ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1622

18F-FDG PET/CT in LVV During Active and Inactive Disease Phases Is Associated with the Metabolic Profile, but Not with Macrophage-related Cytokines: Results of an Integrated Analysis

Dimitrios Anastasios Palamidas1, Georgios Kalykakis2, Dimitra Benaki3, Loukas chatzis1, Ourania Argyropoulou4, Panagiota Palla4, Antonia Kollia5, Pavlos Kafouris5, Marinos Metaxas5, Andreas Goules6, Emmanuel Mikros7, Konstantinos Kambas8, Constantinos Anagnostopoulos5 and Athanasios Tzioufas9, 1Pathophysiology Department, Athens School of Medicine, National and Kapodistrian University of Athens, Athens, Greece, Cholargos Athens, Greece, 2Department of Informatics, Ionian University, Kerkyra, Greece, Athens, Greece, 3Department of Pharmaceutical Chemistry, School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece, Athens, Greece, 4Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece., Athens, Greece, 5PET-CT Department & Preclinical Imaging Unit, Center for Experimental Surgery, Clinical & Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece., Athens, Greece, 6GENERAL HOSPITAL LAIKO ATHENS, Athens, Greece, 7Department of Pharmaceutical Chemistry, School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece., Athens, Greece, 8Laboratory of Molecular Genetics, Department of Immunology, Hellenic Pasteur Institute, Athens, Greece., Athens, Greece, 9LAIKO HOSPITAL, Athens, Greece

Meeting: ACR Convergence 2024

Keywords: , , ,

Session Information

Date: Sunday, November 17, 2024

Title: Vasculitis – Non-ANCA-Associated & Related Disorders Poster II

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: Giant cell arteritis (GCA) may affect temporal arteries (cranial-GCA) or may present as a systemic disease extended to the large vessels [Large Vessel Vasculitis (LVV)]. Although temporal artery biopsy is the gold standard for the diagnosis of cranial-GCA, imaging modalities including 18 F-FDG PET/CT are employed for LVV diagnosis. The infiltrating activated immune cells are the main, but not the only cell components that contribute to the signal intensity of FDG-PET/CT due to enhanced upregulation of glycolysis. However, the change of the FDG-PET/CT before and after treatment as well as the association with macrophage biomarkers in LVV patients has been poorly investigated. This study aims to explore the sensitivity to change of FDG-PET/CT after treatment and to identify novel soluble serum biomarkers in association with FDG-PET/CT in LVV patients.

Methods: Nine LVV-GCA patients, underwent FDG-PET/CT at 2 time points: at diagnosis (active state) and 6 months after treatment (inactive state) while in remission. Twelve cranial-GCA and 7 Polymyalgia Rheumatica (PMR) patients with FDG-PET/CT served as inflammatory controls. The Most-Disease-Segment Target-to-Background Ratio (TBRMDS) of FDG-PET-CT was tested as a sensitivity to change parameter between the active and inactive state of LVV patients. A panel of serum macrophage-related inflammatory mediators (IL-12p70, TNF-α, IL-6, IL-4, IL-10, IL-1β, Arginase, CCL17, IL-1RA, IL-12p40, IL-23, IFN-γ, CXCL10) was evaluated by Cytometric Bead Array and previously published NMR-metabolomics data from the same groups of patients at the 2 time points were also retrieved for analyses. Associations between blood biomarkers (metabolites and cytokines) with PET/CT findings were also explored.

Results: TBRMDS was significantly decreased from the active to inactive LVV disease states (3.45 vs. 2.55, p=0.008), with no statistically significant differences in serum levels of macrophage-related cytokines. Serum levels of alanine (p=0.0195), choline (p=0.004), dimethyl sulfone (p=0.012), and certain lipids [CH2—lipids (p=0.004), and unsaturated lipids CH=CH (p=0.027)] were increased while GlycB levels were decreased (p=0.004) in LVV patients from the active to inactive disease. However, only choline serum levels were exclusively altered in the LVV group compared to the other inflammatory control groups. The generated composite index (the sum of TBRMDS, CRP-categorical, ESR-categorical, and Choline-categorical) showed a statistically significant reduction from the active to the inactive disease (p= 0.0039) and the capacity to discriminate between the 2 phases of the disease compared to TBRMDS alone.

Conclusion: The integration of PET-CT data and blood biomarkers may offer a clinically feasible tool to monitor response to treatment of LVV patients.

Disclosures: D. Palamidas: None; G. Kalykakis: None; D. Benaki: None; L. chatzis: Pfizer, 2; O. Argyropoulou: None; P. Palla: None; A. Kollia: None; P. Kafouris: None; M. Metaxas: None; A. Goules: AbbVie/Abbott, 6, Amgen, 1, Pfizer, 2; E. Mikros: None; K. Kambas: None; C. Anagnostopoulos: None; A. Tzioufas: Pfizer, 2.

To cite this abstract in AMA style:

Palamidas D, Kalykakis G, Benaki D, chatzis L, Argyropoulou O, Palla P, Kollia A, Kafouris P, Metaxas M, Goules A, Mikros E, Kambas K, Anagnostopoulos C, Tzioufas A. 18F-FDG PET/CT in LVV During Active and Inactive Disease Phases Is Associated with the Metabolic Profile, but Not with Macrophage-related Cytokines: Results of an Integrated Analysis [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/18f-fdg-pet-ct-in-lvv-during-active-and-inactive-disease-phases-is-associated-with-the-metabolic-profile-but-not-with-macrophage-related-cytokines-results-of-an-integrated-analysis/. Accessed .

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