Identification of acute phase reactants and cytokines useful for monitoring infliximab therapy in ankylosing spondylitis |
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Authors: | Consuelo Romero-Sánchez William H. Robinson Beren H. Tomooka John Londoño Rafael Valle-Oñate Feng Huang Xiaohu Deng Liyun Zhang Chunhua Yang David Tak Yan Yu |
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Affiliation: | (1) Spondyloarthropathy Group-Division of Rheumatology, Hospital Militar/Universidad de la Sabana, Bogotá, Colombia;(2) Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA;(3) Department of Rheumatology, The Chinese PLA General Hospital, Beijing, 100853, China;(4) Division of Rheumatology, Department of Medicine, University of California, Los Angeles, CA, USA |
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Abstract: | Although most ankylosing spondylitis patients show an apparent clinical response to infliximab therapy, there is considerable individual variation. Because current clinical assessment relies heavily on subjective patient self-evaluation, biomarkers of high sensitivity and specificity are much needed. Here, we assessed potential biomarkers in 47 ankylosing spondylitis patients who received three standard pulses of infliximab. Before each infusion and at week 10, the following were measured: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet count, serum levels of metalloproteinase-3 (MMP-3), and 22 different cytokines. We discovered that, 2 weeks after the first infusion, the combination of ESR, CRP, and platelet count distinguished responders from non-responders with 81.3% sensitivity and 72.7% specificity. The distinguishing power was much less when each acute phase reactant was used alone. Among the 22 cytokines, serum IL-1α was able to distinguish responders from non-responders at week 6, with sensitivity of 84.9% and specificity of 53.8%. Serum IL-1α was probably generated from the joint compartments, as synovial fluid levels were much higher than corresponding serum levels. Although infliximab infusions led to rapid and significant suppression of serum MMP-3 levels, serum MMP-3 levels did not distinguish responders from non-responders. Besides identifying potential biomarkers, our results also demonstrate the usefulness of using sensitivity and specificity to assess usefulness of potential biomarkers. |
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Keywords: | Ankylosing spondylitis Biomarkers Infliximab |
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