Biomarkers in early rheumatoid arthritis: longitudinal associations with inflammation and joint destruction measured by magnetic resonance imaging and conventional radiographs
Biomarkers in early rheumatoid arthritis: longitudinal associations with inflammation and joint destruction measured by magnetic resonance imaging and conventional radiographs
复制标题
DOI：
10.1136/ard.2009.122325
复制
发表时间：
2010-05-01
影响因子：
27.4
通讯作者：
Kvien, Tore K.
中科院分区：
文献类型：
--
作者：
Syversen, Silje W.;Haavardsholm, Espen A.;Kvien, Tore K.
目的探讨一组可溶性生物标志物与早期类风湿关节炎（RA）患者进行性关节破坏的相关性，以及与临床和MRI评估的疾病活动性的纵向相关性。方法84例早期RA患者在基线、3、6和12个月时进行临床检查、血清和尿液采样，优势手腕的MRI扫描和手部的常规X光片。通过ELISA评估一组生物标志物（sCTX-I、uCTX-II、sOPG、sYKL-40、sCOMP和sMMP-3）。根据RA MRI评分（RAMRIS）和货车der Heijde改良Sharp评分（SHS）分别对MRI图像和常规X线片进行评分。生物标志物和MRI炎症和疾病活动度评分（DAS 28）之间的纵向关联和与损害进展的关联进行了检查与调整已知predictors.Results的基线sCTX-I水平预测进展的MRI和传统的X光片评估的关节破坏，而uCTX-II水平是一个预测进展的SHS，但不是RAMRIS。在基线和纵向分析中，除C反应蛋白外，还发现sYKL-40和sMMP-3与MRI炎症（滑膜炎和骨髓水肿）和DAS 28的一致相关性。结论sCTX-I和uCTX-II水平是进行性关节破坏的重要预测因子，而sMMP-3和sYKL-40仅是关节炎症的标志物。这些标记物用于个体患者的临床价值有限，因为进展和无进展患者的水平相当重叠。
Objective To examine associations between a panel of soluble biomarkers and progressive joint destruction assessed by magnetic resonance imaging (MRI) and conventional radiographs as well as longitudinal associations with disease activity assessed clinically and by MRI in early rheumatoid arthritis (RA) patients.Methods 84 early RA patients were evaluated at baseline, 3, 6 and 12 months with clinical examination, serum and urine sampling, MRI scans of the dominant wrist and conventional radiographs of the hands. A panel of biomarkers (sCTX-I, uCTX-II, sOPG, sYKL-40, sCOMP and sMMP-3) was assessed by ELISA. MRI images and conventional radiographs were scored according to the RA MRI score (RAMRIS) and the van der Heijde modified Sharp score (SHS), respectively. Longitudinal associations between biomarkers and MRI inflammation and disease activity score (DAS28) and association with the progression of damage were examined with adjustments for known predictors.Results The baseline sCTX-I level predicted progression in joint destruction assessed by MRI and conventional radiographs, whereas the uCTX-II level was a predictor of progression in SHS but not RAMRIS. Consistent associations, both with MRI inflammation (synovitis and bone marrow oedema) and DAS28 were found for sYKL-40 and sMMP-3 in addition to C-reactive protein at baseline and in longitudinal analyses. Associations remained significant in multivariate analyses.Conclusion Levels of sCTX-I and uCTX-II were significant predictors of progressive joint destruction, whereas sMMP-3 and sYKL-40 were merely markers of joint inflammation. The clinical value of these markers for use in individual patients is limited due to a considerable overlap in levels of patients with progression and no progression.