Phagocyte-specific S100 proteins and high-sensitivity C reactive protein as biomarkers for a risk-adapted treatment to maintain remission in juvenile idiopathic arthritis: a comparative study

dc.contributor.authorGerss, Joachim
dc.contributor.authorRoth, Johannes
dc.contributor.authorHolzinger, Dirk
dc.contributor.authorRuperto, Nicolino
dc.contributor.authorWittkowski, Helmut
dc.contributor.authorFrosch, Michael
dc.contributor.authorWulffraat, Nico
dc.contributor.authorWedderburn, Lucy
dc.contributor.authorStanevicha, Valda
dc.contributor.authorMihaylova, Dimitrina
dc.contributor.authorHarjacek, Miroslav
dc.contributor.authorLen, Claudio Arnaldo [UNIFESP]
dc.contributor.authorToppino, Claudia
dc.contributor.authorMasi, Massimo
dc.contributor.authorMinden, Kirsten
dc.contributor.authorSaurenmann, Traudel
dc.contributor.authorUziel, Yosef
dc.contributor.authorVesely, Richard
dc.contributor.authorTeresa Apaz, Maria
dc.contributor.authorKuester, Rolf-Michael
dc.contributor.authorRua Elorduy, Maria Jesus
dc.contributor.authorBurgos-Vargas, Ruben
dc.contributor.authorIoseliani, Maka
dc.contributor.authorMagni-Manzoni, Silvia
dc.contributor.authorUnsal, Erbil
dc.contributor.authorAnton, Jordi
dc.contributor.authorBalogh, Zsolt
dc.contributor.authorHagelberg, Stefan
dc.contributor.authorMazur-Zielinska, Henryka
dc.contributor.authorTauber, Tsivia
dc.contributor.authorMartini, Alberto
dc.contributor.authorFoell, Dirk
dc.contributor.authorPaediat Rheumatology Int Trials
dc.contributor.institutionUniv Munster
dc.contributor.institutionUniv Childrens Hosp Muenster
dc.contributor.institutionWilhelmina Childrens Hosp
dc.contributor.institutionInst Child Hlth UCL
dc.contributor.institutionRiga Stradins Univ
dc.contributor.institutionUniv Children Hosp
dc.contributor.institutionChildrens Hosp Zagreb
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniv Turin
dc.contributor.institutionUniv Bologna
dc.contributor.institutionUniv Childrens Hosp
dc.contributor.institutionMeir Med Ctr
dc.contributor.institutionDetska Fakultna Nemocn
dc.contributor.institutionUniv Catolica
dc.contributor.institutionN Deutsch Zentrum Kinder & Jugendrheumatol
dc.contributor.institutionHosp Cruces
dc.contributor.institutionHosp Gen Mexico City
dc.contributor.institutionM Iashvili Childrens Cent Clin
dc.contributor.institutionSC Pediat Osped
dc.contributor.institutionDokuz Eylul Univ
dc.contributor.institutionHosp St Joan de Deu
dc.contributor.institutionNatl Inst Rheumatol & Physiotherapy ORFI
dc.contributor.institutionKarolinska Univ Hosp
dc.contributor.institutionMed Univ Silesia
dc.contributor.institutionAsaf Harofe Med Ctr
dc.contributor.institutionUniv Genoa
dc.description.abstractObjectives Juvenile idiopathic arthritis (JIA) is a chronic inflammatory joint disease affecting children. Even if remission is successfully induced, about half of the patients experience a relapse after stopping anti-inflammatory therapy. the present study investigated whether patients with JIA at risk of relapse can be identified by biomarkers even if clinical signs of disease activity are absent.Methods Patients fulfilling the criteria of inactive disease on medication were included at the time when all medication was withdrawn. the phagocyte activation markers S100A12 and myeloid-related proteins 8/14 (MRP8/14) were compared as well as the acute phase reactant high-sensitivity C reactive protein (hsCRP) as predictive biomarkers for the risk of a flare within a time frame of 6 months.Results 35 of 188 enrolled patients experienced a flare within 6 months. Clinical or standard laboratory parameters could not differentiate between patients at risk of relapse and those not at risk. S100A12 and MRP8/14 levels were significantly higher in patients who subsequently developed flares than in patients with stable remission. the best single biomarker for the prediction of flare was S100A12 (HR 2.81). the predictive performance may be improved if a combination with hsCRP is used.Conclusions Subclinical disease activity may result in unstable remission (ie, a status of clinical but not immunological remission). Biomarkers such as S100A12 and MRP8/14 inform about the activation status of innate immunity at the molecular level and thereby identify patients with unstable remission and an increased risk of relapse.en
