was matched by age and sex. A Cox multivariate proportional hazards model was applied to analyze the risk factors for dementia. The hazard ratio (HR) and adjusted HR (aHR) were estimated between the study and control cohorts. The effects of csDMARDs and steroid use on the risk of different types of dementia were also analyzed. In total, 2341 and 11,705 patients constituted the axSpA and control cohort, respectively. The axSpA cohort had a greater risk of vascular dementia (aHR = 2.09 (1.36-3.20). The risk of dementia (aHR = 1.01 (0.55-1.85) did not significantly differ between patients with axSpA who received csDMARDs. In conclusion, patients with axSpA are at a risk of vascular dementia, which could be reduced by csDMARDs.
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Affiliation(s)
- Yu-Hao Lee
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Graduate Institute of Sports Science, National Taiwan Sports University, Taoyuan City 33301, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Graduate Institute of Sports Science, National Taiwan Sports University, Taoyuan City 33301, Taiwan
| | - Chih-Kuang Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan, Taiwan School of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Jia-Pei Hong
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yi-Wen Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Hui-Wen Lin
- Department of Mathematics, Soochow University, Taipei 11102, Taiwan
- ICF Research Center, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
- Correspondence: ; Tel.: +886-2-2881-9471 (ext. 6701); Fax: +886-2-8861-1230
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Watad A, McGonagle D, Anis S, Carmeli R, Cohen AD, Tsur AM, Ben-Shabat N, Lidar M, Amital H. TNF inhibitors have a protective role in the risk of dementia in patients with ankylosing spondylitis: Results from a nationwide study. Pharmacol Res 2022; 182:106325. [PMID: 35752359 DOI: 10.1016/j.phrs.2022.106325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/24/2022] [Accepted: 06/20/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Ankylosing spondylitis (AS) is a chronic progressive and debilitating form of arthritis with associated extra-articular features including uveitis, intestinal and lung apical inflammation and psoriasis. Putative associations between AS and neurologic disorders has been relatively overlooked. The purpose of this study is to assess the link between AS and major neurologic disorders and whether treatment with Tumor-Necrosis-Factor inhibitors (TNFi) has an impact on that association. METHODS A retrospective cross-sectional study was carried out based on the Clalit Health Services (CHS) computerized database. AS patients were compared to age- and gender-matched controls with respect to the proportion of Alzheimer's disease (AD), Parkinson's disease (PD), epilepsy, and multiple sclerosis (MS). The impact of AS therapy (biologic vs conventional therapy) was assessed as well. RESULTS 4,082 AS patients and 20,397 age- and gender-matched controls were identified. AS was associated with a higher prevalence of AD (odds-ratio(OR) 1.46 [95%Confidence-interval(CI) 1.13-1.87], p=0.003), epilepsy (OR 2.33 [95%CI 1.75-3.09] p<0.0001) and PD (OR 2.75 [95%CI 2.04-3.72], p<0.0001), whereas no statistically significant association was found for MS. Association with PD remained significant in the multivariate analysis (OR 1.49 [95%CI 1.05- 2.13],p=0.027). Within AS patients, the use of TNFi (OR 0.10 [95%CI 0.01-0.74], p=0.024) were associated with a lowered risk of developing AD. CONCLUSION AS is positively associated with AD, PD, and epilepsy but not MS. AS patients treated with TNFi have lower rates of AD.
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Affiliation(s)
- Abdulla Watad
- Department of Medicine 'B', Sheba Medical Centre, Tel-Hashomer, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Centre, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel; Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK.
| | - Dennis McGonagle
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK
| | - Saar Anis
- Department of Neurology, Sheba Medical Center, Ramat Gan, Israel
| | - Reut Carmeli
- Department of Medicine 'B', Sheba Medical Centre, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Arnon D Cohen
- Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Avishai M Tsur
- Department of Medicine 'B', Sheba Medical Centre, Tel-Hashomer, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Centre, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel; Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Niv Ben-Shabat
- Department of Medicine 'B', Sheba Medical Centre, Tel-Hashomer, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Centre, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Merav Lidar
- Rheumatology unit, Sheba Medical Centre, Ramat Gan, Israel
| | - Howard Amital
- Department of Medicine 'B', Sheba Medical Centre, Tel-Hashomer, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Centre, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel
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6
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Oxidative Stress and Inflammatory Status in COVID-19 Outpatients: A Health Center-Based Analytical Cross-Sectional Study. Antioxidants (Basel) 2022; 11:antiox11040606. [PMID: 35453291 PMCID: PMC9024445 DOI: 10.3390/antiox11040606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 01/27/2023] Open
Abstract
The antioxidant system can be critical in reducing exacerbated inflammation in COVID-19. This study compared the antioxidant and inflammatory responses between COVID-19 outpatients and seemingly healthy individuals. This descriptive-analytical cross-sectional study was conducted on 53 COVID-19 outpatients and 53 healthy individuals as controls. The serum concentrations of amyloid A (SAA), total antioxidant capacity (TAC), superoxide dismutase (SOD), and glutathione peroxidase (GPx) were measured and compared between COVID-19 patients and controls using the independent sample t-test before and after controlling for dietary supplement use. A generalized estimating equation (GEE) regression model, limited to COVID-19 patients, was used to evaluate the odds ratios (ORs) and 95% confidence intervals (95% CIs) of disease symptoms on days 1, 7, 14, 21, and 28 after the disease onset. Serum concentrations of SOD (p ≤ 0.001) and GPx (p = 0.001) were significantly higher in COVID-19 patients than in controls before adjustment for dietary supplement use. GPx remained significantly higher among COVID-19 patients than in controls after adjustment for all dietary supplements (p = 0.005). Moreover, serum concentrations of GPx (p = 0.003), SOD (p = 0.022), and TAC (p = 0.028) remained significantly higher among COVID-19 patients than in controls after adjustment for vitamin D supplementation. This study showed higher GPx in COVID-19 outpatients than in controls after adjustment for dietary supplement use. Moreover, elevated SOD, GPx, and TAC concentrations were shown in COVID-19 outpatients compared to controls after adjusting for vitamin D supplementation. These results may provide a useful therapeutic target for treating oxidative stress in COVID-19 disease, which may help ameliorate the pandemic.
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Hu QL, Fu S, Huang R, Zhang L, Wu LF, Lv YJ. The Value of Serum Amyloid A in the Diagnosis and Management of Ankylosing Spondylitis. Int J Gen Med 2021; 14:2715-2719. [PMID: 34188526 PMCID: PMC8235943 DOI: 10.2147/ijgm.s310677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/14/2021] [Indexed: 11/23/2022] Open
Abstract
Objective The present study aimed to explore the clinical value of serum amyloid A (SAA) in the diagnosis, treatment, and assessment of ankylosing spondylitis (AS). Methods Seventy-eight patients with AS were enrolled as the case group, while the control group consisted of 80 healthy individuals enrolled during the same time period. According to the criteria of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), patients in the case group were divided into those in the remission phase (36 patients) and those in the active phase (42 patients). Levels of SAA, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured in all enrolled subjects and analyzed. Results SAA levels were significantly higher in the AS group (39.65 ± 12.32 ng/mL) than in the control group (7.64 ± 1.32 ng/mL) (p =0.011) and in patients in the active phase (56.18 ± 17.25 ng/mL) compared with those in the remission phase (20.36 ± 5.36 ng/mL) (p =0.015). The sensitivity and specificity of SAA were 79.49% and 77.50%, respectively. There was a positive correlation between SAA level and the BASDAI grade (r = 0.77, p =0.005), CRP level (r = 0.68, p =0.011), and ESR (r = 0.62, p =0.012). Conclusion Not only is SAA a reliable indicator for the presence of AS, it may also be useful for monitoring the activity of this disease.
