Pentraxin-3 as a marker of disease activity in Takayasu arteritis

Ann Intern Med. 2011 Oct 4;155(7):425-33. doi: 10.7326/0003-4819-155-7-201110040-00005.

Abstract

Background: Because pentraxin-3 (PTX3) is produced by immune and vascular cells in response to proinflammatory signals, it may be a useful biomarker for defining disease activity in patients with Takayasu arteritis.

Objective: To compare PTX3 levels in patients who have Takayasu arteritis with those in healthy and infected controls, and to compare accuracy of PTX3 levels with that of C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR) for distinguishing active and inactive disease.

Design: Cross-sectional, noninterventional study conducted between September 2005 and October 2008.

Setting: Immunology and rheumatology clinic at a university hospital in Italy.

Patients: 57 consecutive patients with Takayasu arteritis and known disease activity, 57 healthy blood donor controls, and 15 patients with acute infection.

Measurements: Disease activity by clinical criteria; plasma PTX3 and CRP levels and ESR.

Results: 27 patients had active Takayasu arteritis; 30 had inactive disease. Levels of PTX3 were higher in patients with active disease (median, >2.14 ng/mL [range, 0.57 to 48.18 ng/mL]) than in those with inactive disease (median, 0.63 ng/mL [range, 0.00 to 1.64 ng/mL]) and were higher than in healthy patients (median, 0.11 ng/mL [range, 0 to 1.20 ng/mL]) or those with acute infection (median, 0.26 ng/mL [range, 0 to 0.75 ng/mL]). A plasma PTX3 level greater than 1 ng/mL was more accurate than normal thresholds of CRP or ESR for distinguishing active from inactive disease.

Limitation: The study excluded patients with unknown or equivocal disease status.

Conclusion: Plasma levels of PTX3 could help distinguish active from inactive Takayasu arteritis but should not be adopted for clinical use until the findings are confirmed in a broader spectrum of patients whose disease activity is unknown or equivocal before testing.

MeSH terms

  • Acute-Phase Proteins / metabolism*
  • Adult
  • Biomarkers / blood
  • Blood Sedimentation
  • C-Reactive Protein / metabolism*
  • Cross-Sectional Studies
  • Disease Progression
  • Female
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • ROC Curve
  • Serum Amyloid P-Component / metabolism*
  • Takayasu Arteritis / immunology
  • Takayasu Arteritis / metabolism*
  • Young Adult

Substances

  • Acute-Phase Proteins
  • Biomarkers
  • Serum Amyloid P-Component
  • PTX3 protein
  • C-Reactive Protein