Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Department of Chemical Pathology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Semin Arthritis Rheum. 2015 Aug;45(1):18-27. doi: 10.1016/j.semarthrit.2015.02.001. Epub 2015 Feb 20.
To study the association between the baseline IL-33 and soluble ST2 (sST2) levels with disease remission and progression of carotid atherosclerosis in early rheumatoid arthritis (ERA) patients.
A total of 98 ERA patients were enrolled. Disease activity and the presence of carotid plaque were evaluated at baseline and 12 months later. Plasma IL-33 and sST2 levels were determined using enzyme-linked immunosorbent assay kits.
Baseline IL-33 and sST2 levels were associated with inflammatory markers and cardiovascular (CV) risk factors. Overall, 44(45%), 18(18%), and 21(21%) patients achieved remission based on 28-joint disease activity score (DAS28), Boolean, and simplified disease activity score (SDAI) criteria at 12 months, respectively. Patients with detectable IL-33 at baseline were less likely to achieve DAS28 (P = 0.010) and SDAI remission (P = 0.021), while a lower baseline sST2 level was able to predict DAS28, Boolean, and SDAI remission (P = 0.005, 0.001, and <0.001, respectively). Using multivariate analysis, a lower baseline sST2 level independently predict Boolean (OR = 0.789; P = 0.005) and SDAI remission (0.812; P = 0.008). Regarding carotid atherosclerosis, 9/98(9.2%) patients had plaque progression at 12 months. Baseline IL-33 was detectable in 8/9(89%) and 42/83(51%) of patients with and without plaque progression respectively (P = 0.029). Baseline detectable IL-33 was an independent predictor for plaque progression after adjusting for traditional CV risk factors (P = 0.017).
Lower baseline sST2 levels independently predict disease remission and baseline detectable IL-33 independently predicts carotid plaque progression in ERA patients. This study suggests that inflammation induced by the IL-33/ST2 axis may play a significant role in the development of cardiovascular disease in RA.
研究基线白细胞介素-33（IL-33）和可溶性 ST2（sST2）水平与早期类风湿关节炎（ERA）患者颈动脉粥样硬化疾病缓解和进展的关系。
共纳入 98 例 ERA 患者。基线和 12 个月后评估疾病活动度和颈动脉斑块的存在。使用酶联免疫吸附试验试剂盒测定血浆 IL-33 和 sST2 水平。
基线 IL-33 和 sST2 水平与炎症标志物和心血管（CV）危险因素相关。总体而言，44（45%）、18（18%）和 21（21%）例患者分别根据 28 关节疾病活动评分（DAS28）、布尔和简化疾病活动评分（SDAI）标准在 12 个月时达到缓解。基线时可检测到 IL-33 的患者不太可能达到 DAS28（P = 0.010）和 SDAI 缓解（P = 0.021），而基线 sST2 水平较低能够预测 DAS28、布尔和 SDAI 缓解（P = 0.005、0.001 和 <0.001）。使用多变量分析，基线较低的 sST2 水平独立预测布尔（OR = 0.789；P = 0.005）和 SDAI 缓解（0.812；P = 0.008）。关于颈动脉粥样硬化，9/98（9.2%）例患者在 12 个月时有斑块进展。基线时 IL-33 可检测到的患者分别为 8/9（89%）和 42/83（51%）例有和无斑块进展患者（P = 0.029）。调整传统 CV 危险因素后，基线可检测到的 IL-33 是斑块进展的独立预测因子（P = 0.017）。
基线 sST2 水平较低独立预测疾病缓解，基线可检测到的 IL-33 独立预测 ERA 患者颈动脉斑块进展。本研究表明，IL-33/ST2 轴诱导的炎症可能在 RA 患者的心血管疾病发展中起重要作用。