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Affiliation(s)
- Qi-Lei Hu
- Department of Clinical Laboratory, The First People's Hospital of Yuhang District, Hangzhou, Hangzhou, Zhejiang, 311100, People's Republic of China
| | - Shui Fu
- Department of Clinical Laboratory, The First People's Hospital of Yuhang District, Hangzhou, Hangzhou, Zhejiang, 311100, People's Republic of China
| | - Rong Huang
- Department of Clinical Laboratory, The First People's Hospital of Yuhang District, Hangzhou, Hangzhou, Zhejiang, 311100, People's Republic of China
| | - Liang Zhang
- Department of Clinical Laboratory, The First People's Hospital of Yuhang District, Hangzhou, Hangzhou, Zhejiang, 311100, People's Republic of China
| | - Li-Feng Wu
- Department of Clinical Laboratory, The First People's Hospital of Yuhang District, Hangzhou, Hangzhou, Zhejiang, 311100, People's Republic of China
| | - Yin-Jiang Lv
- Department of Clinical Laboratory, The First People's Hospital of Yuhang District, Hangzhou, Hangzhou, Zhejiang, 311100, People's Republic of China
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Sorić Hosman I, Kos I, Lamot L. Serum Amyloid A in Inflammatory Rheumatic Diseases: A Compendious Review of a Renowned Biomarker. Front Immunol 2021; 11:631299. [PMID: 33679725 PMCID: PMC7933664 DOI: 10.3389/fimmu.2020.631299] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/31/2020] [Indexed: 12/13/2022] Open
Abstract
Serum amyloid A (SAA) is an acute phase protein with a significant importance for patients with inflammatory rheumatic diseases (IRD). The central role of SAA in pathogenesis of IRD has been confirmed by recent discoveries, including its involvement in the activation of the inflammasome cascade and recruitment of interleukin 17 producing T helper cells. Clinical utility of SAA in IRD was originally evaluated nearly half a century ago. From the first findings, it was clear that SAA could be used for evaluating disease severity and monitoring disease activity in patients with rheumatoid arthritis and secondary amyloidosis. However, cost-effective and more easily applicable markers, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), overwhelmed its use in clinical practice. In the light of emerging evidences, SAA has been discerned as a more sensitive biomarker in a wide spectrum of IRD, especially in case of subclinical inflammation. Furthermore, a growing number of studies are confirming the advantages of SAA over many other biomarkers in predicting and monitoring response to biological immunotherapy in IRD patients. Arising scientific discoveries regarding the role of SAA, as well as delineating SAA and its isoforms as the most sensitive biomarkers in various IRD by recently developing proteomic techniques are encouraging the revival of its clinical use. Finally, the most recent findings have shown that SAA is a biomarker of severe Coronavirus disease 2019 (COVID-19). The aim of this review is to discuss the SAA-involving immune system network with emphasis on mechanisms relevant for IRD, as well as usefulness of SAA as a biomarker in various IRD. Therefore, over a hundred original papers were collected through an extensive PubMed and Scopus databases search. These recently arising insights will hopefully lead to a better management of IRD patients and might even inspire the development of new therapeutic strategies with SAA as a target.
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Affiliation(s)
- Iva Sorić Hosman
- Department of Pediatrics, Zadar General Hospital, Zadar, Croatia
| | - Ivanka Kos
- Division of Nephrology, Dialysis and Transplantation, Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Lovro Lamot
- Division of Nephrology, Dialysis and Transplantation, Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia.,Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia
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Rademacher J, Tietz LM, Le L, Hartl A, Hermann KGA, Sieper J, Mansmann U, Rudwaleit M, Poddubnyy D. Added value of biomarkers compared with clinical parameters for the prediction of radiographic spinal progression in axial spondyloarthritis. Rheumatology (Oxford) 2020; 58:1556-1564. [PMID: 30830164 DOI: 10.1093/rheumatology/kez025] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 12/26/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES The objective of this study was to examine whether adding biomarkers to routine clinical parameters improves prediction of radiographic spinal progression in axial spondyloarthritis. METHODS One hundred and seventeen patients with ankylosing spondylitis who completed the Effects of NSAIDs on RAdiographic Damage in Ankylosing Spondylitis (ENRADAS) trial were included. Radiographic spinal progression was defined as worsening of the modified Stoke Ankylosing Spondylitis Spine Score by ⩾2 points after 2 years. A clinical prediction model was constructed out of baseline syndesmophytes, elevated CRP, cigarette smoking and male sex. The following serum biomarkers were measured at baseline by ELISA: MMP3, VEGF, calprotectin, leptin, high molecular weight adiponectin, osteoprotegerin, sclerostin, N-terminal telopeptide, procollagen type II N-terminal propeptide and serum amyloid A. RESULTS Repeated cross-validation analyses revealed one biomarker combination with potential added predictive value in addition to the clinical model: leptin + high molecular weight adiponectin + VEGF. This biomarker combination showed an area under the curve (AUC)Biomarkers = 0.731 (95% CI: 0.614, 0.848), which was numerically superior to the clinical model [AUCClinical = 0.665 (95% CI: 0.553, 0.776)]. A combination of clinical parameters + biomarkers showed an improved predictive value compared with the clinical model reflected by AUCClinical+Biomarkers = 0.768 (95% CI: 0.666, 0.871), though not statistically significant (P = 0.051). However, by considering the part of the receiver operating characteristic curve with a specificity ⩾75% resulting in partial AUC (pAUC), the improvement becomes significant (pAUCClinical+Biomarkers = 0.119; pAUCClinical = 0.053; P = 0.01). CONCLUSION Biomarkers show potential to improve the prediction of radiographic spinal progression in axial spondyloarthritis when used in addition to the clinical parameters, though the added value seems to be rather small.
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Affiliation(s)
- Judith Rademacher
- Department of Gastroenterology, Infectiology and Rheumatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin.,Berlin Institute of Health, Berlin
| | - Lorraine Madeline Tietz
- Department of Gastroenterology, Infectiology and Rheumatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin.,Berlin Institute of Health, Berlin
| | - Lien Le
- Institute of Medical Informatics, Biometry, and Epidemiology, Ludwig-Maximilian University, Munich
| | - Agnes Hartl
- Department of Gastroenterology, Infectiology and Rheumatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin.,Berlin Institute of Health, Berlin
| | - Kay-Geert A Hermann
- Berlin Institute of Health, Berlin.,Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin
| | - Joachim Sieper
- Department of Gastroenterology, Infectiology and Rheumatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin.,Berlin Institute of Health, Berlin
| | - Ulrich Mansmann
- Institute of Medical Informatics, Biometry, and Epidemiology, Ludwig-Maximilian University, Munich
| | - Martin Rudwaleit
- Department of Gastroenterology, Infectiology and Rheumatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin.,Berlin Institute of Health, Berlin.,Department of Internal Medicine and Rheumatology, Klinikum Bielefeld Rosenhöhe, Bielefeld
| | - Denis Poddubnyy
- Department of Gastroenterology, Infectiology and Rheumatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin.,Berlin Institute of Health, Berlin.,Department of Epidemiology, German Rheumatism Research Centre, Berlin, Germany
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10
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Wu J, Wu X, Chen Z, Lv Q, Yang M, Zheng X, Li Q, Zhang Y, Wei Q, Cao S, Li X, Qi J, Zhao M, Liao Z, Lin Z, Gu J. Circulating Retinol-Binding Protein 4 as a Possible Biomarker of Treatment Response for Ankylosing Spondylitis: An Array-Based Comparative Study. Front Pharmacol 2020; 11:231. [PMID: 32210816 PMCID: PMC7076136 DOI: 10.3389/fphar.2020.00231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/20/2020] [Indexed: 01/31/2023] Open
Abstract
Objective To explore proteins associated with ankylosing spondylitis (AS) and to investigate potential proteins that may predict treatment response of adalimumab (ADA) in AS patients. Methods In the discovery cohort, 39 AS patients and 20 healthy controls (HCs) were included, and 16 AS patients received ADA treatment for 24 weeks after included. In the validation cohort, 43 AS patients and 39 HCs were enrolled, and all 43 patients received ADA treatment after enrollment. Blood samples and clinical information were collected from two cohorts at baseline from all participants and week 24 from patients received ADA treatment. A human antibody array containing 1,000 proteins was used in the discovery phase, and Elisa kits were used for protein validation. Results Compared with HCs, we identified 53 differentially expressed proteins (DEPs) in AS patients. Bioinformatics analysis revealed they were mostly enriched in coagulation function-related pathways, acute response signaling, and LXR/RXR activation. Bone metabolism pathways were also associated. Comparison between samples of pre- and post-ADA treatment revealed 42 DEPs. They were mostly associated with bone metabolism and inflammation response pathways. Significant enrichment was also found in LXR/RXR activation but not the coagulation function-related pathways. Upstream regulator analysis suggested that most regulators also significantly functioned under usage of ADA. Precisely, seven proteins were abnormally expressed in AS and restored after ADA treatment. Retinol-binding protein 4 (RBP4), one of the seven proteins, was validated that its baseline levels were inversely correlated with improvements in Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP). Likewise, percentage changes in RBP4 levels were inversely correlated with changes in ASDAS-CRP score. Conclusion A dysregulated serum protein profile existed in AS. ADA exerted a considerable but not entire alteration toward the dysregulation. RBP4 could be a biomarker for predicting and monitoring ADA treatment response.
