Tombetti Enrico, Di Chio Maria Chiara, Sartorelli Silvia, Papa Maurizio, Salerno Annalaura, Bottazzi Barbara, Bozzolo Enrica Paola, Greco Marta, Rovere-Querini Patrizia, Baldissera Elena, Del Maschio Alessandro, Mantovani Alberto, De Cobelli Francesco, Sabbadini Maria Grazia, Manfredi Angelo A
Arthritis Res Ther. 2014 Nov 14;16(6):479. doi: 10.1186/s13075-014-0479-z.
Progression of arterial involvement is often observed in patients with Takayasu arteritis (TA) thought to be in remission. This reflects the failure of currently used biomarkers and activity criteria to detect smouldering inflammation occurring within arterial wall. Pentraxin-3 (PTX3) is a soluble pattern recognition receptor produced at sites of inflammation and could reveal systemic as well as localized inflammatory processes. We verified whether the blood concentrations of PTX3 and of C-reactive protein (CRP) in patients with Takayasu arteritis (TA) might reflect vascular wall involvement, as assessed by signal enhancement after contrast media administration, and the progression of arterial involvement.
A cross-sectional single-centre study was carried out on 42 patients with TA that comprised assessment of PTX3, of CRP and erythrocyte sedimentation velocity (ESR). In total, 20 healthy controls and 20 patients with Systemic Lupus Erythematous (SLE) served as controls. Vascular imaging was carried out by magnetic resonance angiography, doppler ultrasonography and computed tomography angiography.
Patients with TA and SLE had higher plasmatic PTX3 and CRP concentrations than healthy controls (P = 0.009 and 0.017, respectively). PTX3 levels did not correlate with those of CRP. Patients with active systemic TA had significantly higher concentrations of CRP but similar levels of PTX3 than patients with quiescent disease. In contrast, patients with vascular inflammation detectable at imaging had higher PTX3 concentrations (P = 0.016) than those in which vessel inflammation was not evident, while CRP levels were similar. The concentration of PTX3 but not that of CRP was significantly higher in TA patients with worsening arterial lesions that were not receiving antagonists of tumor necrosis factor-α or interleukin-6.
Arterial inflammation and progression of vascular involvement influence plasma PTX3 levels in TA, while levels of CRP accurately reflect the burden of systemic inflammation. These results support the contention that PTX3 reflects different aspects of inflammation than CRP and might represent a biomarker of actual arteritis in TA.
在被认为处于缓解期的大动脉炎（TA）患者中，常观察到动脉受累情况的进展。这反映了目前使用的生物标志物和活动标准未能检测到动脉壁内发生的隐匿性炎症。五聚素3（PTX3）是一种在炎症部位产生的可溶性模式识别受体，可揭示全身以及局部的炎症过程。我们验证了大动脉炎（TA）患者血液中PTX3和C反应蛋白（CRP）的浓度是否能反映血管壁受累情况（通过造影剂注射后的信号增强评估）以及动脉受累的进展情况。
对42例TA患者进行了一项横断面单中心研究，包括对PTX3、CRP和红细胞沉降速度（ESR）的评估。总共20名健康对照者和20例系统性红斑狼疮（SLE）患者作为对照。通过磁共振血管造影、多普勒超声检查和计算机断层血管造影进行血管成像。
TA患者和SLE患者的血浆PTX3和CRP浓度高于健康对照者（分别为P = 0.009和0.017）。PTX3水平与CRP水平不相关。活动性全身TA患者的CRP浓度显著高于静止期患者，但PTX3水平相似。相比之下，影像学检查可检测到血管炎症的患者PTX3浓度高于血管炎症不明显的患者（P = 0.016），而CRP水平相似。在未接受肿瘤坏死因子-α或白细胞介素-6拮抗剂治疗且动脉病变恶化的TA患者中，PTX3浓度显著升高，而CRP浓度未升高。
动脉炎症和血管受累的进展影响TA患者的血浆PTX3水平，而CRP水平准确反映全身炎症负担。这些结果支持了PTX3反映的炎症方面与CRP不同且可能代表TA中实际动脉炎生物标志物的观点。
