TY - JOUR T1 - Something Old, Something New: Biomarkers in Rheumatoid Arthritis JF - The Journal of Rheumatology JO - J Rheumatol SP - 2091 LP - 2093 DO - 10.3899/jrheum.141069 VL - 41 IS - 11 AU - FEDERICO PRATESI AU - PAOLA MIGLIORINI Y1 - 2014/11/01 UR - http://www.jrheum.org/content/41/11/2091.abstract N2 - In this issue of The Journal, Maksymowych, et al1 propose the detection of the protein 14-3-3η as a novel tool for the diagnosis of rheumatoid arthritis (RA).The protein 14-3-3η belongs to a family of phosphoserine/phosphothreonine–recognition proteins that regulate the activity of several different ligands in various signaling pathways. The expression of these proteins is controlled at the genomic level and post-translationally; a large body of evidence supports the hypothesis that their abnormal expression and/or interaction with targets contributes to a large number of human diseases2. The isoform η is among the most highly induced of these proteins in activated B cells where, by interacting with activation-induced cytidine deaminase, it regulates class-switch recombination3. It is the only isoform that is detectable in increased amounts in microparticles from systemic lupus erythematosus sera4 and in synovial fluids from patients with RA5.Maksymowych, et al1 studied the serum levels of 14-3-3η in 2 cohorts of patients with RA, one with early RA and one with established RA, who were being treated with disease-modifying antirheumatic drugs (DMARD) but not biologicals. Normal healthy subjects and patients affected by osteoarthritis, chronic arthritis [psoriatic arthritis (PsA), spondyloarthritis, gout], connective tissue disorders, and other inflammatory conditions served as controls. The levels of 14-3-3η could discriminate patients with RA from healthy controls and disease controls with high sensitivity and specificity (77% and 92.5% in established RA, 64% and 92.6% in early RA). Moreover, the levels of 14-3-3η were higher in RA patients with higher C-reactive protein and 28-joint Disease Activity Score levels1 and in those showing radiographic progression6. These data, together with the observed downregulation by anti-tumor necrosis factor treatment, suggest that protein levels reflect ongoing articular damage.It is of interest to note that not … Address correspondence to Dr. P. Migliorini, Clinical Immunology and Allergy Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy. E-mail: paola.migliorini{at}med.unipi.it ER -