Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: The classical inflammatory markers, C-reactive protein and erythrocyte sedimentation rate often do not adequately reflect JIA disease activity. Our objective was to assess the serum levels of DKK1, OPG, SOST, RANKL, greline, BAFF, leptine, APRIL, ACPA, CTD, RF IgA and IgM, INFy, IL1β, IL6, IL10, IL17 and TNF in patients with JIA, and detect their relation to disease activity.
Methods: Serum levels of selected cytokines were determined by ELISA in JIA patients registered in Reuma.pt. The Juvenile Arthritis Disease Activity score in 27 joints (JADAS27) and Childhood Health Assessment Questionnaire (CHAQ) were calculated. Multivariate linear regression was used for analyzing the relation between the potential serum biomarkers levels and JADAS27 and CHAQ, adjusting for gender, body mass index, age, disease duration and JIA categories.
Results: 281 patients, 66% female, mean age 17.3±10 years and mean disease duration 10.9±8.7 years. Ninety-eight were persistent oligoarticular (OligoP), 48 extended oligoarticular (OligoE), 45 polyarticular RF negative (poly RF-), 26 Poly RF+, 22 systemic, 28 enthesitis-related arthritis (ERA) and 14 psoriatic arthritis. The global analysis including all JIA patients revealed that APRIL, RF IgA and IL17 levels were correlated with JADAS27 (β=0.14, p=0.02; β=0.12, p=0.006; β=0.36, p=0.014; respectively) and IL6 was inversely correlated with JADAS27 (β=-0.06, p=0.03). Regarding CHAQ, we have found that APRIL, INFγ and TNF were correlated with CHAQ (β=0.01, p=0.001; β=0.003, p=0.02; β=0.003, p=0.04; respectively). In the separate analysis by JIA category, in OligoP, RF IgM, INFy, IL1β, and TNF were correlated with CHAQ (β=0.007, p=0.005; β=0.004, p=0.019; β=0.008, p=0.033; β=0.007, p=0.038; respectively), and, on the other hand, IL10 was inversely correlated with CHAQ (β=-0.007, p=0.023). In OligoE, RF IgA levels were correlated with JADAS27 and CHAQ (β=0.91, p=0.016; β=0.05, p=0.037). In patients with Poly RF+ the serum levels of OPG and ACPA were correlated with JADAS27 (β=0.06, p=0.024; β=0.03, p=0.05), and OPG was also correlated with CHAQ (β=0.004, p=0.032). In PolyRF- patients, DKK1 was correlated with JADAS27 (β=0.014, p=0.047), and serum levels of APRIL and RF IgM were associated with CHAQ (β=0.03, p<0.001; β=0.03, p<0.001). In systemic JIA, CTD lev
els were correlated with JADAS27 (β=82.67, p=0.002), and DKK1 was inversely associated with JADAS27 (β=-0.009, p=0.035). In ERA category we have found leptin was correlated with JADAS27 and CHAQ (β=0.9, p=0.005; β=0.05, p=0.029), and ACPA with CHAQ (β=0.005, p=0.031). Lastly, for psoriatic arthritis patients, APRIL and RF IgA levels were correlated with CHAQ (β=0.17, p=0.046; β=0.13, p=0.008), and DKK1 and SOST were inversely correlated with CHAQ (β=-0.0003, p=0.037; β=-0.001, p=0.030).
Conclusion: Our data underline the heterogeneity of different juvenile idiopathic arthritis categories. Interestingly, we have identified potential biomarkers of disease activity/functional status in JIA categories. Larger studies are needed in order to validate these results.
To cite this abstract in AMA style:Mourão AF, Santos M, Eusébio M, Lopes A, Ramos F, Salgado M, Estanqueiro P, Melo Gomes JA, Magalhaes Martins F, Costa JA, Furtado AC, Figueira R, Brito I, Branco J, Fonseca JE, Canhão H. Potential Biomarkers of Disease Activity in Juvenile Idiopathic Arthritis – Data from the Portuguese Register, Reuma.Pt [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/potential-biomarkers-of-disease-activity-in-juvenile-idiopathic-arthritis-data-from-the-portuguese-register-reuma-pt/. Accessed March 19, 2019.
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