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Affiliation(s)
- Jialing Wu
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xinyu Wu
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zena Chen
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qing Lv
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Mingcan Yang
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xuqi Zheng
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qiuxia Li
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yanli Zhang
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qiujing Wei
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shuangyan Cao
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaomin Li
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jun Qi
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Minjing Zhao
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zetao Liao
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhiming Lin
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jieruo Gu
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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11
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Spiga O, Cicaloni V, Fiorini C, Trezza A, Visibelli A, Millucci L, Bernardini G, Bernini A, Marzocchi B, Braconi D, Prischi F, Santucci A. Machine learning application for development of a data-driven predictive model able to investigate quality of life scores in a rare disease. Orphanet J Rare Dis 2020; 15:46. [PMID: 32050984 PMCID: PMC7017449 DOI: 10.1186/s13023-020-1305-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 01/14/2020] [Indexed: 01/11/2023] Open
Abstract
Background Alkaptonuria (AKU) is an ultra-rare autosomal recessive disease caused by a mutation in the homogentisate 1,2-dioxygenase (HGD) gene. One of the main obstacles in studying AKU, and other ultra-rare diseases, is the lack of a standardized methodology to assess disease severity or response to treatment. Quality of Life scores (QoL) are a reliable way to monitor patients’ clinical condition and health status. QoL scores allow to monitor the evolution of diseases and assess the suitability of treatments by taking into account patients’ symptoms, general health status and care satisfaction. However, more comprehensive tools to study a complex and multi-systemic disease like AKU are needed. In this study, a Machine Learning (ML) approach was implemented with the aim to perform a prediction of QoL scores based on clinical data deposited in the ApreciseKUre, an AKU- dedicated database. Method Data derived from 129 AKU patients have been firstly examined through a preliminary statistical analysis (Pearson correlation coefficient) to measure the linear correlation between 11 QoL scores. The variable importance in QoL scores prediction of 110 ApreciseKUre biomarkers has been then calculated using XGBoost, with K-nearest neighbours algorithm (k-NN) approach. Due to the limited number of data available, this model has been validated using surrogate data analysis. Results We identified a direct correlation of 6 (age, Serum Amyloid A, Chitotriosidase, Advanced Oxidation Protein Products, S-thiolated proteins and Body Mass Index) out of 110 biomarkers with the QoL health status, in particular with the KOOS (Knee injury and Osteoarthritis Outcome Score) symptoms (Relative Absolute Error (RAE) 0.25). The error distribution of surrogate-model (RAE 0.38) was unequivocally higher than the true-model one (RAE of 0.25), confirming the consistency of our dataset. Our data showed that inflammation, oxidative stress, amyloidosis and lifestyle of patients correlates with the QoL scores for physical status, while no correlation between the biomarkers and patients’ mental health was present (RAE 1.1). Conclusions This proof of principle study for rare diseases confirms the importance of database, allowing data management and analysis, which can be used to predict more effective treatments.
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Affiliation(s)
- Ottavia Spiga
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A., 53100, Siena, Italy.
| | - Vittoria Cicaloni
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A., 53100, Siena, Italy.,Toscana Life Sciences Foundation, Siena, Italy
| | | | - Alfonso Trezza
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A., 53100, Siena, Italy
| | - Anna Visibelli
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A., 53100, Siena, Italy.,Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
| | - Lia Millucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A., 53100, Siena, Italy
| | - Giulia Bernardini
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A., 53100, Siena, Italy
| | - Andrea Bernini
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A., 53100, Siena, Italy
| | - Barbara Marzocchi
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A., 53100, Siena, Italy.,UOC Patologia Clinica, Azienda Ospedaliera Senese, Siena, Italy
| | - Daniela Braconi
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A., 53100, Siena, Italy
| | - Filippo Prischi
- School of Life Sciences, University of Essex, Colchester, CO4 3SQ, UK
| | - Annalisa Santucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A., 53100, Siena, Italy
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12
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Liu S, Ji W, Lu J, Tang X, Guo Y, Ji M, Xu T, Gu W, Kong D, Shen Q, Wang D, Lv X, Wang J, Zhu T, Zhu Y, Liu P, Su J, Wang L, Li Y, Gao P, Liu W, Sun L, Yin X, Zhou W. Discovery of Potential Serum Protein Biomarkers in Ankylosing Spondylitis Using Tandem Mass Tag-Based Quantitative Proteomics. J Proteome Res 2020; 19:864-872. [PMID: 31917576 DOI: 10.1021/acs.jproteome.9b00676] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Ankylosing spondylitis (AS) is a systemic, chronic, and inflammatory rheumatic disease that affects 0.2% of the population. Current diagnostic criteria for disease activity rely on subjective Bath Ankylosing Spondylitis Disease Activity Index scores. Here, we aimed to discover a panel of serum protein biomarkers. First, tandem mass tag (TMT)-based quantitative proteomics was applied to identify differential proteins between 15 pooled active AS and 60 pooled healthy subjects. Second, cohort 1 of 328 humans, including 138 active AS and 190 healthy subjects from two independent centers, was used for biomarker discovery and validation. Finally, biomarker panels were applied to differentiate among active AS, stable AS, and healthy subjects from cohort 2, which enrolled 28 patients with stable AS, 26 with active AS, and 28 healthy subjects. From the proteomics study, a total of 762 proteins were identified and 46 proteins were up-regulated and 59 proteins were down-regulated in active AS patients compared to those in healthy persons. Among them, C-reactive protein (CRP), complement factor H-related protein 3 (CFHR3), α-1-acid glycoprotein 2 (ORM2), serum amyloid A1 (SAA1), fibrinogen γ (FG-γ), and fibrinogen β (FG-β) were the most significantly up-regulated inflammation-related proteins and S100A8, fatty acid-binding protein 5 (FABP5), and thrombospondin 1 (THBS1) were the most significantly down-regulated inflammation-related proteins. From the cohort 1 study, the best panel for the diagnosis of active AS vs healthy subjects is the combination of CRP and SAA1. The area under the receiver operating characteristic (ROC) curve was nearly 0.900, the sensitivity was 0.970%, and the specificity was 0.805% at a 95% confidence interval from 0.811 to 0.977. Using 0.387 as the cutoff value, the predictive values reached 92.00% in the internal validation set (62 with active AS vs 114 healthy subjects) and 97.50% in the external validation phase (40 with active AS vs 40 healthy subjects). From the cohort 2 study, a panel of CRP and SAA1 can differentiate well among active AS, stable AS, and healthy subjects. For active AS vs stable AS, the area under the ROC curve was 0.951, the sensitivity was 96.43%, the specificity was 88.46% at a 95% confidence interval from 0.891 to 1, and the coincidence rate was 92.30%. For stable AS vs healthy humans, the area under the ROC curve was 0.908, the sensitivity was 89.29%, the specificity was 78.57% at a 95% confidence interval from 0.836 to 0.980, and the coincidence rate was 83.93%. For active AS vs healthy subjects, the predictive value was 94.44%. The results indicated that the CRP and SAA1 combination can potentially diagnose disease status, especially for active or stable AS, which will be conducive to treatment recommendation for patients with AS.
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Affiliation(s)
- Shijia Liu
- Affiliated Hospital of Nanjing University of Chinese Medicine , Nanjing , Jiangsu 210029 China
| | - Wei Ji
- Affiliated Hospital of Nanjing University of Chinese Medicine , Nanjing , Jiangsu 210029 China
| | - Jiawei Lu
- State Key Laboratory of Natural Medicines, School of Traditional Chinese Pharmacy , China Pharmaceutical University , Nanjing 210009 , China
| | - Xiaojun Tang
- Department of Rheumatology and Immunology , The Affiliated Drum Tower Hospital of Nanjing University Medical School , Nanjing , Jiangsu 210029 , China
| | - Yunke Guo
- Affiliated Hospital of Nanjing University of Chinese Medicine , Nanjing , Jiangsu 210029 China
| | - Mingde Ji
- Affiliated Hospital of Nanjing University of Chinese Medicine , Nanjing , Jiangsu 210029 China
| | - Tian Xu
- Affiliated Hospital of Nanjing University of Chinese Medicine , Nanjing , Jiangsu 210029 China
| | - Wanjian Gu
- Affiliated Hospital of Nanjing University of Chinese Medicine , Nanjing , Jiangsu 210029 China
| | - Deshun Kong
- College of Pharmacy, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization , Nanjing University of Chinese Medicine , Nanjing 210046 , China
| | - Qiuxiang Shen
- College of Pharmacy, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization , Nanjing University of Chinese Medicine , Nanjing 210046 , China
| | - Dandan Wang
- Department of Rheumatology and Immunology , The Affiliated Drum Tower Hospital of Nanjing University Medical School , Nanjing , Jiangsu 210029 , China
| | - Xiangyu Lv
- State Key Laboratory of Natural Medicines, School of Traditional Chinese Pharmacy , China Pharmaceutical University , Nanjing 210009 , China
| | - Jue Wang
- State Key Laboratory of Natural Medicines, School of Traditional Chinese Pharmacy , China Pharmaceutical University , Nanjing 210009 , China
| | - Tianyao Zhu
- College of Pharmacy, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization , Nanjing University of Chinese Medicine , Nanjing 210046 , China
| | - Youjuan Zhu
- College of Pharmacy, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization , Nanjing University of Chinese Medicine , Nanjing 210046 , China
| | - Ping Liu
- Xuzhou Medical University , Xuzhou , Jiangsu 221004 , China
| | - Jinfeng Su
- Xuzhou Medical University , Xuzhou , Jiangsu 221004 , China
| | - Lu Wang
- Xuzhou Medical University , Xuzhou , Jiangsu 221004 , China
| | - Yuhua Li
- Xuzhou Medical University , Xuzhou , Jiangsu 221004 , China
| | - Pan Gao
- Xuzhou Medical University , Xuzhou , Jiangsu 221004 , China
| | - Wei Liu
- Xuzhou Medical University , Xuzhou , Jiangsu 221004 , China
| | - Lingyun Sun
- Department of Rheumatology and Immunology , The Affiliated Drum Tower Hospital of Nanjing University Medical School , Nanjing , Jiangsu 210029 , China
| | - Xiaojian Yin
- State Key Laboratory of Natural Medicines, School of Traditional Chinese Pharmacy , China Pharmaceutical University , Nanjing 210009 , China
| | - Wei Zhou
- State Key Laboratory of Natural Medicines, School of Traditional Chinese Pharmacy , China Pharmaceutical University , Nanjing 210009 , China
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13
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Dai ML, Fan S, Li Z, Yu X, Lin D, Huang XF, Wang Y. Correlation of serum amyloid A levels, clinical manifestations, treatment, and disease activity in patients with acute anterior uveitis. Eye (Lond) 2019; 34:1672-1678. [PMID: 31844164 PMCID: PMC7608421 DOI: 10.1038/s41433-019-0740-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 10/05/2019] [Accepted: 10/14/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose To investigate the association between serum amyloid A (SAA) protein and the clinical features of acute anterior uveitis (AAU), and to evaluate the disease activity and treatment effect in relation to SAA levels. Methods AAU patients and healthy individuals were recruited from October 2016 to August 2017 at the Department of Uveitis, in the Eye Hospital of Wenzhou Medical University. Related demographic, clinical characteristics, and therapeutic data were analyzed. Results One hundred and eight AAU patients and 18 healthy controls were included in this study. Serum SAA levels in AAU patients were significantly higher than those of healthy controls (p all < 0.0001). Significantly higher SAA levels were found in AS+AAU patients than those in AS−AAU patients (p < 0.05). SAA levels were also significantly higher in patients with HLA-B27+AAU compared with those with HLA-B27−AAU (p < 0.05). Furthermore, in each of the AAU subgroups, higher SAA levels were observed in the active state than those in the inactive state (p all < 0.05). In addition, SAA levels were positively correlated to anterior chamber cell counts (r = 0.492, p < 0.0001). ROC curve analysis revealed that SAA had an AUC value of 0.727 for detecting active inflammation (Youden’s index = 0.38). SAA decreased with effective treatments (p = 0.0002). Conclusion Serum levels of SAA were elevated in AAU patients. The increased levels of SAA were correlated with AS and HLA-B27 status. SAA levels were also positively correlated to disease activity and decreased with effective treatments. These findings suggest that SAA is associated with AAU, with a potential role in monitoring inflammatory processes and assessing the efficacy of therapy.
