Angiopoietin-2/-1 ratios and MMP-3 levels as an early warning sign for the presence of giant cell arteritis in patients with polymyalgia rheumatica.
Angiopoietin-2
Giant cell arteritis
Look-alike patients
MMP-3
Platelets
Polymyalgia rheumatica
Journal
Arthritis research & therapy
ISSN: 1478-6362
Titre abrégé: Arthritis Res Ther
Pays: England
ID NLM: 101154438
Informations de publication
Date de publication:
07 03 2022
07 03 2022
Historique:
received:
20
12
2021
accepted:
01
02
2022
entrez:
8
3
2022
pubmed:
9
3
2022
medline:
11
3
2022
Statut:
epublish
Résumé
Diagnosing patients with giant cell arteritis (GCA) remains difficult. Due to its non-specific symptoms, it is challenging to identify GCA in patients presenting with symptoms of polymyalgia rheumatica (PMR), which is a more common disease. Also, commonly used acute-phase markers CRP and ESR fail to discriminate GCA patients from PMR and (infectious) mimicry patients. Therefore, we investigated biomarkers reflecting vessel wall inflammation for their utility in the accurate diagnosis of GCA in two international cohorts. Treatment-naïve GCA patients participated in the Aarhus AGP cohort (N = 52) and the Groningen GPS cohort (N = 48). The AGP and GPS biomarker levels and symptoms were compared to patients presenting phenotypically as isolated PMR, infectious mimicry controls and healthy controls (HCs). Serum/plasma levels of 12 biomarkers were measured by ELISA or Luminex. In both the AGP and the GPS cohort, we found that weight loss, elevated erythrocyte sedimentation rate (ESR) and higher angiopoietin-2/-1 ratios but lower matrix metalloproteinase (MMP)-3 levels identify concomitant GCA in PMR patients. In addition, we confirmed that elevated platelet counts are characteristic of GCA but not of GCA mimicry controls and that low MMP-3 and proteinase 3 (PR3) levels may help to discriminate GCA from infections. This study, performed in two independent international cohorts, consistently shows the potential of angiopoietin-2/-1 ratios and MMP-3 levels to identify GCA in patients presenting with PMR. These biomarkers may be used to select which PMR patients require further diagnostic workup. Platelet counts may be used to discriminate GCA from GCA look-alike patients.
Sections du résumé
BACKGROUND
Diagnosing patients with giant cell arteritis (GCA) remains difficult. Due to its non-specific symptoms, it is challenging to identify GCA in patients presenting with symptoms of polymyalgia rheumatica (PMR), which is a more common disease. Also, commonly used acute-phase markers CRP and ESR fail to discriminate GCA patients from PMR and (infectious) mimicry patients. Therefore, we investigated biomarkers reflecting vessel wall inflammation for their utility in the accurate diagnosis of GCA in two international cohorts.
METHODS
Treatment-naïve GCA patients participated in the Aarhus AGP cohort (N = 52) and the Groningen GPS cohort (N = 48). The AGP and GPS biomarker levels and symptoms were compared to patients presenting phenotypically as isolated PMR, infectious mimicry controls and healthy controls (HCs). Serum/plasma levels of 12 biomarkers were measured by ELISA or Luminex.
RESULTS
In both the AGP and the GPS cohort, we found that weight loss, elevated erythrocyte sedimentation rate (ESR) and higher angiopoietin-2/-1 ratios but lower matrix metalloproteinase (MMP)-3 levels identify concomitant GCA in PMR patients. In addition, we confirmed that elevated platelet counts are characteristic of GCA but not of GCA mimicry controls and that low MMP-3 and proteinase 3 (PR3) levels may help to discriminate GCA from infections.
CONCLUSION
This study, performed in two independent international cohorts, consistently shows the potential of angiopoietin-2/-1 ratios and MMP-3 levels to identify GCA in patients presenting with PMR. These biomarkers may be used to select which PMR patients require further diagnostic workup. Platelet counts may be used to discriminate GCA from GCA look-alike patients.
Identifiants
pubmed: 35255968
doi: 10.1186/s13075-022-02754-5
pii: 10.1186/s13075-022-02754-5
pmc: PMC8900446
doi:
Substances chimiques
Angiopoietin-1
0
Angiopoietin-2
0
Biomarkers
0
Matrix Metalloproteinase 3
EC 3.4.24.17
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
65Informations de copyright
© 2022. The Author(s).
Références
Joint Bone Spine. 2021 Mar;88(2):105045
pubmed: 32649986
J Orthop Surg Res. 2020 Mar 4;15(1):87
pubmed: 32131874
Rheumatology (Oxford). 2020 Jan 1;59(1):176-184
pubmed: 31292652
Front Immunol. 2019 Aug 22;10:1981
pubmed: 31507597
Arthritis Rheum. 1999 Dec;42(12):2624-30
pubmed: 10616010
JAMA Intern Med. 2020 Oct 1;180(10):1295-1304
pubmed: 32804186
Arterioscler Thromb Vasc Biol. 2011 Sep;31(9):e35-44
pubmed: 21719762
Am J Pathol. 1999 Sep;155(3):765-74
pubmed: 10487834
Arthritis Rheum. 2011 Mar;63(3):633-9
pubmed: 21360492
Rheumatology (Oxford). 2017 Apr 1;56(4):506-515
pubmed: 27481272
Mediators Inflamm. 2019 Apr 17;2019:9213074
pubmed: 31148950
Arthritis Rheum. 2003 Dec;48(12):3522-31
pubmed: 14674004
J Rheumatol. 2021 Jul;48(7):1053-1059
pubmed: 33060304
Expert Rev Clin Immunol. 2013 Jul;9(7):641-8
pubmed: 23899234
Clin Transl Immunology. 2020 Aug 27;9(9):e1164
pubmed: 32884747
Eur J Nucl Med Mol Imaging. 2018 Jul;45(7):1119-1128
pubmed: 29671039
Thromb Res. 2019 Jul;179:114-120
pubmed: 31128560
Circ Res. 2018 Aug 31;123(6):700-715
pubmed: 29970365
Mod Rheumatol. 2016;26(2):259-64
pubmed: 26156043
Circulation. 2005 Jul 12;112(2):264-9
pubmed: 15998676
Autoimmun Rev. 2018 Feb;17(2):188-194
pubmed: 29196244
Lancet Rheumatol. 2021 Jan;3(1):e71-e82
pubmed: 33521671
Rheumatology (Oxford). 2019 Feb 25;:
pubmed: 30805622
RMD Open. 2020 Sep;6(3):
pubmed: 32994361
J Pathol. 2004 Nov;204(3):311-6
pubmed: 15476267
Arthritis Rheumatol. 2018 Sep;70(9):1366-1376
pubmed: 29648680
Autoimmun Rev. 2017 Aug;16(8):833-844
pubmed: 28564617