Pentraxin 3 is a marker of early joint inflammation in patients with juvenile idiopathic arthritis

Abstract

Pentraxin 3 (PTX3) is an acute phase protein produced in different body tissues. The aims of this study were to characterize PTX3 secretion in synovial fluid (SF) of juvenile idiopathic arthritis (JIA) patients and to analyze the correlation of PTX3 levels in SF with clinical characteristics and the course of the disease. SF-PTX3 levels were measured in a cohort of 75 consecutive JIA patients followed in a single center. Patients' clinical characteristics, disease course, and therapies were analyzed for their correlation with SF-PTX3 levels. A synovial cell line was used to study the kinetics of PTX3 secretion by synoviocytes. SF-PTX3 levels varied over a wide range. Elevated SF-PTX3 levels were detected in patients who subsequently required treatment with disease-modifying antirheumatic drugs during the follow-up period. SF-PTX3 levels were found to be inversely correlated with the length of time from onset of joint swelling. No correlation was found between synovial and serum PTX3 or C-reactive protein (CRP). Following in vitro stimulation of synovial cell line with TNFa or IL1, the secretion of PTX3 increases transiently in the first 48-72 h. A similar increase was obtained in patients' synovial fluids but not with IL6. Higher SF-PTX3 levels were found when tested closer to arthritis exacerbation and 48-72 h after in vitro stimulation of cells from a synovial cell line, implying that PTX3 plays a role in early stages of inflammation. Higher SF-PTX3 levels were associated with several clinical features reflecting disease severity and prognostic data. Measuring SF-PTX3 levels may help in providing a more focused and patient-adjusted treatment.

Pentraxin 3 as a Prognostic Biomarker in Patients with Systemic Inflammation or Infection

“…Of interest, PTX3 is not only present in human plasma or serum but can also be found in other body fluids, including urine [ 50 , 51 ], cerebrospinal fluid [ 52 ], pleural [ 53 , 54 ], amniotic fluid [ 55 ], and joint fluid [ 56 , 57 ]. The number of studies investigating the value of PTX3 in body fluids other than plasma or serum, however, is very limited.…”

Serum levels of alpha‐1 acid glycoprotein and pentraxin 3 in patients with Behçet's disease and relationship with disease activity

“…High serum levels of PTX3 have been found in patients with autoimmune diseases, such as RA, psoriasis, and systemic sclerosis, and in those with vasculitis such as Takayasu arteritis, Churg–Strauss syndrome, Wegener's granulomatosis, and microscopic polyangiitis . In addition, PTX3 expressions have been observed locally in the aortic lesions of Takayasu arteritis, in the synovial fluids of patients with RA and juvenile idiopathic arthritis, and in vessels of patients with leukocytoclastic small vessel vasculitis . Bevelacqua et al .…”

PTX3 Stimulates Osteoclastogenesis by Increasing Osteoblast RANKL Production

“…This is indicated by the fact that it is induced and secreted by dendritic cells and macrophages in response to various inflammatory signals such as TNF‐α, IL‐1β, and Toll‐like receptor engagement (Lee and Kim, ). It also appears to be a marker of early joint inflammation in juvenile idiopathic arthritis and correlates with the degree of bone erosion in the inflamed joints (Padeh et al, ). However, its pathological function in such inflammatory bone sites remains unclear.…”