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Affiliation(s)
- Ma-Li Dai
- School of Ophthalmology and Optometry, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shipei Fan
- School of Ophthalmology and Optometry, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhuoran Li
- New England College of Optometry, Boston, MA, USA
| | - Xuewen Yu
- School of Ophthalmology and Optometry, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Dan Lin
- School of Ophthalmology and Optometry, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiu-Feng Huang
- School of Ophthalmology and Optometry, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China. .,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. .,Translational Genomics Group, Institute of Health and Biomedical Innovation, Queensland University of Technology at Translational Research Institute, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.
| | - Yuqin Wang
- School of Ophthalmology and Optometry, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China. .,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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14
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Lu W, Chen B, Wang C, Yang X, Zhou C. Serum amyloid A levels in acute and chronic urticaria. An Bras Dermatol 2019; 94:411-415. [PMID: 31644612 PMCID: PMC7007030 DOI: 10.1590/abd1806-4841.20197761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 04/25/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Serum amyloid A is an acute-phase protein. There is no available data regarding serum amyloid A levels in patients with acute (AU) and chronic urticaria (CU). OBJECTIVE To investigate the association between serum amyloid A and urticaria. METHODS This was a case-control study of 81 patients who visited our Hospital between June and December 2016 with a diagnosis of urticaria. Eighty healthy controls (HC) who visited for routine health examination and physical checkups were recruited. Serum amyloid A and C-reactive protein levels were measured by automated methods. RESULTS Serum amyloid A and C-reactive protein levels were significantly higher in AU (Serum amyloid A: 207.1 (6.7-439.0) mg/L; C-reactive protein: 16.0 (0.2-90.0) mg/L) and CU (Serum amyloid A: 6.5 (2.5-35.8) mg/L; C-reactive protein: 1.0 (0.1-16.0) mg/L) compared with HC (Serum amyloid A: 5.04 (2.0-9.1) mg/L; C-reactive protein: 1.2 (0.1-5.6) mg/L), and in AU compared with CU (all P<0.05). There were no differences between the CU and HC group. In CU, Serum amyloid A levels in those with moderate/severe urticaria (median, 16.4 (9.7-35.8) mg/L) were higher than in those with mild urticaria (median, 5.7 (2.5-9.5) mg/L) and HC (all P<0.05). Serum amyloid A and C-reactive protein levels exceeded the normal lab range in 90.7% and 72.1% patients with AU compared with 28.9% and 13.2% patients with CU, respectively. Significant positive correlations were found between serum amyloid A and C-reactive protein (r = 0.562, P < 0.001). STUDY LIMITATIONS There was no comparison between active disease and remission. CONCLUSION There was an association between serum amyloid A levels and urticaria. Higher serum amyloid A levels were associated with AU and more severe CU. Serum amyloid A may help to identify CU patients earlier.
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Affiliation(s)
- Wei Lu
- Medical Laboratory Center, Zhejiang Province Traditional Chinese Medical Hospital, Hangzhou, Zhejiang, China
| | - Baobing Chen
- Medical Laboratory Center, The Third People’s Hospital of Hangzhou, Hangzhou, Zhejiang, China
| | - Chunfeng Wang
- Medical Laboratory Center, Zhejiang Province Traditional Chinese Medical Hospital, Hangzhou, Zhejiang, China
| | - Xiaohong Yang
- Dermatological Department, Zhejiang Province Traditional Chinese Medical Hospital, Hangzhou, Zhejiang, China
| | - Changyu Zhou
- Radiology Department, Zhejiang Province Traditional Chinese Medical Hospital, Hangzhou, Zhejiang, China
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15
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Cicaloni V, Spiga O, Dimitri GM, Maiocchi R, Millucci L, Giustarini D, Bernardini G, Bernini A, Marzocchi B, Braconi D, Santucci A. Interactive alkaptonuria database: investigating clinical data to improve patient care in a rare disease. FASEB J 2019; 33:12696-12703. [PMID: 31462106 DOI: 10.1096/fj.201901529r] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Alkaptonuria (AKU) is an ultrarare autosomal recessive disorder (MIM 203500) that is caused byby a complex set of mutations in homogentisate 1,2-dioxygenasegene and consequent accumulation of homogentisic acid (HGA), causing a significant protein oxidation. A secondary form of amyloidosis was identified in AKU and related to high circulating serum amyloid A (SAA) levels, which are linked with inflammation and oxidative stress and might contribute to disease progression and patients' poor quality of life. Recently, we reported that inflammatory markers (SAA and chitotriosidase) and oxidative stress markers (protein thiolation index) might be disease activity markers in AKU. Thanks to an international network, we collected genotypic, phenotypic, and clinical data from more than 200 patients with AKU. These data are currently stored in our AKU database, named ApreciseKUre. In this work, we developed an algorithm able to make predictions about the oxidative status trend of each patient with AKU based on 55 predictors, namely circulating HGA, body mass index, total cholesterol, SAA, and chitotriosidase. Our general aim is to integrate the data of apparently heterogeneous patients with AKUAKU by using specific bioinformatics tools, in order to identify pivotal mechanisms involved in AKU for a preventive, predictive, and personalized medicine approach to AKU.-Cicaloni, V., Spiga, O., Dimitri, G. M., Maiocchi, R., Millucci, L., Giustarini, D., Bernardini, G., Bernini, A., Marzocchi, B., Braconi, D., Santucci, A. Interactive alkaptonuria database: investigating clinical data to improve patient care in a rare disease.
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Affiliation(s)
- Vittoria Cicaloni
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy.,Toscana Life Sciences Foundation, Siena, Italy
| | - Ottavia Spiga
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy
| | | | - Rebecca Maiocchi
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy.,Toscana Life Sciences Foundation, Siena, Italy
| | - Lia Millucci
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy
| | - Daniela Giustarini
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy
| | - Giulia Bernardini
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy
| | - Andrea Bernini
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy
| | - Barbara Marzocchi
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy.,Unità Operativa Complessa (UOC) Patologia Clinica, Azienda Ospedaliera Senese, Siena, Italy
| | - Daniela Braconi
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy
| | - Annalisa Santucci
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy
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16
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Jang HD, Park JS, Kim DW, Han K, Shin BJ, Lee JC, Choi SW, Suh SW, Yang JH, Park SY, Cho WJ, Hong JY. Relationship between dementia and ankylosing spondylitis: A nationwide, population-based, retrospective longitudinal cohort study. PLoS One 2019; 14:e0210335. [PMID: 30703142 PMCID: PMC6354978 DOI: 10.1371/journal.pone.0210335] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/20/2018] [Indexed: 12/13/2022] Open
Abstract
Among a variety of comorbidities of ankylosing spondylitis (AS), the association between dementia and AS by using an extensive dataset from the Korean National Health Insurance System was evaluated in this study. We extracted 15,547 newly diagnosed AS subjects among the entire Korean population and excluded wash-out patients (n = 162) and patients that were inappropriate for cohort match (n = 1192). Finally, 14,193 subjects were chosen as the AS group, and through 1:5 age- and sex-stratified matching, 70,965 subjects were chosen as the control group. We evaluated patient demographics, household incomes, and comorbidities, including hypertension, diabetes, and dyslipidemia. The prevalence of overall dementia (1.37%) and Alzheimer’s dementia (AD) (0.99%) in the AS group was significantly higher than in the control group (0.87% and 0.63%), respectively. The adjusted hazard ratio of the AS group for overall dementia (1.758) and AD (1.782) showed statistical significance also. On the other hand, the prevalence of vascular dementia did not differ significantly between the two groups. Subgroup analyses revealed the following risk factors for dementia in the AS group: male gender, greater than 65 years in age, fair income (household income greater than 20% of the median), urban residency, no diabetes, and no hypertension. From the nationwide, population-based, retrospective, longitudinal cohort study, AS patients showed a significantly higher prevalence of overall dementia and Alzheimer’s dementia. Comprehensive patient assessment using our subgroup analysis could help to prevent dementia in patients suffering from AS.
