Metastasin S100A4 is increased in proportion to radiographic damage in patients with RA.

• OBJECTIVE: To assess the potential of metastasin S100A4 as a biological marker in patients with RA. METHODS: A total of 87 unselected patients with established RA (disease duration 2-44 years) and treated with MTX and infliximab at a single rheumatology centre were included in a cross-sectional study. Radiographs of hands and feet were taken prior to infliximab treatment and at inclusion (time interval 48±27 months) and scored for the radiographic damage. S100A4 levels were analysed in relation to radiographic damage, clinical disease activity (DAS-28), inflammation (IL-6, CRP, ESR), bone and cartilage markers [MMP-3, COMP, C-telopeptide of type I collagen (CTX-I)] and proto-oncogenes [survivin, insulin-like growth factor 1 (IGF-1), Flt3 ligand]. RESULTS: High levels of S100A4 were associated with severe radiographic damage (OR=3.40, P=0.025), non-response to infliximab (OR=4.63, P=0.003), presence of antibodies to infliximab (OR=6.24, P=0.003) and high levels of Flt3 ligand (OR=2.73, P=0.04). Regression analysis showed that high S100A4 was predictive for radiographic progression during infliximab treatment [positive predictive value (PPV) 0.68, P=0.05]. Low levels of S100A4 were associated with response to infliximab (OR=2.67, P=0.049), clinical remission (OR=4.01, P=0.0047) and negative RF (OR=9.22, P=0.0047). S100A4 correlated with survivin (r=0.71, P>0.0001). CONCLUSION: S100A4 levels are increased in proportion to radiographic damage and its further progression in RA patients. High S100A4 levels were associated with a poor clinical response to infliximab and high rate of anti-infliximab antibodies. The finding of a correlation between S100A4 and survivin and Flt3 ligand suggests that these proteins may represent a new cluster of biomarkers predicting radiographic progression and poor treatment response in RA patients.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)

Nyckelord

Adult

Aged

Aged

80 and over

Antibodies

Monoclonal

therapeutic use

Antirheumatic Agents

therapeutic use

Arthritis

Rheumatoid

blood

drug therapy

radiography

Biological Markers

blood

Bone and Bones

radiography

Cross-Sectional Studies

Disease Progression

Female

Foot

radiography

Hand

radiography

Humans

Inhibitor of Apoptosis Proteins

blood

Male

Membrane Proteins

blood

Methotrexate

therapeutic use

Middle Aged

Predictive Value of Tests

S100 Proteins

blood

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ref (ämneskategori)

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