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@article{1321777,
author = {Závada, Jakub and Uher, Michal and Svobodová, Radka and Olejárová, Marta and Hušáková, Markéta and Ciferská, Hana and Hulejová, Hana and Tomčík, Michal and Šenolt, Ladislav and Vencovský, Jiří},
article_location = {London},
article_number = {341},
doi = {http://dx.doi.org/10.1186/s13075-015-0862-4},
keywords = {Tenascin-C; Biomarker; SLE; Disease activity; Flare},
language = {eng},
issn = {1478-6354},
journal = {Arthritis Research & Therapy},
title = {Serum tenascin-C discriminates patients with active SLE from inactive patients and healthy controls and predicts the need to escalate immunosuppressive therapy: a cohort study},
volume = {17},
year = {2015}
}
TY - JOUR
ID - 1321777
AU - Závada, Jakub - Uher, Michal - Svobodová, Radka - Olejárová, Marta - Hušáková, Markéta - Ciferská, Hana - Hulejová, Hana - Tomčík, Michal - Šenolt, Ladislav - Vencovský, Jiří
PY - 2015
TI - Serum tenascin-C discriminates patients with active SLE from inactive patients and healthy controls and predicts the need to escalate immunosuppressive therapy: a cohort study
JF - Arthritis Research & Therapy
VL - 17
IS - 341
SP - 1-11
EP - 1-11
PB - BioMed Central
SN - 14786354
KW - Tenascin-C
KW - Biomarker
KW - SLE
KW - Disease activity
KW - Flare
N2 - Introduction: The aim of this study was to examine whether circulating levels of the proinflammatory glycoprotein tenascin-C (TNC) are useful as an activity-specific or predictive biomarker in systemic lupus erythematosus (SLE). Methods: Serum TNC levels were determined by enzyme-linked immunosorbent assay at inception visit in a prospective cohort of 59 SLE patients, and in 65 healthy controls (HC). SLE patients were followed for a mean of 11 months, disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K) and British Isles Lupus Assessment Group disease activity index (BILAG-2004), clinical and laboratory data were recorded every 3-6 months, and changes in glucocorticoids (GC) and immunosuppressants (IS) were recorded serially. We examined cross-sectionally the relationships between serum concentrations of TNC and SLE status, SLEDAI-2 K scores, strata of disease activity, and levels of conventional biomarkers [anti-double-stranded DNA (dsDNA), anti-nucleosome antibodies, C3 and C4]. We also explored the utility of TNC levels for predicting disease flares, defined as (i) new/increased GC, (ii) new/increased GC or IS, and (iii) increase in SLEDAI by >= 3 or (iv) BILAG A or B flare. Results: There was no significant difference in the mean levels of TNC between the SLE patients and HC. However, in SLE patients with active disease (SLEDAI >= 6), the TNC levels were significantly higher than in the HC (p = 0.004) or in patients with no/low disease activity (p = 0.004). In SLE patients, TNC levels were significantly associated with positivity of anti-dsDNA (p = 0.03) and anti-nucleosome antibodies (p = 0.008). Flares defined by a need to escalate immunosuppressive therapy were captured more frequently and earlier than flares defined by standard activity indices. Higher baseline levels of serum TNC presented a significantly greater risk of flare (i) [hazard ratio (HR) 1.39, 95 % confidence interval (CI) 1.11-1.73] or (ii) (HR 1.25, 95 % CI 1.02-1.52) but not of flares (iii) or (iv). The baseline serum TNC level was the single most important independent predictor of flare (i) compared with conventional biomarkers. Conclusions: TNC is not disease-specific, but it seems to indicate the activity of SLE and may predict the need to escalate immunosuppressive therapy. TNC levels may thus serve as a useful activity-specific and predictive biomarker in SLE.
ER -
ZÁVADA, Jakub, Michal UHER, Radka SVOBODOVÁ, Marta OLEJÁROVÁ, Markéta HUŠÁKOVÁ, Hana CIFERSKÁ, Hana HULEJOVÁ, Michal TOMČÍK, Ladislav ŠENOLT and Jiří VENCOVSKÝ. Serum tenascin-C discriminates patients with active SLE from inactive patients and healthy controls and predicts the need to escalate immunosuppressive therapy: a cohort study. \textit{Arthritis Research \&{} Therapy}. London: BioMed Central, 2015, vol.~17, No~341, p.~1-11. ISSN~1478-6354. Available from: https://dx.doi.org/10.1186/s13075-015-0862-4.
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