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Affiliation(s)
- Hae-Dong Jang
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Bucheon-si, Gyeonggi-do, South Korea
| | - Jin-Sung Park
- Department of Orthopedics, Korea University Hospital, Ansan, Danwon-gu, Ansan-si, Gyeonggi-do, South Korea
| | - Dae Woong Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Yongsan-gu, Seoul, South Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, Catholic University, Jongno-gu, Seoul, South Korea
| | - Byung-Joon Shin
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Yongsan-gu, Seoul, South Korea
| | - Jae Chul Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Yongsan-gu, Seoul, South Korea
| | - Sung-Woo Choi
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Yongsan-gu, Seoul, South Korea
| | - Seung-Woo Suh
- Scoliosis Research Institute, Department of Orthopedics, Korea University Medical College, Guro Hospital, Guro-gu, Seoul, South Korea
| | - Jae-Hyuk Yang
- Scoliosis Research Institute, Department of Orthopedics, Korea University Medical College, Guro Hospital, Guro-gu, Seoul, South Korea
| | - Si-Young Park
- Department of Orthopaedic Surgery, Korea University, College of Medicine, Anam Hospital, Seongbuk-gu, Seoul, South Korea
| | - Whi Je Cho
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Bucheon-si, Gyeonggi-do, South Korea
| | - Jae-Young Hong
- Department of Orthopedics, Korea University Hospital, Ansan, Danwon-gu, Ansan-si, Gyeonggi-do, South Korea
- * E-mail:
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17
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Dev S, Singh A. Study of role of serum amyloid A (SAA) as a marker of disease activity in juvenile idiopathic arthritis. J Family Med Prim Care 2019; 8:2129-2133. [PMID: 31334192 PMCID: PMC6618225 DOI: 10.4103/jfmpc.jfmpc_339_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: Role of serum amyloid A (SAA) protein as a biomarker for the disease activity in juvenile idiopathic arthritis (JIA) has not been explored. This study was done to find its role as marker of disease activity in JIA. Methods: A case–control study with 50 newly diagnosed cases of JIA of all subtypes and 40 healthy controls was done. Serum amyloid A (SAA), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were measured in both patients and healthy controls. Quantitative measurement of SAA level was measured by using standard human SAA enzyme-linked immunosorbent assay (ELISA). Disease activity was assessed clinically and by ultrasonography (USG) score determined by examining eight large joints (bilateral elbow, wrist, knee, ankle). Serum SAA levels were found significantly higher in JIA patients as compared with healthy controls (P < 0.001). Significant positive correlations were found between SAA with presence of active joints (r = 0.64, P < 0.001), ESR (r = 0.39, P < 0.05), and CRP (r = 0.36, P < 0.05). However, significant correlations was not found between ESR and the presence of active joints (r = 0.21, P = 0.225) and between CRP and the presence of active joints (r = 0.034, P = 0.855). The mean USG score of patients with increased SAA level was significantly higher than that of patients with normal SAA level (P < 0.05). Conclusion: A significant increase in SAA levels was found in JIA patients with strong positive correlation between SAA level and JIA disease activity. The study discerned SAA to be a more sensitive laboratory marker than ESR and CRP for evaluating the presence of active joints.
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Affiliation(s)
- Sharad Dev
- Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Anup Singh
- Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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18
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Braconi D, Giustarini D, Marzocchi B, Peruzzi L, Margollicci M, Rossi R, Bernardini G, Millucci L, Gallagher JA, Le Quan Sang KH, Imrich R, Rovensky J, Al-Sbou M, Ranganath LR, Santucci A. Inflammatory and oxidative stress biomarkers in alkaptonuria: data from the DevelopAKUre project. Osteoarthritis Cartilage 2018; 26:1078-1086. [PMID: 29852277 DOI: 10.1016/j.joca.2018.05.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/30/2018] [Accepted: 05/03/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this work was to assess baseline serum levels of established biomarkers related to inflammation and oxidative stress in samples from alkaptonuric subjects enrolled in SONIA1 (n = 40) and SONIA2 (n = 138) clinical trials (DevelopAKUre project). METHODS Baseline serum levels of Serum Amyloid A (SAA), IL-6, IL-1β, TNFα, CRP, cathepsin D (CATD), IL-1ra, and MMP-3 were determined through commercial ELISA assays. Chitotriosidase activity was assessed through a fluorimetric method. Advanced Oxidation Protein Products (AOPP) were determined by spectrophotometry. Thiols, S-thiolated proteins and Protein Thiolation Index (PTI) were determined by spectrophotometry and HPLC. Patients' quality of life was assessed through validated questionnaires. RESULTS We found that SAA serum levels were significantly increased compared to reference threshold in 57.5% and 86% of SONIA1 and SONIA2 samples, respectively. Similarly, chitotriosidase activity was above the reference threshold in half of SONIA2 samples, whereas CRP levels were increased only in a minority of samples. CATD, IL-1β, IL-6, TNFα, MMP-3, AOPP, thiols, S-thiolated protein and PTI showed no statistically significant differences from control population. We provided evidence that alkaptonuric patients presenting with significantly higher SAA, chitotriosidase activity and PTI reported more often a decreased quality of life. This suggests that worsening of symptoms in alkaptonuria (AKU) is paralleled by increased inflammation and oxidative stress, which might play a role in disease progression. CONCLUSIONS Monitoring of SAA may be suggested in AKU to evaluate inflammation. Though further evidence is needed, SAA, chitotriosidase activity and PTI might be proposed as disease activity markers in AKU.
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Affiliation(s)
- D Braconi
- Dipartimento di Biotecnologie, Chimica e Farmacia, Università degli Studi di Siena, Siena, Italy.
| | - D Giustarini
- Dipartimento Scienze Mediche, Chirurgiche e Neuroscienze, Università degli Studi di Siena, Siena, Italy.
| | - B Marzocchi
- Dipartimento di Biotecnologie, Chimica e Farmacia, Università degli Studi di Siena, Siena, Italy; UOC Patologia Clinica, Azienda Ospedaliera Senese, Siena, Italy.
| | - L Peruzzi
- Dipartimento di Biotecnologie, Chimica e Farmacia, Università degli Studi di Siena, Siena, Italy; UOC Medicina Molecolare e Genetica, Azienda Ospedaliera Senese, Siena, Italy.
| | - M Margollicci
- UOC Medicina Molecolare e Genetica, Azienda Ospedaliera Senese, Siena, Italy.
| | - R Rossi
- Dipartimento Scienze della Vita, Università degli Studi di Siena, Siena, Italy.
| | - G Bernardini
- Dipartimento di Biotecnologie, Chimica e Farmacia, Università degli Studi di Siena, Siena, Italy.
| | - L Millucci
- Dipartimento di Biotecnologie, Chimica e Farmacia, Università degli Studi di Siena, Siena, Italy.
| | - J A Gallagher
- Department of Musculoskeletal Biology, University of Liverpool, Liverpool, UK.
| | | | - R Imrich
- Center for Molecular Medicine, Slovak Academy of Sciences, Bratislava, Slovakia.
| | - J Rovensky
- National Institute of Rheumatic Diseases, Piešťany, Slovakia.
| | - M Al-Sbou
- Department of Pharmacology, Alkaptonuria Research Office, Faculty of Medicine, Mutah University, Mutah, Karak, Jordan.
| | - L R Ranganath
- Department of Musculoskeletal Biology, University of Liverpool, Liverpool, UK; Department of Clinical Biochemistry and Metabolism, Royal Liverpool University Hospital, Liverpool, UK.
| | - A Santucci
- Dipartimento di Biotecnologie, Chimica e Farmacia, Università degli Studi di Siena, Siena, Italy.
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Bauer D, Kasper M, Walscheid K, Koch JM, Müther PS, Kirchhof B, Heiligenhaus A, Heinz C. Multiplex Cytokine Analysis of Aqueous Humor in Juvenile Idiopathic Arthritis-Associated Anterior Uveitis With or Without Secondary Glaucoma. Front Immunol 2018; 9:708. [PMID: 29675026 PMCID: PMC5895756 DOI: 10.3389/fimmu.2018.00708] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 03/22/2018] [Indexed: 12/14/2022] Open
Abstract
Patients with juvenile idiopathic arthritis often develop chronic anterior uveitis (JIAU). JIAU patients possess a particularly high risk for developing secondary glaucoma when inflammatory inactivity has been achieved. By using multiplex bead assay analysis, we assessed levels of pro- and anti-inflammatory cytokines, chemokines, or metalloproteinases in the aqueous humor (AH) of patients with clinically inactive JIAU with (JIAUwG) or without secondary glaucoma (JIAUwoG), or from patients with senile cataract as controls. Laser-flare photometry analysis prior to surgery showed no significant differences between JIAUwG or JIAUwoG. Compared with the control group, levels of interleukin-8, matrix metalloproteinase-2, -3, -9, serum amyloid A (SAA), transforming growth factor beta-1, -2, -3 (TGFβ-1, -2, -3), and tumor necrosis factor-alpha in the AH were significantly higher in patients with clinically inactive JIAUwG or JIAUwoG. Samples from JIAwoG patients displayed significantly higher levels of SAA (P < 0.0116) than JIAUwG patients. JIAUwG patients showed an increased level of TGFβ-2 in AH samples compared with JIAUwoG (P < 0.0009). These molecules may contribute to the clinical development of glaucoma in patients with JIAU.
