The Toll-like receptor 4 agonist MRP8/14 protein complex is a sensitive indicator for disease activity and predicts relapses in systemic-onset juvenile idiopathic arthritis
The Toll-like receptor 4 agonist MRP8/14 protein complex is a sensitive indicator for disease activity and predicts relapses in systemic-onset juvenile idiopathic arthritis
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DOI：
10.1136/annrheumdis-2011-200598
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发表时间：
2012-06-01
影响因子：
27.4
通讯作者：
Wittkowski, Helmut
中科院分区：
文献类型：
--
作者：
Holzinger, Dirk;Frosch, Michael;Wittkowski, Helmut
背景血清髓样相关蛋白8和14复合物（MRP 8/14）浓度分析是一种潜在的新工具，可用于诊断全身型幼年特发性关节炎（SJIA）伴不明原因发热。14种血清浓度监测SJIA患者的疾病活动性，并对有复发风险的患者进行分层。52例SJIA患者中14例用双抗体夹心ELISA法检测。监测的治疗方案针对白细胞介素1和肿瘤坏死因子a，甲氨蝶呤治疗进行了分析和诊断能力预测flareswerest.Results MRP 8/14水平明显提高，在活动性疾病和减少显着响应成功的治疗。MRP 8/14的血清浓度显著增加（p740 ng/ml准确预测疾病发作（敏感性92%，特异性88%）。MRP 8/14水平与临床疾病活动性相关，如医生对疾病活动性的总体评估（r=0.62）、儿童健康评估问卷（r=0.56）、活动关节计数（r=0.46）、C反应蛋白（r=0.71）和红细胞沉降率（r=0.72）（对于所有患者，MRP 8/14水平均与临床疾病活动性相关。
Background Analysis of myeloid-related protein 8 and 14 complex (MRP8/14) serum concentrations is a potential new tool to support the diagnosis of systemic-onset juvenile idiopathic arthritis (SJIA) in the presence of fever of unknown origin.Objective To test the ability of MRP8/14 serum concentrations to monitor disease activity in patients with SJIA and stratify patients at risk of relapse.Methods Serum concentrations of MRP8/14 in 52 patients with SJIA were determined by a sandwich ELISA. The monitoring of therapeutic regimens targeting interleukin 1 and tumour necrosis factor a, and methotrexate treatment was analysed and diagnostic power to predict flares was tested.Results MRP8/14 levels were clearly raised in active disease and decreased significantly in response to successful treatments. Serum concentrations of MRP8/14 increased significantly (p740 ng/ml predicted disease flares accurately (sensitivity 92%, specificity 88%). MRP8/14 levels correlated well with clinical disease activity, as assessed by physician's global assessment of disease activity (r=0.62), Childhood Health Assessment Questionnaire (r=0.56), active joint count (r=0.46) and with C-reactive protein (r=0.71) and erythrocyte sedimentation rate (r=0.72) (for all p