Anticitrullinated Protein Antibodies and Radiological Progression in Juvenile Idiopathic Arthritis

2012 ◽  
Vol 39 (5) ◽  
pp. 1078-1087 ◽  
Author(s):  
JOANNA LIPIŃSKA ◽  
HENRYKA BRÓZIK ◽  
JERZY STAŃCZYK ◽  
ELZBIETA SMOLEWSKA
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Early Stage ◽  
Joint Destruction ◽  
Serum Levels ◽  
Disease Course ◽  
Predictive Information ◽  
Severity Of Disease ◽  
Anticitrullinated Protein Antibodies

Objective.The aim of the study was to investigate whether determination of anticitrullinated protein antibodies (ACPA) provides predictive information on severity of disease course and joint destruction in children with juvenile idiopathic arthritis (JIA).Methods.Sera from 74 children with JIA were examined for ACPA using the ELISA test. To assess joint destruction, plain radiographs of both hands were scored twice according to the Steinbrocker scale: at the beginning of observation and after 8.9 to 15.2 months (median 11.5 months) of the followup. Correlations between ACPA serum levels and the disease characteristics (type of JIA onset, disease activity, disease duration, radiological status) were investigated.Results.Twenty-six out of 74 examined children with JIA (35.0%) were ACPA-positive [> 5 relative units (RU)/ml]. ACPA were present in all types of JIA onset, including 36.6% of children with early stage JIA (disease duration < 6 months). All of the IgM-rheumatoid factor (RF)-positive children with polyarticular type of JIA onset were simultaneously positive for ACPA. ACPA levels correlated positively with disease activity at the beginning of the study (rho = 0.7196; p < 0.0001) and after followup (rho = 0.2485; p = 0.0486). Disease duration did not significantly affect ACPA serum levels. ACPA levels correlated positively with radiological joint destruction in children with JIA, both at the beginning of the study (rho = 0.4599; p = 0.0004) and after the followup period (rho = 0.5523; p < 0.0001).Conclusion.ACPA were superior to IgM-RF in diagnosing JIA and provided predictive information on severity of disease course and radiological outcome.

scholarly journals THU0358 NEGATIVE CHANGES OF BODY COMPOSITION IN MYOSITIS PATIENTS AND THEIR ASSOCIATION WITH DISEASE SPECIFIC CHARACTERISTICS, PHYSICAL ACTIVITY AND NUTRITIONAL STATUS.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 410.3-410
Author(s):  
S. Oreska ◽  
M. Špiritović ◽  
P. Česák ◽  
O. Marecek ◽  
H. Štorkánová ◽  
...  
Keyword(s):  
Physical Activity ◽  
Skeletal Muscle ◽  
Body Composition ◽  
Lipid Metabolism ◽  
Nutritional Status ◽  
Disease Activity ◽  
Inflammatory Cytokines ◽  
Disease Duration ◽  
Serum Levels ◽  
Muscle Involvement

