Background/Purpose:

Pentraxin 3 (PTX3) plays an important role in inflammation, immunity, and atherosclerosis. Plasma PTX3 level is recognized as a marker that responds to local inflammation. PTX3 stimulates osteoclastogenesis by increasing osteoblast RANKL production in vitro. PTX3 is strongly expressed in human atherosclerotic plaque, and plasma PTX3 concentration increases in patients with atherosclerotic cardiovascular disease such as unstable angina pectoris and myocardial infarction. Rheumatoid arthritis (RA) is a chronic inflammatory disorder, which is known to develop joint damage and atherosclerosis. We examined the hypotheses that the PTX3 concentrations are elevated in patients with RA and are associated with 3-year progression of joint destruction and subclinical atherosclerosis.

Methods: Plasma PTX3 concentrations were measured in 72 female patients with RA and 80 healthy control. The patients were also evaluated with respect to their clinical characteristics, joint damage, atherosclerosis and medications. Radiographs of the hands and feet were evaluated using the van der Heijde modified Sharp scoring method at baseline and at 3 years in patients with RA. We also performed carotid ultrasonography to measure subclinical atherosclerosis at the two time points in RA patients. Among female patients with RA, we investigated whether plasma PTX3 levels were associated with the progression of joint destruction and carotid intima media thickness (IMT), a surrogate marker of atherosclerosis during 3 years of follow-up.

Results:

Plasma PTX3 levels were significantly higher in female patients with RA (4.05±2.91 ng/mL) compared to healthy females (1.61±1.05 ng/mL) (Wilcoxon’s rank sum test: P<0.001). Follow-up imaging of articular radiographs and carotid ultrasonography were not obtained from 10 and 8 patients, respectively. Progression of joint damage was observed in 72.6% out of 62 patients during 3 years. Incident plaque was observed in 45% patients (40 out of 64) without baseline plaque. IMT progression was detected in 34 (53%) out of 64 patients. By multivariate analysis using multiple linear regression model for the RA patients, baseline plasma PTX3 levels were significantly associated with total Sharp score (P=0.004), erosion score (P=0.002) and joint space narrowing score (P=0.031) after 3 years follow-up with adjustment for baseline score of joint damage, age, BMI, rheumatoid factor, DAS28-ESR4, postmenopausal, use of biologics. Besides, PTX3 did not predict 3-year carotid artery IMT progression nor incident plaque in RA.

Conclusion: Female patients with RA have increased concentrations of PTX3 compared with control subjects. PTX3 was significantly associated with radiographic progression of joint damage but not with carotid atherosclerosis in RA.

« Back to 2015 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/plasma-pentraxin-3-concentration-is-associated-with-progression-of-radiographic-joint-damage-but-not-with-carotid-atherosclerosis-in-female-patients-with-rheumatoid-arthritis-results-from-a-3-year-pr/