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Tomografia por emissão de pósitrons com 18F‐fluordesoxiglicose e citocinas séricas e metaloproteinases da matriz na avaliação da atividade da doença na arterite de Takayasu

Authors: Neusa Pereira da Silva; Eduardo Lima; Emilia Inoue Sato; Henrique A. Mariz; Ivone do Carmo Gonçalves Torres; Anne Elizabeth Diniz Arraes; Alexandre Wagner Silva de Souza; +1 Authors

Tomografia por emissão de pósitrons com 18F‐fluordesoxiglicose e citocinas séricas e metaloproteinases da matriz na avaliação da atividade da doença na arterite de Takayasu

Abstract

ResumoObjetivoAvaliar a captação de 18F‐fluordesoxiglicose (FDG) na tomografia por emissão de pósitrons – tomografia computadorizada (PET‐CT) – e os níveis séricos de diferentes citocinas e da metaloproteinases da matriz (MMP) em pacientes com arterite de Takayasu (AT) e associações com a atividade da doença.MétodosForam mensurados os níveis séricos do fator de necrose tumoral‐α (TNF‐α), interleucina (IL)‐2, IL‐6, IL‐8, IL‐12, IL‐18, MMP‐3 e MMP‐9 em 36 pacientes com AT e 36 controles. O valor padronizado de captação máximo (SUVmax) de 18F‐FDG nas paredes arteriais foi determinado por exames de PET‐CT. Os pacientes com AT foram classificados como doença ativa, doença inativa e possível doença ativa.ResultadosOs níveis séricos de IL‐6 e MMP‐3 foram mais altos em pacientes com AT do que nos controles (p<0,001). Os níveis séricos de IL‐6 foram mais elevados em pacientes com doença ativa e em pacientes com possível doença ativa do que naqueles com doença inativa (p<0,0001). Os pacientes com doença ativa apresentaram níveis séricos mais elevados de TNF‐α do que os pacientes com doença inativa (p=0,049), enquanto os indivíduos com possível doença ativa apresentaram maiores níveis séricos de IL‐18 do que os pacientes com doença inativa (p=0,046). Aqueles com doença ativa apresentaram maiores valores de SUVmax do que aqueles com doença inativa (p=0,042). De acordo com a curva ROC, o SUVmax foi capaz de predizer a doença ativa na AT e valores ≥ 1,3 estavam associados à atividade da doença (p=0,039). Os níveis séricos de TNF‐α foram maiores em pacientes com SUVmax ≥ 1,3 do que naqueles com valor<1,3 (p=0,045) e controles (p=0,012). Os níveis séricos de IL‐6 foram mais elevados em pacientes com SUVmax ≥ 1,3 do que nos controles (p<0,001). Não foram encontradas diferenças em relação a outros biomarcadores entre pacientes com AT e controles.ConclusõesNíveis séricos elevados de IL‐6 e TNF‐α, bem como uma maior captação arterial de 18F‐FDG, estão associados à AT ativa.AbstractObjectiveTo evaluate 18F‐fluorodeoxyglucose (FDG) uptake on positron emission tomography‐computed tomography (PET‐CT)‐and serum levels of different cytokines and matrix metalloproteinases (MMPs) in patients with Takayasu's arteritis (TA) and associations with disease activity.MethodsSerum levels of tumor necrosis factor‐α (TNF‐α), interleukin (IL)‐2, IL‐6, IL‐8, IL‐12, IL‐18, MMP‐3 and MMP‐9 were measured in 36 TA patients and 36 controls. Maximum standard uptake value (SUVmax) of 18F‐FDG in arterial walls was determined by PET‐CT scans. TA patients were classified as active disease, inactive disease and possible active disease.ResultsSerum IL‐6 and MMP‐3 levels were higher in TA patients than in controls (p<0.001). Serum IL‐6 was higher in patients with active disease and in patients with possible active disease than in inactive disease (p<0.0001). Patients with active disease had higher serum TNFα levels than patients with inactive disease (p=0.049) while patients with possible active disease presented higher IL‐18 levels than patients with inactive disease (p=0.046). Patients with active disease had higher SUVmax values than those with inactive disease (p=0.042). By ROC curve SUVmax was predictive of active disease in TA and values ≥1.3 were associated with disease activity (p=0.039). Serum TNF‐α levels were higher in patients with SUVmax ≥1.3 than<1.3 (p=0.045) and controls (p=0.012). Serum IL‐6 levels were higher in patients with SUVmax ≥1.3 than in controls (p<0.001). No differences regarding other biomarkers were found between TA patients and controls.ConclusionsHigher serum IL‐6 and TNFα levels as well as higher arterial 18F‐FDG uptake are associated with active TA.

Keywords

Takayasu's arteritis, Arterite de Takayasu, Matrix metalloproteinases, Rheumatology, Tomografia computadorizada, Cytokines, Citocinas, Positron emission tomography scan, Metaloproteinases da matriz

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    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
15
Top 10%
Average
Top 10%
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