Background:Skeletal muscle, pulmonary and articular involvement in idiopathic inflammatory myopathies (IIM) limit the mobility/self-sufficiency of patients, and can have a negative impact on body composition.Objectives:The aim was to assess body composition and physical activity of IIM patients and healthy controls (HC) and the association with selected inflammatory cytokines/chemokines and laboratory markers of nutrition and lipid metabolism.Methods:54 patients with IIM (45 females; mean age 57.7; disease duration 5.8 years; polymyositis (PM, 22) / dermatomyositis (DM, 25) / necrotizing myopathy (IMNM, 7)) and 54 age-/sex-matched HC (45 females, mean age 57.7) without rheumatic/tumor diseases were included. PM/DM patients fulfilled Bohan/Peter criteria for PM/DM. We assessed body composition (densitometry: iDXA Lunar, bioelectric impedance: BIA2000-M), physical activity (Human Activity Profile, HAP questionnaire), serum levels of 27 cytokines/chemokines (commercial multiplex ELISA kit, Bio-Rad Laboratories) and serum levels of selected parameters of nutrition and lipidogram. Disease activity (MITAX and MYOACT activity score) and muscle involvement (manual muscle testing, MMT-8, and functional index 2, FI2) were evaluated. Data are presented as mean±SD.Results:Compared to HC, patients with IIM had a trend towards significantly increased body fat % (BF%; iDXA: 39.9±7.1 vs. 42.4±7.1 %, p=0.077), but significantly decreased lean body mass (LBM; iDXA: 45.6±8.1 vs. 40.6±7.2 kg, p=0.001; BIA: 52.6±8.8 vs. 48.7±9.0 kg, p=0.023), increased extracellular mass/body cell mass (ECM/BCM) ratio (1.06±0.15 vs. 1.44±0.42, p<0.001), reflecting deteriorated nutritional status and predisposition for physical activity, and significantly lower bone mineral density (BMD: 1.2±0.1 vs. 1.1±0.1 g/cm2, p<0.001). Disease duration negatively correlated with BMD and LBM-BIA. Disease activity (MITAX, MYOACT) positively correlated with LBM (by BIA and DXA), similarly as with basal metabolic rate (BMR), and fat free mass (FFM). CRP was positively associated with BF% (BIA and DXA). Higher BF%-DEXA was associated with worse physical endurance (FI2) and worse ability to perform physical activity (HAP). MMT-8 score negatively correlated with ECM/BCM ratio. Serum levels of several inflammatory cytokines/chemokines (specifically IL-1ra, MCP, IL-10) and markers of nutrition (specifically albumin, C3-, C4-complement, cholinesterase, amylase, insulin and C-peptide, vitamin-D, orosomucoid), and lipid metabolism (specifically triglycerides, high-density lipoprotein, apolipoprotein A and B, atherogenic index of plasma) were significantly associated with alterations of body composition in IIM patients. (p<0.05 for all correlations)Conclusion:Compared to healthy age-/sex-matched individuals we found significant negative changes in body composition of our IIM patients associated with their disease activity and duration, inflammatory status, skeletal muscle involvement, and physical activity. These data could reflect their impaired nutritional status and predispositions for physical exercise, aerobic fitness and performance.Serum levels of certain inflammatory cytokines/chemokines and markers of nutrition and lipid metabolism were associated with alterations of body composition in IIM patients. This might further support the role of systemic inflammation and nutritional status on the negative changes in body composition of IIM patients.Acknowledgments:Supported by AZV NV18-01-00161A, MHCR 023728, SVV 260373 and GAUK 312218Disclosure of Interests:Sabina Oreska: None declared, Maja Špiritović: None declared, Petr Česák: None declared, Ondrej Marecek: None declared, Hana Štorkánová: None declared, Barbora Heřmánková: None declared, Kateřina Kubinova: None declared, Martin Klein: None declared, Lucia Vernerová: None declared, Olga Růžičková: None declared, Karel Pavelka Consultant of: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Speakers bureau: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Ladislav Šenolt: None declared, Heřman Mann: None declared, Jiří Vencovský: None declared, Michal Tomčík: None declared

P013 Serum osteoprotegerin and RANKL in patients with Juvenile Idiopathic Arthritis and their correlation with bone mineral density

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Radwa Helmy Shalaby ◽  
Elham Mohamed Kassem ◽  
Nagat Mohamed El-Gazzar ◽  
Sahar Ahmed Fathy Hammoudah ◽  
Amal Mohamed El-Barbary
Keyword(s):  
Bone Mineral Density ◽  
Juvenile Idiopathic Arthritis ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Disease Duration ◽  
Serum Levels ◽  
Z Score ◽  
Low Bone Mass ◽  
Mineral Density ◽  
Serum Rankl