dc.description.affiliationUniv Munster, Inst Immunol, D-48149 Munster, Germany
dc.description.affiliationUniv Munster, Inst Biostat & Clin Res, D-48149 Munster, Germany
dc.description.affiliationUniv Munster, Interdisciplinary Ctr Clin Res, D-48149 Munster, Germany
dc.description.affiliationUniv Childrens Hosp Muenster, Dept Gen Pediat, Munster, Germany
dc.description.affiliationPRINTO, IRCCS G Gaslini, Genoa, Italy
dc.description.affiliationWilhelmina Childrens Hosp, Dept Paediat Immunol & Rheumatol, Utrecht, Netherlands
dc.description.affiliationInst Child Hlth UCL, Rheumatol Unit, London, England
dc.description.affiliationRiga Stradins Univ, Riga, Latvia
dc.description.affiliationUniv Children Hosp, Dept Paediat Rheumatol, Sofia, Bulgaria
dc.description.affiliationChildrens Hosp Zagreb, Dept Pediat, Zagreb, Croatia
dc.description.affiliationUniversidade Federal de São Paulo, São Paulo, Brazil
dc.description.affiliationUniv Turin, Pediat Clin, Dipartimento Sci Pediat & Adolescenza, Turin, Italy
dc.description.affiliationUniv Bologna, Policlin S Orsola Malpighi, Pediat Clin, Bologna, Italy
dc.description.affiliationCharite, Kinderklin, Berlin, Germany
dc.description.affiliationUniv Childrens Hosp, Zurich, Switzerland
dc.description.affiliationMeir Med Ctr, Dept Pediat, Kefar Sava, Israel
dc.description.affiliationDetska Fakultna Nemocn, Dept Pediat 1, Kosice, Slovakia
dc.description.affiliationUniv Catolica, Clin Reina Fabiola, GESER Rheumatol, Cordoba, Argentina
dc.description.affiliationN Deutsch Zentrum Kinder & Jugendrheumatol, Rheumaklin Bad Bramstedt, Bad Bramstedt, Germany
dc.description.affiliationHosp Cruces, Unidad Reumatol Pediat, Bilbao Vizcaya, Spain
dc.description.affiliationHosp Gen Mexico City, Serv Reumatol, Mexico City, DF, Mexico
dc.description.affiliationM Iashvili Childrens Cent Clin, Div Rheumatol, Tbilisi, Rep of Georgia
dc.description.affiliationSC Pediat Osped, Fdn IRCCS Policlin S Matteo, Pavia, Italy
dc.description.affiliationDokuz Eylul Univ, Fac Med, Div Pediat Rheumatol Immunol, Izmir, Turkey
dc.description.affiliationHosp St Joan de Deu, Unidad Reumatol Pediat, Esplugues, Barcelona, Spain
dc.description.affiliationNatl Inst Rheumatol & Physiotherapy ORFI, Gen & Pediat Rheumatol Dept 3, Budapest, Hungary
dc.description.affiliationKarolinska Univ Hosp, Pediat Rheumatol Unit, Stockholm, Sweden
dc.description.affiliationMed Univ Silesia, Dept Pediat, Zabrze, Poland
dc.description.affiliationAsaf Harofe Med Ctr, Pediat Rheumatol Clin, Zerifin, Israel
dc.description.affiliationUniv Genoa, Dipartimento Pediat, Genoa, Italy
dc.description.affiliationUnifespUniversidade Federal de São Paulo, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipInterdisciplinary Centre of Clinical Research at the University of Muenster
dc.description.sponsorshipFP7-Network PHARMACHILD
dc.description.sponsorshipIDInterdisciplinary Centre of Clinical Research at the University of Muenster: IZKF CRA04
dc.identifier.citationAnnals of the Rheumatic Diseases. London: Bmj Publishing Group, v. 71, n. 12, p. 1991-1997, 2012.
dc.publisherBmj Publishing Group
dc.relation.ispartofAnnals of the Rheumatic Diseases
dc.rightsAcesso restrito
dc.titlePhagocyte-specific S100 proteins and high-sensitivity C reactive protein as biomarkers for a risk-adapted treatment to maintain remission in juvenile idiopathic arthritis: a comparative studyen