Relationship between inflammatory markers, oxidant-antioxidant status and intima-media thickness in prepubertal children with juvenile idiopathic arthritis
Relationship between inflammatory markers, oxidant-antioxidant status and intima-media thickness in prepubertal children with juvenile idiopathic arthritis
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DOI：
10.1007/s00392-012-0496-3
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发表时间：
2013-01-01
影响因子：
5
通讯作者：
Mohn, A.
中科院分区：
文献类型：
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作者：
Breda, L.;Di Marzio, D.;Mohn, A.
为了探讨幼年特发性关节炎(JIA)青春期前儿童早期动脉粥样硬化改变的可能性，并确定1年治疗的潜在益处。对38例JIA儿童(12m/26f，平均年龄7.05±2.39岁)和40例对照组(18m/22f，18m/22f)的炎症标志物(C反应蛋白、血沉)、促炎细胞因子(IL-1β、IL-6、干扰素-γ、肿瘤坏死因子-α)、血脂和氧化-抗氧化状态(尿异前列腺素[PGF-2α])进行了检测。平均年龄6.34+/-2.25岁)。测量颈动脉内膜中层厚度(CIMT)并测量血压。治疗1年后，JIA儿童的所有参数都被重新评估。在基线时，JIA儿童与对照组相比呈现出更高的炎症标志物、促炎细胞因子、总胆固醇、低密度脂蛋白和PGF-2α水平(均为千分之0.01)。此外，血压和CIMT显著升高(P均为千分之0.01)。在非类固醇抗炎药(NSAIDs)和抗风湿病药物(DMARDS)治疗1年后，所有参数均显著降低(均为千分之0.01)。这与血压和cIMT(两者均为千分之0.01)的显著降低有关。在JIA组中，需要依那西普的患者在基线时的实验室数值和cIMT测量较差。然而，经过一年的治疗后，所有参数都得到了相同的改善。逐步多元回归分析显示，低密度脂蛋白和IL-1β主要与CIMT有关，慢性炎症和全身炎症可能导致早期动脉粥样硬化异常，甚至在青春期前的JIA儿童中也是如此。经过1年的适当治疗可以获得实质性的改善。
To investigate the presence of possible early atherosclerotic changes in a group of prepubertal children with juvenile idiopathic arthritis (JIA) and to establish the potential beneficial effects of 1-year treatment.Inflammatory markers (C-reactive protein, erythrocyte sedimentation rate), proinflammatory cytokines (IL-1 beta, IL-6, IFN-gamma, TNF-alpha), lipid profile and oxidant-antioxidant status (urinary isoprostanes [PGF-2 alpha]) were assessed in 38 JIA children (12M/26F, mean age 7.05 +/- A 2.39 years) and compared with 40 controls (18M/22F, mean age 6.34 +/- A 2.25 years). Carotid intima-media wall thickness (cIMT) was obtained and blood pressure was measured. All parameters were reassessed in JIA children after 1 year of therapy.At baseline JIA children presented compared to controls higher levels of inflammatory markers, proinflammatory cytokines, total cholesterol, LDL cholesterol, and PGF-2 alpha (all p a parts per thousand currency sign 0.01). Furthermore, blood pressure and cIMT were significantly increased (both p a parts per thousand currency sign 0.01). After a 1-year treatment with non-steroid anti-inflammatory (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs), a significant reduction of all parameters was detected (all p a parts per thousand currency sign 0.01). This was associated with a significant reduction in blood pressure and cIMT (both p a parts per thousand currency sign 0.01). Within the JIA group, patients requiring etanercept presented worse laboratory values and cIMT measurements at baseline. Nevertheless, the same improvement of all parameters was obtained after a 1-year treatment. In stepwise multiple regression, LDL cholesterol and IL-1 beta were mainly related to cIMT.Chronic and systemic inflammation seems to lead to early atherosclerotic abnormalities even in pre-pubertal JIA children. Substantial improvement can be obtained with 1-year of appropriate therapy.