Department of Clinical Chemistry and Laboratory Diagnostics, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, ul. Jedności 8, 41-200 Sosnowiec, Poland.
Department of Rheumatology, The John Paul II Pediatric Center in Sosnowiec, ul. Gabrieli Zapolskiej 3, 41-218 Sosnowiec, Poland.
Biomolecules. 2021 Apr 28;11(5):648. doi: 10.3390/biom11050648.
Joint destruction in juvenile idiopathic arthritis (JIA), initiated in the early, preclinical stage of the disease, is diagnosed on the basis of clinical evaluation and radiographic imaging. The determination of circulating cartilage-matrix turnover markers can facilitate the diagnosis and application of better and earlier treatment strategies for JIA. We have shown that 96 JIA patients have elevated levels of procollagen II C-terminal propeptide (PIICP), reflecting the extent of joint cartilage biosynthesis, and C-telopeptide of type II collagen (CTXII), a biomarker of the resorption of this tissue. Patients who did not respond to treatment had particularly high levels of these markers. JIA treatment resulted in the normalization of these markers in remissive patients, but not in those with active JIA. We showed correlations between examined variables and inflammatory process indicators, i.e., C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and tumor necrosis factor-α (TNF-α). The TNF-α of patients responding to treatment correlated with PIICP, especially in the patients before treatment (r = 0.898, < 0.001). Significant changes in serum PIICP during JIA therapy suggest its potential diagnostic utility in the monitoring of disease activity and the possibility of its use in assessing treatment towards remission. Understanding changes in type II collagen metabolism over the course of the discussed arthritis may allow the implementation of both new diagnostic tools and new therapeutic strategies in children with JIA.
关节破坏在幼年特发性关节炎（JIA），在疾病的早期，临床前阶段开始，是基于临床评估和影像学诊断。确定循环软骨基质转换标志物可以促进 JIA 的诊断和更好、更早的治疗策略的应用。我们已经表明，96 例 JIA 患者的 II 型前胶原 C 端前肽（PIICP）水平升高，反映了关节软骨生物合成的程度，以及 II 型胶原 C 端肽（CTXII），这种组织吸收的生物标志物。对治疗无反应的患者这些标志物水平特别高。JIA 治疗使缓解患者的这些标志物恢复正常，但对活动性 JIA 患者无效。我们发现了检查变量与炎症过程指标之间的相关性，即 C 反应蛋白（CRP）、红细胞沉降率（ESR）和肿瘤坏死因子-α（TNF-α）。对治疗有反应的患者的 TNF-α与 PIICP 相关，尤其是在治疗前的患者中（r = 0.898，<0.001）。JIA 治疗过程中血清 PIICP 的显著变化提示其在监测疾病活动方面具有潜在的诊断效用，并可能用于评估治疗缓解的可能性。了解讨论性关节炎过程中 II 型胶原代谢的变化可能允许在儿童 JIA 中实施新的诊断工具和新的治疗策略。