Abstract Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic arthropathy of childhood and is associated with low bone mass, and may hasten the onset of osteoporosis later in life1. Bone loss occurs because of an imbalance between osteoclasts-activating factors like receptor activator of nuclear factor-κB ligand (RANKL) and its inhibitor osteoprotegerin (OPG) 2. Dual energy X-ray absorptiometry (DXA) is the preferred method for measuring bone mineral density (BMD) in children and to identify and follow individuals at risk for fracture 3. The objective is the Evaluation of serum levels of osteoprotegerin and RANKL and their correlation with BMD in JIA patients. Methods Forty JIA patients (according to the revised classification criteria of ILAR) and 40 healthy children individually matched for age, sex and race were included in this study. Children excluded from the study were those with primary and secondary causes of osteoporosis (such as chronic illness). All patients were assessed clinically by: age, sex, body mass index, type of JIA, disease duration and disease activity (by Juvenile Arthritis Disease Activity Score; JADAS 10). The functional disability was assessed by the Childhood Health Assessment Questionnaire (CHAQ). Blood samples were collected from JIA patients and healthy controls to determine serum levels of OPG and RANKL by ELISA. DXA scans were done using GE Healthcare Lunar DPX, Madison, Wisconsin. Bone mineral density of the L1-L4 lumbar spine and total body less head (TBLH) was evaluated in g/cm2 and expressed as Z score for age, sex according to the reference data given for this equipment. Results The study included 40 patients (25 females) with a mean age of 11.14 years and median disease duration of 2.5 years. As regard JIA type, 45% of patients were oligoarticular, 32.5% were polyarticular, and 22.5% were systemic JIA. Median JADAS 10 was 13.95. Patients (especially polyarticular JIA) had significantly higher serum RANKL levels and lower serum OPG and OPG/RANKL ratio when compared with controls (with p-value &lt;0.001, 0.032 and &lt;0.001 respectively). A diagnosis of low BMD (BMD Z-score ≤ -2) was given in 25% of patients (15% polyarticular and 10% systemic) by DXA of lumbar spine, and 20% (10% polyarticular and 10% systemic) by DXA of TBLH. On the other hand, no patient was given a diagnosis of osteoporosis (BMD Z-score ≤ -2 and a significant fracture history). Low BMD at lumbar spine and TBLH was negatively correlated with serum RANKL while positively correlated with OPG/RANKL ratio. Moreover, low BMD at lumbar spine was positively correlated with serum OPG level Conclusion High RANKL and low OPG levels appear to be associated with low bone mass in JIA patients. Patients with JIA (especially polyarticular and systemic subtype) are at increased risk of low bone mineral mass. Disclosure of Interests None declared

scholarly journals Predictive Factors Related to the Efficacy of Golimumab in Patients with Rheumatoid Arthritis

2015 ◽  
Vol 8 ◽  
pp. CMAMD.S22155 ◽  
Author(s):  
Katsuaki Kanbe ◽  
Junji Chiba ◽  
Yasuo Inoue ◽  
Masashi Taguchi ◽  
Akiko Yabuki
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Predictive Factors ◽  
Disease Duration ◽  
Radiographic Progression ◽  
Serum Levels ◽  
Serum Concentrations ◽  
Regression Analyses ◽  
Tnf Α ◽  
Baseline Characteristics

In order to investigate the predictive factors related to clinical efficacy and radiographic progression at 24 weeks by looking at the serum levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6 including baseline characteristics in patients with rheumatoid arthritis (RA) treated with golimumab, serum concentrations of TNF-α and IL-6 were analyzed every 4 weeks up to 24 weeks in 47 patients treated with golimumab. Baseline levels of the Disease Activity Score 28 C-reactive protein (DAS28-CRP) and Simplified Disease Activity Index (SDAI) scores were also assessed. Radiographic progression using the van der Heijde-modified Sharp (vdH-S) score was assessed in 29 patients. Multiple regression analyses related to the DAS28-CRP score and delta total sharp score at 24 weeks was undertaken using the baseline characteristics of patients and serum concentrations of matrix metalloproteinase (MMP)-3, TNF-α, and IL–6. The DAS28-CRP score and SDAI decreased significantly at 4 weeks up to 24 weeks compared with baseline. Serum levels of TNF-α were not changed significantly up to 24 weeks compared with baseline, but those of IL-6 decreased significantly at 4 weeks up to 8 weeks. Multiple regression analyses showed that disease duration and serum levels of MMP-3 were related significantly to the DAS28-CRP score at 24 weeks. Radiographic progression was related significantly to disease duration with regard to joint space narrowing and bone erosion. However, serum levels of TNF-α and IL-6 were not correlated significantly with the DAS28-CRP score and radiographic progression. These data suggest that decreasing serum levels of IL-6 significantly, MMP-3, and disease duration are predictive factors for RA activity in patients taking golimumab.

