Neutrophils extracellular traps formation may serve as a biomarker for disease activity in oligoarticular juvenile idiopathic arthritis: a pilot study.

Juvenile idiopathic arthritis (JIA) Myeloperoxidase (MPO) Neutrophil Neutrophil elastase (NE) Neutrophil extracellular traps (NETs)

Journal

Arthritis research & therapy
ISSN: 1478-6362
Titre abrégé: Arthritis Res Ther
Pays: England
ID NLM: 101154438

Informations de publication

Date de publication:
31 07 2023
Historique:
received: 07 10 2022
accepted: 04 07 2023
medline: 2 8 2023
pubmed: 1 8 2023
entrez: 31 7 2023
Statut: epublish

Résumé

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children, causing significant morbidity. Despite the dramatic improvement in treatment, many patients do not achieve complete remission, and biomarkers for subclinical disease, flares, and response to treatment are lacking. Neutrophils and neutrophil extracellular traps (NETs) play key roles in the pathogenesis of autoimmune and inflammatory conditions. In this study, we characterized neutrophil enzyme activity and NETs formation in oligoarticular and polyarticular JIA and explored their association with disease activity. Neutrophils from 6 healthy controls and 7 patients with oligoarticular and polyarticular JIA were freshly isolated at time of diagnosis and after glucocorticoid intra-articular injection. Enzymatic activity of neutrophil granular enzymes was monitored by colorimetry and PMA-activated NETs formation was assessed using fluorescent microscopy. In this pilot and feasibility study, we revealed that NETs were significantly increased in oligoarticular JIA patients at time of diagnosis compared to healthy controls. Anti-inflammatory treatment using intra-articular steroid injection normalized NETs formation in these patients. Correlation between NETs formation and clinical Juvenile Activity Disease Activity Score-10 (cJADAS-10) was linear and significant (P = 0.007) in oligo but not in poly JIA patients. This is the first study exploring the link of NETs formation with oligo and poly JIA activity. We demonstrated a statistically significant linear correlation between cJADAS-10 and NETs formation in oligo but not in poly JIA patients. Hence, we suggest that NETs may reflect clinical disease activity in JIA, and may serve as a putative biomarker. Further work is needed to validate these initial results and determine the dynamics of NETs formation in JIA.

Sections du résumé

BACKGROUND
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children, causing significant morbidity. Despite the dramatic improvement in treatment, many patients do not achieve complete remission, and biomarkers for subclinical disease, flares, and response to treatment are lacking. Neutrophils and neutrophil extracellular traps (NETs) play key roles in the pathogenesis of autoimmune and inflammatory conditions. In this study, we characterized neutrophil enzyme activity and NETs formation in oligoarticular and polyarticular JIA and explored their association with disease activity.
METHODS
Neutrophils from 6 healthy controls and 7 patients with oligoarticular and polyarticular JIA were freshly isolated at time of diagnosis and after glucocorticoid intra-articular injection. Enzymatic activity of neutrophil granular enzymes was monitored by colorimetry and PMA-activated NETs formation was assessed using fluorescent microscopy.
RESULTS
In this pilot and feasibility study, we revealed that NETs were significantly increased in oligoarticular JIA patients at time of diagnosis compared to healthy controls. Anti-inflammatory treatment using intra-articular steroid injection normalized NETs formation in these patients. Correlation between NETs formation and clinical Juvenile Activity Disease Activity Score-10 (cJADAS-10) was linear and significant (P = 0.007) in oligo but not in poly JIA patients.
CONCLUSIONS
This is the first study exploring the link of NETs formation with oligo and poly JIA activity. We demonstrated a statistically significant linear correlation between cJADAS-10 and NETs formation in oligo but not in poly JIA patients. Hence, we suggest that NETs may reflect clinical disease activity in JIA, and may serve as a putative biomarker. Further work is needed to validate these initial results and determine the dynamics of NETs formation in JIA.

Identifiants

pubmed: 37525216
doi: 10.1186/s13075-023-03104-9
pii: 10.1186/s13075-023-03104-9
pmc: PMC10388488
doi:

Substances chimiques

Biomarkers 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

135

Informations de copyright

© 2023. The Author(s).

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Auteurs

Merav Heshin-Bekenstein (M)

Pediatric Rheumatology Service, Dana Dwek Children's Hospital of Tel Aviv Medical Center, Tel Aviv, Israel. meravheshin@gmail.com.
School of Medicine, Tel Aviv University, Tel Aviv, Israel. meravheshin@gmail.com.

Szilvia Baron (S)

School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatric Hemato-Oncology Research Laboratory, Tel Aviv Medical Center, Tel Aviv, Israel.

Grant Schulert (G)

Division of Rheumatology, Cincinnati, OH, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Anna Shusterman (A)

School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatric Hemato-Oncology Research Laboratory, Tel Aviv Medical Center, Tel Aviv, Israel.

Victoria Fidel (V)

School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatric Hemato-Oncology Research Laboratory, Tel Aviv Medical Center, Tel Aviv, Israel.

Yoav Ben-Shahar (Y)

School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Pediatric Surgery, Tel Aviv Medical Center, Tel Aviv, Israel.

Rachel Shukrun (R)

School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatric Hemato-Oncology Research Laboratory, Tel Aviv Medical Center, Tel Aviv, Israel.

Yoav Binenbaum (Y)

School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatric Hemato-Oncology Research Laboratory, Tel Aviv Medical Center, Tel Aviv, Israel.

Ronit Elhasid (R)

School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatric Hemato-Oncology Research Laboratory, Tel Aviv Medical Center, Tel Aviv, Israel.
Department of Pediatric Hemato-Oncology, Tel Aviv Medical Center, Tel Aviv, Israel.

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