Relationship between inflammatory markers, oxidant-antioxidant status and intima-media thickness in prepubertal children with juvenile idiopathic arthritis
Clinical Research in Cardiology, 08/20/2012
Breda L et al. – Chronic and systemic inflammation seems to lead to early atherosclerotic abnormalities even in pre–pubertal juvenile idiopathic arthritis children. Substantial improvement can be obtained with 1–year of appropriate therapy.Methods
- Inflammatory markers (C-reactive protein, erythrocyte sedimentation rate), proinflammatory cytokines (IL-1 β, IL-6, IFN- γ, TNF- α), lipid profile and oxidant–antioxidant status (urinary isoprostanes [PGF-2α]) were assessed in 38 JIA children (12M/26F, mean age 7.05 ± 2.39 years) and compared with 40 controls (18M/22F, mean age 6.34 ± 2.25 years).
- Carotid intima-media wall thickness (cIMT) was obtained and blood pressure was measured.
- All parameters were reassessed in JIA children after 1 year of therapy.
- At baseline JIA children presented compared to controls higher levels of inflammatory markers, proinflammatory cytokines, total cholesterol, LDL cholesterol, and PGF-2 α (all p ≤ 0.01).
- Furthermore, blood pressure and cIMT were significantly increased (both p ≤ 0.01).
- After a 1-year treatment with non-steroid anti-inflammatory (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs), a significant reduction of all parameters was detected (all p ≤ 0.01).
- This was associated with a significant reduction in blood pressure and cIMT (both p ≤ 0.01).
- Within the JIA group, patients requiring etanercept presented worse laboratory values and cIMT measurements at baseline.
- Nevertheless, the same improvement of all parameters was obtained after a 1-year treatment.
- In stepwise multiple regression, LDL cholesterol and IL-1β were mainly related to cIMT.