scholarly journals Prevalence and Significance of Serum 14-3-3η in Juvenile Idiopathic Arthritis

2020 ◽  
Author(s):  
Iris Reyhan ◽  
Olga S. Zhukov ◽  
Robert J. Lagier ◽  
Robert F. Bridgeforth ◽  
Gary J. Williams ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Los Angeles ◽  
Disease Activity ◽  
Elevated Serum ◽  
Serum Levels ◽  
Control Group ◽  
Adult Rheumatoid Arthritis ◽  
Single Positive ◽  
Prompt Diagnosis

Abstract Background: Prompt diagnosis of juvenile idiopathic arthritis (JIA) is important to avoid long term complications. Elevated serum 14-3-3η levels improve the diagnostic sensitivity of rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibody in adult rheumatoid arthritis (RA), and have been associated with more severe phenotype. We investigated the prevalence and clinical significance of serum 14-3-3η in different types of JIA.Methods: JIA patients (n=151) followed by the Pediatric Rheumatology Core at Children’s Hospital of Los Angeles were categorized into 5 groups: polyarticular JIA RF+ (PJIA RF+; n=39), PJIA RF- (n=39), psoriatic arthritis (PsA; n=19), enthesitis-related arthritis (ERA; n=18), and oligoarticular JIA (OJIA [control group]; n=36). RF, CCP antibody, and 14-3-3η were measured for all patients. 14-3-3η serum levels >0.2ng/mL were considered positive. Disease activity was assessed by the Juvenile Arthritis Disease Activity Score-71 (JADAS-71). Results: Elevated 14-3-3h levels were detected in 34/151 (23%) patients, and across all groups tested. Most patients with 14-3-3h had titers ≥4 times above the cutoff value. The majority (22, 65%) of 14-3-3h-positive patients were also positive for RF or CCP antibodies, 16 (47%) were positive for all 3, and 12 (35%) were single-positive for 14-3-3η. The highest prevalence of 14-3-3η was in PJIA RF+ patients (49%), followed by OJIA (22%). Positivity for 14-3-3h was not significantly associated with disease activity or age at diagnosis. Conclusion: Serum 14-3-3h can be detected in all forms of JIA tested but appears to be most common in PJIA RF+. 14-3-3h does not appear to correlate with disease activity in JIA.

P028 Impact of Juvenile Idiopathic Arthritis on schooling

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
A Fazaa ◽  
F Ben Messaoud ◽  
S Miladi ◽  
L Souabni ◽  
K Ouenniche ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Disease Activity ◽  
Rheumatoid Factor ◽  
Disease Duration ◽  
Activity Index ◽  
Drop Out ◽  
School Level ◽  
Tender Joint ◽  
Enthesitis Related Arthritis ◽  
The Impact

