Omma Ahmet, Colak Seda, Can Sandikci Sevinc, Yucel Cigdem, Erden Abdulsamet, Sertoglu Erdim, Ozgurtas Taner
Department of Rheumatology, Health Sciences University, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Department of Clinical Biochemistry, Health Sciences University, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Int J Rheum Dis. 2019 Oct;22(10):1920-1925. doi: 10.1111/1756-185X.13673. Epub 2019 Aug 14.
The aims of the study are to investigate serum neopterin and ischemia modified albumin (IMA) levels in patients with immunoglobulin A vasculitis (IgAV) and evaluate the association of these markers with disease activity and relapse.
Thirty-four consecutive adult patients (24 male and 10 female) admitted to the rheumatology clinic and met the IgAV American College of Rheumatology (ACR) criteria were enrolled in this cross-sectional study. Demographic and clinical features of IgAV and a control group were recorded into a predefined protocol. Disease activity was categorized as "remission" or "active" according to Birmingham Vasculitis Activity Score (BVAS). BVAS ≥ 1 was accepted as "active". Serum neopterin levels, high-sensitivity C-reactive protein (hsCRP) and IMA were evaluated according to BVAS and compared to the healthy control group.
Serum median (interquartile range) neopterin, IMA levels and hsCRP were higher in the study group than in control group (2.01 [12.5] ng/mL vs 1.77 [1.37] ng/mL, 0.67 [0.2] ng/mL vs. 0.43 [0.17] ng/mL, 5.6 [17.1] mg/L vs. 1.55 [1.6] mg/L, P = .095, P < .001 and P = .002, respectively). When evaluated according to BVAS, IMA and hsCRP levels were significantly higher in the group with active disease (0.77 [0.12] vs 0.61 [0.13] and 14.85 [4.6], P = .009 and P = .03, respectively). Serum neopterin levels were significantly higher in the active group compared to BVAS (18.95 [32.36] vs 1.63 [1.48], P < .001).
Oxidative stress is important in IgAV pathogenesis. Roles of hsCRP, neopterin and IMA as potential markers of diagnosis and disease activity seem to be worth studying in future studies with larger study groups.
本研究旨在调查免疫球蛋白A血管炎（IgAV）患者的血清新蝶呤和缺血修饰白蛋白（IMA）水平，并评估这些标志物与疾病活动度和复发的相关性。
本横断面研究纳入了34例连续入住风湿病门诊且符合美国风湿病学会（ACR）IgAV标准的成年患者（24例男性和10例女性）。将IgAV患者和对照组的人口统计学和临床特征记录到预先定义的方案中。根据伯明翰血管炎活动评分（BVAS）将疾病活动度分为“缓解”或“活动”。BVAS≥1被视为“活动”。根据BVAS评估血清新蝶呤水平、高敏C反应蛋白（hsCRP）和IMA，并与健康对照组进行比较。
研究组血清新蝶呤、IMA水平和hsCRP的中位数（四分位间距）高于对照组（分别为2.01[12.5]ng/mL对1.77[1.37]ng/mL、0.67[0.2]ng/mL对0.43[0.17]ng/mL、5.6[17.1]mg/L对1.55[1.6]mg/L，P = 0.095、P < 0.001和P = 0.002）。根据BVAS评估时，疾病活动组的IMA和hsCRP水平显著更高（分别为0.77[0.12]对0.61[0.13]和14.85[4.6]，P = 0.009和P = 0.03）。活动组的血清新蝶呤水平与BVAS相比显著更高（18.95[32.36]对1.63[1.48]，P < 0.001）。
氧化应激在IgAV发病机制中很重要。hsCRP、新蝶呤和IMA作为诊断和疾病活动度潜在标志物的作用在未来更大样本量的研究中似乎值得探讨。
