Abstract
BackgroundTo investigate the association between blood biomarkers and disease activity of Takayasu’s arteritis (TAK) in a follow-up cohort.MethodsDisease activity was assessed by clinical manifestations and repeated vascular Doppler examinations. The association between erythrocyte sedimentation rate (ESR), serum levels of high-sensitive C-reactive protein (hsCRP), interleukin-6(IL-6), and tumor necrosis factor-α (TNFα) and disease activity were analyzed by logistic regression and survival analysis. Kaplan-Meier method was used to estimate the cumulative remission rate curve, log-rank tests for group comparison, and Cox regression for estimating hazard ratios of these parameters for disease activity.Results428 patients were included. 188 patients were in active disease, and 240 patients were in inactive disease at baseline. Elevation of ESR, hsCRP, and IL-6 were associated with active disease at baseline and during follow-up. Cox regression and Kaplan-Meier analysis showed that lower possibility and longer time to remission were associated with elevated ESR (hazard ratio [HR] = 0.32, 80 vs 33 weeks, p < 0.001), hsCRP (HR = 0.45, 70 vs 31 weeks, p < 0.001), and IL-6 (HR = 0.54, 66 vs 34 weeks, p < 0.01) in patients with active disease at baseline, while higher risk and shorter time for relapse were associated with elevated ESR (HR = 2.1, 59 vs 111 weeks, p < 0.001), hsCRP (HR = 2.1, 79 vs 113 weeks, p < 0.001), IL-6 (HR = 2.5, 64 vs 117 weeks, p < 0.001), and TNFα (HR = 2.7, 65 vs 114 weeks, p < 0.001) in patients with inactive disease at baseline.ConclusionsElevated ESR, CRP, and IL-6 are associated with active disease, lower possibility, and longer time to achieve disease remission. Elevation of any among ESR, CRP, IL-6, and TNFα is associated with high risk and short time for relapse during follow-up.
Highlights
To investigate the association between blood biomarkers and disease activity of Takayasu’s arteritis (TAK) in a follow-up cohort
In this study, we found that Erythrocyte sedimentation rate (ESR), high-sensitive C-reactive protein (hsCRP), tumor necrosis factor-α (TNFα), and IL-6 were associated with active disease during follow-up by survival analysis, both in Cox regression and Kaplan-Meier models
Elevated level of ESR, C-reactive protein (CRP), and IL-6 are associated with active disease of TAK in this study
Summary
To investigate the association between blood biomarkers and disease activity of Takayasu’s arteritis (TAK) in a follow-up cohort. Takayasu’s arteritis (TAK) is an uncommon systemic vasculitis that involves aorta and its major branches [1]. The assessment of disease activity in TAK patients is very challenging due to its complicated clinical features and lack of reliable biomarkers. Interleukin-6 (IL-6) and tumor necrosis factor-α (TNFα) have been shown to be involved in the pathogenesis of TAK [3, 4]. Both of them were over-expressed in the diseased aorta and its branches [5]. The elevated level of TNFα and IL-6 may be associated with active disease
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