Diagnosis and assessment of Takayasu arteritis by multiple biomarkers

Circ J. 2013;77(2):477-83. doi: 10.1253/circj.cj-12-0131. Epub 2012 Oct 26.

Abstract

Background: Patients with Takayasu arteritis (TA) often show recurrence under steroid treatment without an elevation of C-reactive protein (CRP). There is a report that matrix metalloproteinase (MMP)-2, MMP-3, MMP-9 and pentraxin3 (PTX3) could be sensitive biomarkers, but the characteristics of these biomarkers have not been established.

Methods and results: We enrolled 45 consecutive patients; 28 were grouped in an active phase as evidenced by clinical recurrence within 2 years of blood sampling. Circulating levels of high-sensitivity (hs)CRP, MMPs, and PTX3 were determined. Patients in an active phase showed higher levels of hsCRP, MMP-9, and PTX3. Area under the receiving operating characteristics curves of hsCRP and PTX3 were significantly higher than that of MMP-9. Among the 28 patients with active TA, 71% was positive for hsCRP and 82% for PTX3. Patients without recurrence showed significantly higher plasma levels of MMP-9. There was a positive correlation between the plasma MMP-3 level and the prednisolone dose. However, PTX3 and MMP-9 levels did not have such a correlation.

Conclusions: PTX3 and MMP-9, which are not affected by prednisolone, could be sensitive biomarkers for assessing TA activity. Evaluation of MMP-9 may suggest prior existence of TA.

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Dose-Response Relationship, Drug
  • Female
  • Glucocorticoids / administration & dosage
  • Humans
  • Male
  • Matrix Metalloproteinase 2 / blood*
  • Matrix Metalloproteinase 3 / blood*
  • Matrix Metalloproteinase 9 / blood*
  • Middle Aged
  • Prednisolone / administration & dosage
  • Sensitivity and Specificity
  • Serum Amyloid P-Component / metabolism*
  • Severity of Illness Index
  • Takayasu Arteritis / blood*
  • Takayasu Arteritis / diagnosis
  • Takayasu Arteritis / drug therapy
  • Young Adult

Substances

  • Biomarkers
  • Glucocorticoids
  • Serum Amyloid P-Component
  • PTX3 protein
  • C-Reactive Protein
  • Prednisolone
  • MMP3 protein, human
  • Matrix Metalloproteinase 3
  • MMP2 protein, human
  • Matrix Metalloproteinase 2
  • MMP9 protein, human
  • Matrix Metalloproteinase 9