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Affiliation(s)
- Dirk Bauer
- Department of Ophthalmology and Ophtha-Laboratory at St. Franziskus-Hospital Münster, Münster, Germany
| | - Maren Kasper
- Department of Ophthalmology and Ophtha-Laboratory at St. Franziskus-Hospital Münster, Münster, Germany
| | - Karoline Walscheid
- Department of Ophthalmology and Ophtha-Laboratory at St. Franziskus-Hospital Münster, Münster, Germany
| | - Jörg M Koch
- Department of Ophthalmology and Ophtha-Laboratory at St. Franziskus-Hospital Münster, Münster, Germany
| | - Philipp S Müther
- Center for Ophthalmology, University of Cologne, Cologne, Germany
| | - Bernd Kirchhof
- Center for Ophthalmology, University of Cologne, Cologne, Germany
| | - Arnd Heiligenhaus
- Department of Ophthalmology and Ophtha-Laboratory at St. Franziskus-Hospital Münster, Münster, Germany.,Center for Ophthalmology, University of Duisburg-Essen, Essen, Germany
| | - Carsten Heinz
- Department of Ophthalmology and Ophtha-Laboratory at St. Franziskus-Hospital Münster, Münster, Germany.,Center for Ophthalmology, University of Duisburg-Essen, Essen, Germany
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Couderc E, Morel F, Levillain P, Buffière-Morgado A, Camus M, Paquier C, Bodet C, Jégou JF, Pohin M, Favot L, Garcia M, Huguier V, Mcheik J, Lacombe C, Yssel H, Guillet G, Bernard FX, Lecron JC. Interleukin-17A-induced production of acute serum amyloid A by keratinocytes contributes to psoriasis pathogenesis. PLoS One 2017; 12:e0181486. [PMID: 28708859 PMCID: PMC5510841 DOI: 10.1371/journal.pone.0181486] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 06/30/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Acute-serum Amyloid A (A-SAA), one of the major acute-phase proteins, is mainly produced in the liver but extra-hepatic synthesis involving the skin has been reported. Its expression is regulated by the transcription factors NF-κB, C/EBPβ, STAT3 activated by proinflammatory cytokines. OBJECTIVES We investigated A-SAA synthesis by resting and cytokine-activated Normal Human Epidermal Keratinocytes (NHEK), and their inflammatory response to A-SAA stimulation. A-SAA expression was also studied in mouse skin and liver in a model mimicking psoriasis and in the skin and sera of psoriatic and atopic dermatitis (AD) patients. METHODS NHEK were stimulated by A-SAA or the cytokines IL-1α, IL-17A, IL-22, OSM, TNF-α alone or in combination, previously reported to reproduce features of psoriasis. Murine skins were treated by imiquimod cream. Human skins and sera were obtained from patients with psoriasis and AD. A-SAA mRNA was quantified by RT qPCR. A-SAA proteins were dosed by ELISA or immunonephelemetry assay. RESULTS IL-1α, TNF-α and mainly IL-17A induced A-SAA expression by NHEK. A-SAA induced its own production and the synthesis of hBD2 and CCL20, both ligands for CCR6, a chemokine receptor involved in the trafficking of Th17 lymphocytes. A-SAA expression was increased in skins and livers from imiquimod-treated mice and in patient skins with psoriasis, but not significantly in those with AD. Correlations between A-SAA and psoriasis severity and duration were observed. CONCLUSION Keratinocytes could contribute to psoriasis pathogenesis via A-SAA production, maintaining a cutaneous inflammatory environment, activating innate immunity and Th17 lymphocyte recruitment.
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Affiliation(s)
- Elodie Couderc
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
- Service de Dermatologie, CHU de Poitiers, Poitiers, France
| | - Franck Morel
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
| | | | - Amandine Buffière-Morgado
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
- Service de Dermatologie, CHU de Poitiers, Poitiers, France
| | - Magalie Camus
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
- Service de Dermatologie, CHU de Poitiers, Poitiers, France
| | - Camille Paquier
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
- Service de Dermatologie, CHU de Poitiers, Poitiers, France
| | - Charles Bodet
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
| | - Jean-François Jégou
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
| | - Mathilde Pohin
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
| | - Laure Favot
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
| | - Martine Garcia
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
| | - Vincent Huguier
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
- Service de Dermatologie, CHU de Poitiers, Poitiers, France
- Service d’Anatomopathologie, CHU de Poitiers, Poitiers, France
- Service de Chirurgie plastique, CHU de Poitiers, Poitiers, France
| | - Jiad Mcheik
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
- Service de Dermatologie, CHU de Poitiers, Poitiers, France
- Service d’Anatomopathologie, CHU de Poitiers, Poitiers, France
- Service de Chirurgie plastique, CHU de Poitiers, Poitiers, France
- Service de Chirurgie pédiatrique, CHU de Poitiers, Poitiers, France
| | - Corinne Lacombe
- Service d’Anatomopathologie, CHU de Poitiers, Poitiers, France
- Service d’Immunologie et Inflammation, CHU de Poitiers, Poitiers, France
| | - Hans Yssel
- Centre d'Immunologie et des Maladies Infectieuses, Inserm U1135, Hôpital Pitié-Salpêtrière, Paris, France
| | - Gérard Guillet
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
- Service de Dermatologie, CHU de Poitiers, Poitiers, France
| | | | - Jean-Claude Lecron
- Laboratoire Inflammation, Tissus Epithéliaux et Cytokines, UPRES EA4331, Pôle Biologie Santé, Université de Poitiers, TSA, POITIERS, France
- Service d’Immunologie et Inflammation, CHU de Poitiers, Poitiers, France
- * E-mail:
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Prajzlerová K, Grobelná K, Pavelka K, Šenolt L, Filková M. An update on biomarkers in axial spondyloarthritis. Autoimmun Rev 2016; 15:501-9. [DOI: 10.1016/j.autrev.2016.02.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 01/28/2016] [Indexed: 12/17/2022]
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Mitulescu TC, Stavaru C, Voinea LM, Banica LM, Matache C, Predeteanu D. The role of Vitamin D in immuno-inflammatory responses in Ankylosing Spondylitis patients with and without Acute Anterior Uveitis. J Med Life 2016; 9:26-33. [PMID: 27713770 PMCID: PMC5052489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Hypothesis:Abnormal Vitamin D (Vit D) level could have consequences on the immuno-inflammatory processes in Ankylosing Spondylitis (AS). Aim:The purpose of this study was to analyze the role of Vitamin D in the interplay between immune and inflammation effectors in AS associated-Acute Anterior Uveitis (AAU). Methods and Results:25-hydroxyvitamin D (Vit D), LL-37 peptide, IL-8 and Serum Amyloid A (SAA) were identified and quantified in the serum/ plasma of thirty-four AS patients [eleven AS patients presenting AAU (AAU AS patients) and twenty-three AS patients without AAU (wAAU AS patients)] and eighteen healthy individuals (Control) using enzyme-linked immunosorbent assay. Acute-phase SAA level was significantly higher in AS patients compared to Controls. Contrary with wAAU AS patients, significantly elevated levels of IL-8, and diminished levels of Vit D characterized AAU AS patients. Regarding LL-37, its level decreased concomitantly with the level of Vit D. When AS patients were subgrouped based on AAU presence or on Vit D level, important associations between immuno-inflammatory assessed markers and AS features were noticed. Generally, Vit D levels were associated indirectly with leukocytes/ neutrophils number or with ESR, CRP, and Fibrinogen levels. The levels of SAA and IL-8 associated directly with AAU or with AAU relapses, especially in AS patients with Vit D insufficiency, while SAA associated directly with infection/ inflammatory markers and with disease activity indexes or with the degree of functional limitation. Discussion:Altered levels of Vit D affect the balance between LL-37, IL-8 and SAA, suggesting an association with AAU, an extra-articular manifestation of AS. Abbreviations:Vit D = Vitamin D, AS = Ankylosing Spondylitis, AAU = Acute Anterior Uveitis, AAU AS = AS patients with AAU, wAAU AS = AS patients without AAU, SSZ = Sulphasalazine, Leu = Leukocytes, Neu = Neutrophils.
