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
Annals of Rheumatic Diseases, 06/22/2012
Gerss J et al. – 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.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- Patients fulfilling the criteria of inactive disease on medication were included at the time when all medication was withdrawn.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.
- 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.