Biomarkers in Systemic Juvenile Idiopathic Arthritis, Macrophage Activation Syndrome and Their Importance in COVID Era

Abstract

Systemic juvenile idiopathic arthritis (sJIA) and its complication, macrophage activation syndrome (sJIA-MAS), are rare but sometimes very serious or even critical diseases of childhood that can occasionally be characterized by nonspecific clinical signs and symptoms at onset—such as non-remitting high fever, headache, rash, or arthralgia—and are biologically accompanied by an increase in acute-phase reactants. For a correct positive diagnosis, it is necessary to rule out bacterial or viral infections, neoplasia, and other immune-mediated inflammatory diseases. Delays in diagnosis will result in late initiation of targeted therapy. A set of biomarkers is useful to distinguish sJIA or sJIA-MAS from similar clinical entities, especially when arthritis is absent. Biomarkers should be accessible to many patients, with convenient production and acquisition prices for pediatric medical laboratories, as well as being easy to determine, having high sensitivity and specificity, and correlating with pathophysiological disease pathways. The aim of this review was to identify the newest and most powerful biomarkers and their synergistic interaction for easy and accurate recognition of sJIA and sJIA-MAS, so as to immediately guide clinicians in correct diagnosis and in predicting disease outcomes, the response to treatment, and the risk of relapses. Biomarkers constitute an exciting field of research, especially due to the heterogeneous nature of cytokine storm syndromes (CSSs) in the COVID era. They must be selected with utmost care—a fact supported by the increasingly improved genetic and pathophysiological comprehension of sJIA, but also of CSS—so that new classification systems may soon be developed to define homogeneous groups of patients, although each with a distinct disease.

Longitudinal Fluctuations in Protein Concentrations and Higher-Order Structures in the Plasma Proteome of Kidney Failure Patients Subjected to a Kidney Transplant

“…The also by hepatocytes secreted leucine-rich α-2 glycoprotein 1 (LRG1) has been implicated in multiple diseases, including cancer, diabetes, cardiovascular disease, neurological disease, and inflammatory disorders. 25 It has been postulated as an APP with rapidly increasing plasma concentrations following microbial infections and other inflammatory stimuli, although its APP status is not as recognized as CRP and SAA. 26 , 27 In our data, the temporal concentration profiles of LRG1 matched extremely well that of CRP ( Figure 5 a).…”

Longitudinal fluctuations in protein concentrations and higher-order structures in the plasma proteome of kidney failure patients subjected to a kidney transplant

“…The also by hepatocytes secreted leucine-rich α-2 glycoprotein 1 (LRG1) has been implicated in multiple diseases, including cancer, diabetes, cardiovascular disease, neurological disease, and inflammatory disorders 25 . It has been postulated as an APP with rapidly increasing plasma concentrations following microbial infections and other inflammatory stimuli, although its APP status is not as recognized as CRP and SAA 26, 27 .…”

Recent advances in photobiomodulation therapy for brain diseases

“…Recently, the protective effect of curcumin against some neurodegenerative diseases has been proven by in vivo and in vitro studies 93 . Curcumin, the dietary polyphenol isolated from Curcuma longa (turmeric), is a kind of photosensitizer that can be activated by the intravenous PBMT and downregulate the expression of various proinflammatory cytokines in patients 93,94 . PBMT integrated with the above‐mentioned nanomedicines offers promising therapeutic avenues in brain diseases.…”