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Affiliation(s)
- TC Mitulescu
- Department of Ophthalmology, University Emergency Hospital, Bucharest, Romania
| | - C Stavaru
- Cellular and Molecular Immunity Laboratory, Cantacuzino National Institute for Research, Bucharest, Romania
| | - LM Voinea
- Department of Ophthalmology, University Emergency Hospital, Bucharest, Romania,”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - LM Banica
- Cellular and Molecular Immunity Laboratory, Cantacuzino National Institute for Research, Bucharest, Romania
| | - C Matache
- Cellular and Molecular Immunity Laboratory, Cantacuzino National Institute for Research, Bucharest, Romania
| | - D Predeteanu
- ”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,Department of Rheumatology, “Sf. Maria” Clinical Hospital, Bucharest, Romania
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Shen C, Sun XG, Liu N, Mu Y, Hong CC, Wei W, Zheng F. Increased serum amyloid A and its association with autoantibodies, acute phase reactants and disease activity in patients with rheumatoid arthritis. Mol Med Rep 2014; 11:1528-34. [PMID: 25352049 DOI: 10.3892/mmr.2014.2804] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 10/01/2014] [Indexed: 01/12/2023] Open
Abstract
Determination of disease activity in patients with rheumatoid arthritis (RA) has become an important component for RA management. The aim of the present study was to investigate the association between circulating levels of serum amyloid A (SAA) and disease activity in RA patients. The types of disease and the respective number of patients enrolled in the present study were as follows: RA, 88; osteoarthritis (OA), 54; systemic lupus erythematosus (SLE), 43; and other autoimmune diseases, 30, as well as 50 healthy controls (HC). SAA levels were measured using an ELISA assay and western blot analysis was used to detect serum SAA levels. The correlations between SAA levels and disease activity score for 28 joints (DAS28), erythrocyte sedimentation rate (ESR) and C‑reactive protein (CRP), respectively, were evaluated; in addition, the presence and absence of rheumatoid factor (RF) and anti‑cyclic citrullinated peptide antibody (anti‑CCP) were detected in respect to SAA levels. The results of the present study demonstrated that serum levels of SAA in RA patients were significantly increased compared to those of the OA, SLE, others and HC patients (P<0.05). SAA levels were found to be positively correlated with DAS28, ESR and CRP levels (R2=0.6174, 0.4422 and 0.3919, respectively). In addition, anti‑CCP was not correlated with DAS28 (R2=0.0154). Furthermore, increased SAA levels were detected in patients with positive anti‑CCP compared with those in anti‑CCP negative subjects (P<0.01). In conclusion, the results of the present study provided further evidence for possible roles of SAA in RA, which indicated that it may be a useful biomarker for assessing disease severity and may provide additional information about disease activity.
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Affiliation(s)
- Chen Shen
- Department of Clinical Immunology, School of Laboratory Medicine, Tianjin Medical University, Tianjin 300203, P.R. China
| | - Xu-Guo Sun
- Department of Clinical Immunology, School of Laboratory Medicine, Tianjin Medical University, Tianjin 300203, P.R. China
| | - Na Liu
- Department of Clinical Immunology, School of Laboratory Medicine, Tianjin Medical University, Tianjin 300203, P.R. China
| | - Yun Mu
- Department of Medical Laboratory, Tianjin Hospital of Children, Tianjin 300074, P.R. China
| | - Cheng-Cheng Hong
- Department of Clinical Immunology, School of Laboratory Medicine, Tianjin Medical University, Tianjin 300203, P.R. China
| | - Wei Wei
- Department of Rheumatology, General Hospital, Tianjin Medical University, Tianjin 300052, P.R. China
| | - Fang Zheng
- Department of Clinical Immunology, School of Laboratory Medicine, Tianjin Medical University, Tianjin 300203, P.R. China
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Coşkun BN, Öksüz MF, Ermurat S, Tufan AN, Oruçoğlu N, Doğan A, Dalkılıç E, Pehlivan Y. Neutrophil lymphocyte ratio can be a valuable marker in defining disease activity in patients who have started anti-tumor necrosis factor (TNF) drugs for ankylosing spondylitis. Eur J Rheumatol 2014; 1:101-105. [PMID: 27708888 DOI: 10.5152/eurjrheumatol.2014.034] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 06/12/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Neutrophil lymphocyte ratio (NLR) has emerged as a valuable and reliable method for follow-up of systemic inflammatory disease. We herein aimed to evaluate the role of NLR in the clinical follow-up of inflammation and also to compare its relationship with other measures, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). MATERIAL AND METHODS A total of 35 active ankylosing spondylitis (AS) and 38 healthy volunteers were included in the study. The patient group was enrolled for treatment with one anti-tumor necrosis factor (TNF) drug. Total blood count, ESR, CRP, and BASDAI score were obtained before and 3 months following the treatment. NLR was found with a mathematical calculation of the ratio of neutrophils with lymphocytes. RESULTS The mean NLR value of the control group and patients was 1.90±0.89 and 2.67±1.17, respectively (p<0.05). After a 3-month course of treatment, the patient group had a mean NLR value of 1.8±0.7, which was significantly lower than pretreatment values (p<0.001). The post-treatment mean ESR, CRP, and BASDAI scores were significantly lower than mean baseline scores (p<0.001, p=0.007, p<0.001, respectively). Also, NLR was found to be correlated with BASDAI, ESR, and CRP (r=0.388, p<0.001; r=0.455, p<0.0001; and r=0.3389, p<0.005, respectively). CONCLUSION Neutrophil lymphocyte ratio could be a reliable and easily accessible method for follow-up of patients with AS.
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Affiliation(s)
- Belkıs Nihan Coşkun
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Mustafa Ferhat Öksüz
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Selime Ermurat
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Ayşe Nur Tufan
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Nurdan Oruçoğlu
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Akif Doğan
- Department of Internal Medicine, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Ediz Dalkılıç
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Yavuz Pehlivan
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
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Siebuhr AS, He Y, Gudmann NS, Gram A, Kjelgaard-Petersen CF, Qvist P, Karsdal MA, Bay-Jensen AC. Biomarkers of cartilage and surrounding joint tissue. Biomark Med 2014; 8:713-31. [DOI: 10.2217/bmm.13.144] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The identification and clinical demonstration of efficacy and safety of osteo- and chondro-protective drugs are met with certain difficulties. During the last few decades, the pharmaceutical industry has, in the field of rheumatology, experienced disappointments associated with the development of disease modification. Today, the vast amount of patients suffering from serious, chronic joint diseases can only be offered treatments aimed at improving symptoms, such as pain and acute inflammation, and are not aimed at protecting the joint tissue. This huge, unmet medical need has been the driver behind the development of improved analytical techniques allowing better and more efficient clinical trial design, implementation and analysis. With this review, we aim to provide a brief and general overview of biochemical markers of joint tissue, with special focus on neoepitopes. Furthermore, we highlight recent studies applying biochemical markers in joint degenerative diseases. These disorders, including osteoarthritis, rheumatoid arthritis and spondyloarthropathies, are the most predominant disorders in Europe and the USA, and have enormous socioeconomical impact.
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Affiliation(s)
- Anne S Siebuhr
- Nordic Bioscience, Biomarkers & Research, Herlev Hovedgade 207, Herlev DK-2730, Denmark
| | - Yi He
- Nordic Bioscience, Biomarkers & Research, Herlev Hovedgade 207, Herlev DK-2730, Denmark
| | - Natasja S Gudmann
- Nordic Bioscience, Biomarkers & Research, Herlev Hovedgade 207, Herlev DK-2730, Denmark
| | - Aurelie Gram
- Nordic Bioscience, Biomarkers & Research, Herlev Hovedgade 207, Herlev DK-2730, Denmark
| | | | - Per Qvist
- Nordic Bioscience, Biomarkers & Research, Herlev Hovedgade 207, Herlev DK-2730, Denmark
| | - Morten A Karsdal
- Nordic Bioscience, Biomarkers & Research, Herlev Hovedgade 207, Herlev DK-2730, Denmark
| | - Anne C Bay-Jensen
- Nordic Bioscience, Biomarkers & Research, Herlev Hovedgade 207, Herlev DK-2730, Denmark
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Rosa Neto NS, de Carvalho JF, Shoenfeld Y. Screening tests for inflammatory activity: applications in rheumatology. Mod Rheumatol 2014. [DOI: 10.3109/s10165-009-0211-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kim W, Kim SA, Yun KJ, Na SJ, Hyun JI, Jung JI, Kwok SK, Park SH. Coexistence of AA and AL Cardiac Amyloidosis in a Patient with Ankylosing Spondylitis Accompanying Monoclonal Gammopathy of Undetermined Significance. JOURNAL OF RHEUMATIC DISEASES 2014. [DOI: 10.4078/jrd.2014.21.3.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Woohyeon Kim
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seon A Kim
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Jin Yun
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Soo Jin Na
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji In Hyun
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Im Jung
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung-Ki Kwok
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Hwan Park
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Ehrenfeld M. Spondyloarthropathies. Best Pract Res Clin Rheumatol 2013; 26:135-45. [PMID: 22424199 DOI: 10.1016/j.berh.2012.01.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 12/20/2011] [Accepted: 01/04/2012] [Indexed: 12/17/2022]
Abstract
Spondyloarthropathies (SpA) are a group of common inflammatory rheumatic disorders characterised by axial and or peripheral arthritis, associated with enthesitis, dactylitis and potential extra-articular manifestations such as uveitis and skin rash. The diseases, which comprise the group, share a common genetic predisposition, the HLA-B27 gene; however, this association varies markedly among the various SpAs and among different ethnic groups. Environmental factors seem to be triggering the diseases in the genetically predisposed individuals. The radiographic hallmark of the group is sacroiliitis, which when present is of help in the diagnosis. Various sets of diagnostic and classification criteria were developed over the years including the European Spondyloarthropathy Study Group (ESSG) criteria which were until recently the most widely used. The new Assessment in SpondyloArthritis international Society (ASAS) international working group has recently proposed a new set of diagnostic criteria that would enable identification of SpA before structural changes develop in the spine. Magnetic resonance imaging (MRI) changes have now been included in the new classification criteria of early axial SpA and are now considered as a major tool in the diagnosis. Until recently, there were no real disease-modifying anti-rheumatic drugs which were able to halt the disease progression. Over the past decade, tumour necrosis factor (TNF)-alfa-blocking agents have been extensively investigated and became the mainstream of therapy providing the patients an effective treatment option.
