Profiles of serum cytokine levels in Takayasu arteritis patients: Potential utility as biomarkers for monitoring disease activity

Tamura, Naotoshi; Maejima, Yasuhiro; Tezuka, Daisuke; Takamura, Chisato; Yoshikawa, Shunji; Ashikaga, Takashi; Hirao, Kazuyuki; Isobe, Mitsuaki

doi:10.1016/j.jjcc.2016.10.016

Cited by 41 publications

(27 citation statements)

References 30 publications

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“…Serum IL-23 levels were similar to those of healthy controls in patients with TAK. However, IL-23 levels stayed high in inactive disease, suggesting that it might be a factor for disease relapses, similar to the observations in GCA (58,60).…”

Section: Immune Pathogenesis Of Takayasu Arteritissupporting

confidence: 85%

Takayasu arteritis: an update

Keser¹,

Aksu²,

Direskeneli³

2018

Turk J Med Sci

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Takayasu arteritis (TAK) is a challenging chronic, granulomatous, large-vessel systemic vasculitis, mostly due to difficulties in early diagnosis and assessing actual disease activity. Since there are no specific diagnostic laboratory tests, biomarkers, or autoantibodies, many patients experience considerable delay in diagnosis. Remembering the possibility of TAK together with the use of acute phase responses and appropriate imaging studies may be helpful for early diagnosis. Since there may be discrepancies between systemic and vascular wall inflammation, using only acute phase responses is not reliable in assessing current disease activity. Therefore, physical examination and new imaging findings should also be used to assess current disease activity. Despite its limitations, the Indian Takayasu Clinical Activity Score (ITAS2010) may also be helpful for this purpose. The rationale of medical treatment is to suppress both vascular and systemic inflammation with appropriate systemic immunosuppression, including corticosteroids and conventional immunosuppressive agents. In cases of refractory disease activity, leflunomide and biologic agents such as TNF inhibitors and tocilizumab may be tried. In selected cases with persistent lesions that cannot be reversed with medical treatment, endovascular interventions including balloon angioplasty, stent and stent graft replacement, or surgery may be tried. However, such procedures should be performed after suppression of inflammation, i.e. during inactive disease. Prognosis of TAK is probably getting better with lower mortality rates reported in recent years, probably due to the use of more effective medical treatments as well as the use of endovascular interventions when necessary and available.

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Section: Immune Pathogenesis Of Takayasu Arteritissupporting

confidence: 85%

Takayasu arteritis: an update

Keser¹,

Aksu²,

Direskeneli³

2018

Turk J Med Sci

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“…[18]. A very recent Japanese study has also observed an increase in the levels of IL-6 and TNF-α in TA patients during active phase [19]. However, in yet another study from Turkey, IL-18 but not IL-6 was found to be elevated in active disease [20].…”

Section: Discussionmentioning

confidence: 99%

Serum Cytokine Profile in Asian Indian Patients with Takayasu Arteritis and its Association with Disease Activity

Goel

Kabeerdoss

Ram

et al. 2017

TORJ

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Background:Arterial inflammation Takayasu arteritis (TA) is an outcome of balance between pro- and anti-inflammatory cytokines. Comprehensive assessment of these cytokines is important for understanding pathogenesis and assessing disease activity.Objective:To study pro- and anti-inflammatory cytokines representing different T-helper cell pathway in serum samples of Asian Indian patients with TA and to assess their association with disease activity.Methods:Consecutive Indian patients with TA were assayed for serum interferon-γ, interleukin-6, interleukin-23, interleukin-17, interleukin-10 and transforming growth factor- β levels at baseline and follow up visit. Patients were grouped into active and stable disease based on Indian Takyasu Arteritis clinical Activity Score-2010. Serum levels of these cytokines between active and stable disease and between baseline and follow up visits were compared by non-parametric tests.Results:Among 32 patients enrolled, 15 were classified as active while 17 as stable disease at baseline. IFN-γ levels were significantly higher in active disease than stable disease (p=0.0129) while other cytokines did not differ significantly between 2 groups. Serum levels of none of the cytokines changed significantly over 2 visits in both responders and non-responders. IL23 levels positively correlate with disease duration ((r=0.999; p<0.005). Modest correlation was observed between IFN-γ and IL23 levels at both baseline and follow up and between IFN-γ and IL-6 and CRP at follow up.Conclusion:IFN-γ levels are raised in active disease in TA and correlates well with other biomarkers of disease activity and proinflammatory cytokines. There is also a direct correlation between Il-23 levels and disease duration.

