Neopterin and quinolinic acid are surrogate measures of disease activity in the juvenile idiopathic inflammatory myopathies.
Neopterin and quinolinic acid are surrogate measures of disease activity in the juvenile idiopathic inflammatory myopathies.
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DOI：
10.1093/clinchem/48.10.1681
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发表时间：
2002-09
影响因子：
9.3
通讯作者：
L. Rider;Adam Schiffenbauer;M. Zito;K. L. Lim;A. Ahmed;L. Zemel;R. Rennebohm;M. Passo;R. Summers;J. Hicks;P. Lachenbruch;M. Heyes;F. Miller
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文献类型：
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作者：
L. Rider;Adam Schiffenbauer;M. Zito;K. L. Lim;A. Ahmed;L. Zemel;R. Rennebohm;M. Passo;R. Summers;J. Hicks;P. Lachenbruch;M. Heyes;F. Miller
目的 我们评估了新蝶呤和喹啉酸 (QUIN) 作为青少年特发性炎症性肌病 (IIM) 疾病活动性替代指标的效用。方法 使用商业 ELISA、HPLC 或气相色谱-质谱法，对 45 名青少年 IIM 患者和 79 名健康对照者的血浆和晨起首次尿样中的新蝶呤和 QUIN 进行检测。获得肌炎疾病活动评估。结果 与健康对照相比，青少年 IIM 患者血浆和尿液中新蝶呤和 QUIN 浓度升高（P <0.017）。尿液新蝶呤和 QUIN 彼此高度相关 (r(s) = 0.73；P <0.0001）。尿液新蝶呤和 QUIN 与肌炎疾病活动评估呈中度相关，包括医生和家长的整体活动评估、肌肉力量测试、功能评估（儿童肌炎评估量表、儿童健康评估问卷）、皮肤整体活动和磁共振成像水肿（r(s) = 0.42-0.62；P <0.05），但通常与血清中的肌肉相关酶无关。尿液新蝶呤或 QUIN 与血清乳酸脱氢酶 (LD) 或天冬氨酸转氨酶 (AST) 结合，可显着预测总体疾病活动度 (R(2) =0.40-0.56；P <0.002），并且两者都比这些血清酶对变化更敏感（标准化响应平均值为 -0.41 至 -0.48）。结论 尿新蝶呤和 QUIN 是青少年 IIM 患者疾病活动性的候选指标，与血清 LD 或 AST 值相结合可显着增加总体疾病活动性的预测。在早晨第一次排尿样本中测量这些标记物似乎与测量它们在血浆中的浓度一样好，甚至可能更好。
OBJECTIVE We evaluated the utility of neopterin and quinolinic acid (QUIN) as surrogate measures of disease activity in juvenile idiopathic inflammatory myopathies (IIMs). METHODS Plasma and first morning void urine samples were measured for neopterin and QUIN using commercial ELISA, HPLC, or gas chromatography-mass spectrometry in 45 juvenile IIM patients and 79 healthy controls. Myositis disease activity assessments were obtained. RESULTS Plasma and urine neopterin and QUIN concentrations were increased in juvenile IIM patients compared with healthy controls (P <0.017). Urine neopterin and QUIN highly correlated with each other (r(s) = 0.73; P <0.0001). Urine neopterin and QUIN correlated moderately with myositis disease activity assessments, including physician and parent global activity assessments, muscle strength testing, functional assessments (Childhood Myositis Assessment Scale, Childhood Health Assessment Questionnaire), skin global activity, and edema on magnetic resonance imaging (r(s) = 0.42-0.62; P <0.05), but generally not with muscle-associated enzymes in serum. Urine neopterin or QUIN, in combination with either serum lactate dehydrogenase (LD) or aspartate aminotransferase (AST), significantly predicted global disease activity (R(2) =0.40-0.56; P <0.002), and both were more sensitive to change than these serum enzymes (standardized response means, -0.41 to -0.48). CONCLUSIONS Urinary neopterin and QUIN are candidate measures of disease activity in juvenile IIM patients and add significantly to the prediction of global disease activity in combination with serum LD or AST values. Measurement of these markers in first morning void urine specimens appears to be as good as, or possibly better than, measurements of their concentrations in plasma.