Abstract Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children and is one of the major causes of morbidity and physical disability. Due to frequent absences, children with chronic health impairments are also often confronted with educational difficulties. The aims of this study were to assess the impact of JIA on children’s schooling and to determine the factors that influence their school level. Methods This is a cross-sectional study including patients with JIA (ILAR criteria). A detailed questionnaire was completed for each participant by interviewing them or their parents as well as by information obtained from their medical records. Collected data included age, sex, subtype of JIA, disease duration, level of disability according to the Childhood Heath Assessment Questionnaire (CHAQ), visual analogue scale for patient’s overall assessment of disease activity (VASOA), duration of morning stiffness, tender joint counts (TJCs), swollen joint counts (SJCs), erythrocyte sedimentation rate (ESR), C-Reactive Protein (CRP), Disease Activity Score (DAS28) for polyarticular and oligoarticular JIA, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for Enthesitis-related arthritis. Medications used for JIA treatment were also documented. Data on the school performance of patients and their siblings were obtained using telephone interviews (educational level, absenteeism, school delay by repetition, drop-out). Results A total of 43 patients with JIA were included, 25 female and 18 male, with a mean age of 26 years [12–51] and a mean disease duration of 237 months (5–496). The average age of the onset of the disease was 7.4 years [1.5–16]. The most common subtype was rheumatoid factor-positive polyarthritis (n = 18) followed by systematic (n = 8), oligoarticular (n = 8), rheumatoid factor-negative polyarthritis (n = 5) and Enthesitis-related arthritis (n = 4). The mean DAS28 was 3.02 [0.76 – 5.55] and the median CHAQ was 0.66 [0–3]. Twenty-nine of the children were receiving corticosteroid. Disease-modifying anti-rheumatic drugs were used by 38 of the 43 patients: methotrexate (n = 27), sulfasalazine (n = 8), leflunomide (n = 7), biotherapies (n = 16). Twenty patients had complications: Hip arthritis (n = 18), growth stunting (n = 14), uveitis (n = 5). Joint replacement was required in 11 cases. Four patients were illiterate, 14 had dropped out of school, 24 reported repeated absences due to illness. A year of schooling was repeated by 50.85% of patients. Eleven out of 32 patients over the age of 20 had an university level. Almost 80% of patients were exempted of physical education. There were no significant associations between the school-related problems, the socio-demographic characteristics and the various parameters of clinical and biological activity studied. Conclusion Our study suggested that JIA negatively affects schooling of children. More studies, with a larger sample of children, are needed to identify the variables associated with school failure in order to ensure the proper management of these patients and to increase their academic performance.

P040 Effect of parental smoking on Juvenile Idiopathic Arthritis activity

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
H Hajji ◽  
D Ben Nessib ◽  
K Maatallah ◽  
H Ferjani ◽  
W Triki ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Disease Activity ◽  
Passive Smoking ◽  
Disease Duration ◽  
Biological Data ◽  
Parental Smoking ◽  
P Value ◽  
Major Health Problem ◽  
Number Of Patients ◽  
The Mean

Abstract Background Juvenile idiopathic arthritis (JIA) is an heterogeneous group of autoimmune diseases considered as the main cause of chronic arthritis among children and teenagers. This group of children is thought to be more vulnerable because of chronic inflammation and long-term immunosuppressive therapy. Passive smoking, which is a major health problem, is likely to be particularly harmful for these children whose immunity is already compromised by their disease. The aim of our study was to assess the effect of parental smoking on disease activity in children with JIA Methods A monocentric cross-sectional study of patients with JIA according to the criteria of the International League Against Rheumatism (ILAR) was conducted in the rheumatology department of Kassab Institute. The following clinical and biological data were collected: sex, age, disease duration, BASDAI activity score, functional impairment assessed by the BASFI score, biological inflammation assessed by the erythrocyte sedimentation rate (ESR) and the C-reactive protein (CRP). All parents were contacted and smoking data were recorded: parent smoking, pack-years history, smoking in an indoor or outdoor space, impact of passive smoking on disease activity. We considered any child with at least one smoking parent and living in the same house to be exposed to parental passive smoking. Patients were divided into two groups: group 1 (G1) including patients who are not exposed to parental smoking and group 2 (G2) including patients exposed to smoking by one or both parents. Data were analyzed using SPSS (Statistical Package for the Social Sciences) version 24 software. The significance level was set at a p-value &lt; 0.05. Results Twenty-three patients were included: 15 girls and 8 boys. Sex ratio M/F was 0.53. The mean age was 16.5 + 8.1 years [8–40]. The mean disease duration was 4.9 + 4.9 years [0.15]. The mean ESR was 21.5 + 27.1 mm and the mean CRP was 4.7 + 7.1 mg/l. Nine patients had coxitis, including 4 who were exposed to passive smoking. Passive smoking noted in 11 patients (47.8%), including 6 boys and 5 girls. In 63.6% of the cases, this exposure occurred indoor in the family home. The number of cigarettes smoked per day was 11.7 + 8.4 [1,20]. Among the exposed patients, 36.4% considered that this exposure was an exacerbating factor of their disease. Clinical and biological data were comparable between the 2 groups as shown in table 1. Conclusion Although the adverse effect of maternal smoking during pregnancy on the risk of developing JIA in the child has been demonstrated, few studies have investigated the effect of parental smoking once the disease is established. Our study did not find a statistically significant association between smoking exposure and high disease activity or poor prognosis. However, further studies including a larger number of patients are needed to assess the potential effect of parental smoking on the prognosis of JIA.