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Affiliation(s)
- Michael Ehrenfeld
- Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel.
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Cantarini L, Giani T, Fioravanti A, Iacoponi F, Simonini G, Pagnini I, Spreafico A, Chellini F, Galeazzi M, Cimaz R. Serum amyloid A circulating levels and disease activity in patients with juvenile idiopathic arthritis. Yonsei Med J 2012; 53:1045-8. [PMID: 22869491 PMCID: PMC3423833 DOI: 10.3349/ymj.2012.53.5.1045] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The aim of our study was to evaluate the association between circulating levels of serum amyloid A protein (SAA) and disease activity in patients with juvenile idiopathic arthritis (JIA). Our study group included 41 JIA patients (9 male, 32 female), classified according to the International League of Associations for Rheumatology (ILAR) criteria (5); 16 had polyarticular onset disease and 25 had oligoarticular onset disease. Among 25 patients with oligoarticular disease, three had extended oligoarthritis. Serum amyloid A (SAA), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured in both patients and 26 healthy controls. SAA levels were higher in JIA patients versus healthy controls (p<0.001). Significant positive correlations were found between SAA and the presence of active joints (rho=0.363, p<0.05), the number of active joints (rho=0.418, p<0.05), ESR (R=0.702, p<0.05) and CRP (R=0.827, p<0.05). No significant correlations between ESR and the presence of active joints (rho=0.221, p=0.225) or between ESR and the number of active joints (rho=0.118, p=0.520) were demonstrated in JIA patients. No significant correlations were obtained between CRP and the presence of active joints (rho=0.034, p=0.855) or between CRP and the number of active joints (rho=0.033, p=0.859). We discovered a significant increase in SAA levels in JIA patients, compared to controls, and a strong positive correlation between SAA level and JIA disease activity. We also discerned SAA to be a more sensitive laboratory marker than ESR and CRP for evaluating the presence and number of active joints. We suggest that SAA can be used as an additional indicator of disease activity in JIA.
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Affiliation(s)
- Luca Cantarini
- Rheumatology Unit, Department of Clinical Medicine and Immunologic Sciences, University of Siena, Siena, Italy.
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Eras Z, Oğuz S, Dizdar EA, Sari FN, Dilmen U. Serum amyloid-A levels in neonatal necrotizing enterocolitis. J Clin Lab Anal 2012; 25:233-7. [PMID: 21786324 DOI: 10.1002/jcla.20464] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
We aimed to evaluate serum levels of serum amyloid-A (SAA) both in the diagnosis and monitoring the treatment response of necrotizing enterocolitis (NEC). Forty-five preterm neonates were enrolled in the study, including 15 infants with NEC, 15 with sepsis, and 15 healthy preterm infants. Pre- and posttreatment serum SAA levels were measured. Among patients with NEC, 11 had stage 1 and 4 had stage 2 disease according to the modified Bell's staging criteria. Baseline SAA levels of the infants with NEC were significantly higher than controls (P=0.013) and were significantly lower than those with sepsis (P=0.004). When infants with stage 1 and stage 2 NEC were analyzed separately, baseline SAA levels of the infants with stage 2 NEC were significantly higher than controls (P=0.027) than those with stage 1 NEC (P=0.018), but similar to those with sepsis. There was a trend that baseline SAA levels were also correlated with the Bell stage (r=0.501, P=0.057). Posttreatment SAA levels significantly decreased in infants with sepsis (P=0.002). Pre- and posttreatment SAA levels were similar in patients with stage 1 and 2 NEC. In conclusion, SAA rises in early stages of NEC and may aid in diagnosis as a serum marker.
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Affiliation(s)
- Zeynep Eras
- Zekai Tahir Burak Maternity Teaching Hospital, Neonatal Intensive Care Unit, Ankara, Turkey
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Abstract
The study of biomarkers has become a very important field of research in spondyloarthropathy. Biomarkers are useful for different aspects of the disease such as diagnosis, assessment of disease activity and outcome, including damage. The most commonly used biomarkers in spondyloarthropathies are HLA-B27 for diagnosis and erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) for disease activity. HLA-B27 is very sensitive but has a low specificity. ESR and CRP have both low sensitivity and specificity. The introduction of new and very expensive therapies is another reason for analysis of biomarkers. Clinicians need tools to predict more accurately disease activity, disease progression and response to therapy. This article focusses on the several known and new biomarkers of promise, including markers for cartilage and bone damage, and discusses some of the problems encountered during the search and development of new biomarkers. Biomarkers, soluble and tissue-related, reflecting structural damage and disease activity, constitute a high priority for the drug discovery process and the understanding of the pathogenesis of a particular disease. The identification of relevant tools to evaluate the natural course, disease activity, treatment response and outcome of ankylosing spondylitis is of increasing relevance since the raised awareness and development of new therapeutic options. Until now these different aspects are monitored by artificial patient-centred or physician-centred constructs. Very often, their approach is indirect and is not free from disease-unrelated influences. The Outcome Measures in Rheumatology Soluble Biomarker Working Group has taken several major steps towards the development and implementation of such assessment methods. The major drawback is that these tools do not directly reflect biological and pathological processes. Serological biomarkers objectively measure different aspects of the biological and pathological process and may contribute to a major advance in the assessments of patients. The ultimate goal is the use of biomarkers in a personalised approach for disease management in clinical practice.
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Affiliation(s)
- Kurt de Vlam
- Department of Musculoskeletal sciences, Division of Rheumatology, Katholieke Universiteit Leuven, Belgium.
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Abstract
Key challenges in the management of spondyloarthritis focus on the lack of availability of measures of disease activity and the inability to predict joint damage or response to treatment, which is expensive and associated with potentially serious toxicity. Recent studies have focused on the possible contribution of soluble biomarkers, which have been selected based on current understanding of their role in inflammation and/or their association with turnover of joint matrix. Emerging candidates for disease activity markers include interleukin-6 and soluble cytotoxic T lymphocyte associated molecule-4. Potential predictors of damage include metalloproteinase-3 and sclerostin. Acute-phase reactants C-reactive protein and serum amyloid A and interleukin-6 are currently the best predictors of treatment response. Significant study limitations are small sample size and the lack of multivariate analyses that can determine whether the biomarker contributes information that is independent of other clinical and laboratory variables used in routine care.
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Affiliation(s)
- Walter P Maksymowych
- Department of Medicine, University of Alberta, 562 Heritage Medical Research Building, Edmonton, AB, T6G 2S2, Canada.
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Screening and evaluating the mimic peptides as a useful serum biomarker of ankylosing spondylitis using a phage display technique. Rheumatol Int 2010; 31:1009-16. [DOI: 10.1007/s00296-010-1403-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2009] [Accepted: 02/27/2010] [Indexed: 01/17/2023]
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de Vries MK, van Eijk IC, van der Horst-bruinsma IE, Peters MJL, Nurmohamed MT, Dijkmans BAC, Hazenberg BPC, Wolbink GJ. Erythrocyte sedimentation rate, C-reactive protein level, and serum amyloid A protein for patient selection and monitoring of anti-tumor necrosis factor treatment in ankylosing spondylitis. Arthritis Care Res (Hoboken) 2009; 61:1484-90. [DOI: 10.1002/art.24838] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Screening tests for inflammatory activity: applications in rheumatology. Mod Rheumatol 2009; 19:469-77. [PMID: 19697096 DOI: 10.1007/s10165-009-0211-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Accepted: 07/07/2009] [Indexed: 10/20/2022]
Abstract
Inflammation is a hallmark of rheumatic diseases. The response to tissue injury comprises a series of changes which result in the shedding of pathogens, limitation of tissue damage and restoration of affected structures. These changes depend on increased or decreased serum concentrations of certain proteins known as inflammatory biomarkers. Laboratory analysis of these markers, together with clinical data and other complementary tests enable the assessment of disease activity and treatment response and can indicate the presence of infection. The screening tests currently available for identifying inflammatory activity include the determination of C-reactive protein level and erythrocyte sedimentation rate as well as protein electrophoresis. Here, we review the characteristics of a number of inflammatory biomarkers and their use in the assessment of inflammatory activity in rheumatic diseases.
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Biomarkers in Spondyloarthropathies. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2009; 649:122-32. [DOI: 10.1007/978-1-4419-0298-6_9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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