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Title: Phagocyte-specific S100 proteins and high-sensitivity C reactive protein as biomarkers for a risk-adapted treatment to maintain remission in juvenile idiopathic arthritis: a comparative study
Authors: Gerss, Joachim
Roth, Johannes
Holzinger, Dirk
Ruperto, Nicolino
Wittkowski, Helmut
Frosch, Michael
Wulffraat, Nico
Wedderburn, Lucy
Stanevicha, Valda
Mihaylova, Dimitrina
Harjacek, Miroslav
Len, Claudio Arnaldo [UNIFESP]
Toppino, Claudia
Masi, Massimo
Minden, Kirsten
Saurenmann, Traudel
Uziel, Yosef
Vesely, Richard
Teresa Apaz, Maria
Kuester, Rolf-Michael
Rua Elorduy, Maria Jesus
Burgos-Vargas, Ruben
Ioseliani, Maka
Magni-Manzoni, Silvia
Unsal, Erbil
Anton, Jordi
Balogh, Zsolt
Hagelberg, Stefan
Mazur-Zielinska, Henryka
Tauber, Tsivia
Martini, Alberto
Foell, Dirk
Paediat Rheumatology Int Trials
Univ Munster
Univ Childrens Hosp Muenster
Wilhelmina Childrens Hosp
Inst Child Hlth UCL
Riga Stradins Univ
Univ Children Hosp
Childrens Hosp Zagreb
Universidade Federal de São Paulo (UNIFESP)
Univ Turin
Univ Bologna
Univ Childrens Hosp
Meir Med Ctr
Detska Fakultna Nemocn
Univ Catolica
N Deutsch Zentrum Kinder & Jugendrheumatol
Hosp Cruces
Hosp Gen Mexico City
M Iashvili Childrens Cent Clin
SC Pediat Osped
Dokuz Eylul Univ
Hosp St Joan de Deu
Natl Inst Rheumatol & Physiotherapy ORFI
Karolinska Univ Hosp
Med Univ Silesia
Asaf Harofe Med Ctr
Univ Genoa
Issue Date: 1-Dec-2012
Publisher: Bmj Publishing Group
Citation: Annals of the Rheumatic Diseases. London: Bmj Publishing Group, v. 71, n. 12, p. 1991-1997, 2012.
Abstract: Objectives Juvenile idiopathic arthritis (JIA) is a chronic inflammatory joint disease affecting children. Even if remission is successfully induced, about half of the patients experience a relapse after stopping anti-inflammatory therapy. the present study investigated whether patients with JIA at risk of relapse can be identified by biomarkers even if clinical signs of disease activity are absent.Methods Patients fulfilling the criteria of inactive disease on medication were included at the time when all medication was withdrawn. the phagocyte activation markers S100A12 and myeloid-related proteins 8/14 (MRP8/14) were compared as well as the acute phase reactant high-sensitivity C reactive protein (hsCRP) as predictive biomarkers for the risk of a flare within a time frame of 6 months.Results 35 of 188 enrolled patients experienced a flare within 6 months. Clinical or standard laboratory parameters could not differentiate between patients at risk of relapse and those not at risk. S100A12 and MRP8/14 levels were significantly higher in patients who subsequently developed flares than in patients with stable remission. the best single biomarker for the prediction of flare was S100A12 (HR 2.81). the predictive performance may be improved if a combination with hsCRP is used.Conclusions Subclinical disease activity may result in unstable remission (ie, a status of clinical but not immunological remission). Biomarkers such as S100A12 and MRP8/14 inform about the activation status of innate immunity at the molecular level and thereby identify patients with unstable remission and an increased risk of relapse.
ISSN: 0003-4967
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