Early-stage disease activity of the wrist in juvenile idiopathic arthritis (JIA): assessment with MRI in a pilot study

2013 ◽  
Vol 81 (S1) ◽  
pp. 89-89
Author(s):  
Charlotte M. Nusman ◽  
Robert Hemke ◽  
Dieneke Schonenberg ◽  
J. Merlijn van den Berg ◽  
Eline E. Deurloo ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Pilot Study ◽  
Disease Activity ◽  
Early Stage ◽  
Early Stage Disease ◽  
Stage Disease

scholarly journals Metabolites of type I, II, III, and IV collagen may serve as markers of disease activity in axial spondyloarthritis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Markéta Hušáková ◽  
Anne-C. Bay-Jensen ◽  
Šárka Forejtová ◽  
Kateřina Zegzulková ◽  
Michal Tomčík ◽  
...  
Keyword(s):  
Disease Activity ◽  
Disease Duration ◽  
Collagen Type ◽  
Axial Spondyloarthritis ◽  
Serum Levels ◽  
Collagen Type I ◽  
Enzyme Linked Immunosorbent Assay ◽  
Type I ◽  
Type Iv ◽  
Affected Tissue

Abstract Local inflammation in axial spondyloarthritis (axSpA) leads to the release of collagen metabolites from the disease-affected tissue. We investigated whether collagen metabolites were associated with disease activity and could distinguish non-radiographic(nr)-axSpA from ankylosing spondylitis (AS). A total of 193 axSpA patients (nr-axSpA, n = 121 and AS, n = 72) and asymptomatic controls (n = 100) were included. Serum levels of metalloproteinase (MMP)-degraded collagen type I (C1M), type II (C2M), type III (C3M) and type IV (C4M2) were quantified by enzyme-linked immunosorbent assay (ELISA). All metabolites were higher in axSpA than in controls (all p < 0.001). Serum levels of C1M, C3M, and C4M2 were increased in AS compared to nr-axSpA (43.4 ng/mL vs. 34.6; p < 0.001, 15.4 vs. 12.8; p = 0.001, and 27.8 vs. 22.4; p < 0.001). The best metabolite to differentiate between axSpA and controls was C3M (AUC 0.95; specificity 92.0, sensitivity 83.4). C1M correlated with ASDAS-CRP in nr-axSpA (ρ = 0.37; p < 0.001) and AS (ρ = 0.57; p < 0.001). C1M, C3M, and C4M2 were associated with ASDAS-CRP in AS and nr-axSpA after adjustment for age, gender, and disease duration. Serum levels of collagen metabolites were significantly higher in AS and nr-axSpA than in controls. Moreover, the present study indicates that collagen metabolites reflect disease activity and are useful biomarkers of axSpA.

First trimester interleukin 8 levels are associated with postpartum relapse in multiple sclerosis

2009 ◽  
Vol 15 (11) ◽  
pp. 1356-1358 ◽  
Author(s):  
Rinze F Neuteboom ◽  
Evert Verbraak ◽  
Jane SA Voerman ◽  
Marjan van Meurs ◽  
Eric AP Steegers ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
High Risk ◽  
Disease Activity ◽  
Serum Levels ◽  
First Trimester ◽  
Interleukin 8 ◽  
Disease Course ◽  
Third Trimester ◽  
The Third

Pregnancy has an ameliorating effect on multiple sclerosis (MS), but directly after delivery the risk of a relapse is increased. The pro-inflammatory chemokine interleukin 8 is associated with disease activity. We aimed to investigate whether pregnancy-induced fluctuations of interleukin 8 correlate with periods of enhanced and diminished disease activity. Thirty-six women with MS were prospectively studied before, during and after pregnancy. Serum levels of interleukin 8 were significantly decreased during the third trimester (p = 0.03). High first trimester serum levels of interleukin 8 were associated with a high risk of postpartum relapse (p = 0.007). These results help us to further understand the altered disease course during pregnancy.

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