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“…Thus, the hydrolysis of triglyceride to free fatty acids can also be enhanced through TNF‐α expressed by stimulated PVAT macrophages, forming a loop to evoke inflammation . PVAT inflammation participates in the development of cardiovascular diseases by breaking the homeostasis of vessels, leading to excessive secretion of proinflammatory factors such as IL‐6, IL‐17, leptin, visfatin, and TNF‐α and reduction of anti‐inflammatory factors including adiponectin, angiotensin 1‐7, and IL‐10, and many of these factors have also been reported to contribute to the pathogenesis of TA . To date, there is no definitive evidence showing how PVAT inflammation affects the vascular wall in TA …”

Section: Discussionmentioning

confidence: 99%

“…The etiology of TA is still unknown, although previous studies have shown that both innate and adaptive immune responses, as well as cytokines and chemokines, are involved . A study conducted in Japan suggested that serum levels of monoclonal anti‐tumor necrosis factor‐α (TNF‐α) antibody might be a potent biomarker that can reflect disease activity . Our previous studies showed that interleukin‐6 (IL‐6) was not only a strong marker for active disease but also played a critical role in pathogenesis and vascular fibrosis .…”

Section: Introductionmentioning

confidence: 99%

Serum leptin, a potential predictor of long‐term angiographic progression in Takayasu’s arteritis

Dai

et al. 2019

Int J of Rheum Dis

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Aim:In patients with Takayasu's arteritis (TA), current biomarkers that properly reflect the progression of the vascular structure remain absent. We aimed to determine the serum leptin level to investigate its relationship with imaging changes and assess its value as a predictor for long-term radiological progression. Method:This study included 34 untreated TA patients and 40 age-matched healthy controls. At baseline and during the 5-year follow-up, we assessed disease activity using Kerr's criteria and Indian Takayasu Clinical Activity Score (ITAS2010) and monitored laboratory biomarkers as well as imaging findings. Serum leptin levels were measured by enzyme-linked immunosorbent assay. Results:The baseline serum leptin levels were significantly higher in TA patients than in healthy controls. Leptin was significantly positively correlated with triglyceride and high-density lipoprotein cholesterol levels and negatively correlated with fibrinogen and C-reactive protein levels. Patients were subdivided into three groups based on their baseline leptin level. During a 5-year follow-up, patients in the high and medium leptin groups showed more radiological progression compared to those in the low leptin group. Cox proportional hazard regression analysis showed that a high serum leptin level was a positive predictor of radiological progression. Conclusion:Leptin is a potential biomarker for assessing TA structural progression.Untreated patients with elevated serum leptin levels are at a higher risk of progression in the aorta. Thus, the leptin level can be a predictor of long-term radiological progression. K E Y W O R D S disease progression, leptin, radiography, Takayasu's arteritis | 2135 MA et Al.

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Profiles of serum cytokine levels in Takayasu arteritis patients: Potential utility as biomarkers for monitoring disease activity

Abstract: Both TNF-α and IL-6 levels, but not IL-12 or IL-23 levels, in the serum could be potent biomarkers that can reflect the activity of TA.

Cited by 41 publications

References 30 publications

Takayasu arteritis: an update

Takayasu arteritis: an update

Serum Cytokine Profile in Asian Indian Patients with Takayasu Arteritis and its Association with Disease Activity

Serum leptin, a potential predictor of long‐term angiographic progression in Takayasu’s arteritis

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