Relationship between inflammatory markers, oxidant–antioxidant status and intima-media thickness in prepubertal children with juvenile idiopathic arthritis

• DOI: 10.1007/s00392-012-0496-3
• Publication Date: 2012-08-10T16:28:08Z
• Authors: L. Breda; D. Di Marzio; C. Giannini; S. Gaspari; M. Nozzi; A. Scarinci; F. Chiarelli; A. Mohn
• Keywords: Male; Blood Pressure; Carotid Intima-Media Thickness; Antioxidants; 03 medical and health sciences; 0302 clinical medicine; Humans; Longitudinal Studies; Child; Atherosclerotic changes, Carotid intima-media wall thickness, Children, Cytokines, Inflammation, Juvenile idiopathic arthritis; Age Factors; Atherosclerosis; Lipids; Arthritis, Juvenile; Plaque, Atherosclerotic; 3. Good health; Carotid Arteries; Antirheumatic Agents; Case-Control Studies; Child, Preschool; Linear Models; Female; Inflammation Mediators; Biomarkers

To investigate the presence of possible early atherosclerotic changes in a group of prepubertal children with juvenile idiopathic arthritis (JIA) and to establish the potential beneficial effects of 1-year treatment.Inflammatory markers (C-reactive protein, erythrocyte sedimentation rate), proinflammatory cytokines (IL-1β, IL-6, IFN-γ, TNF-α), lipid profile and oxidant-antioxidant status (urinary isoprostanes [PGF-2α]) were assessed in 38 JIA children (12M/26F, mean age 7.05 ± 2.39 years) and compared with 40 controls (18M/22F, mean age 6.34 ± 2.25 years). Carotid intima-media wall thickness (cIMT) was obtained and blood pressure was measured. All parameters were reassessed in JIA children after 1 year of therapy.At baseline JIA children presented compared to controls higher levels of inflammatory markers, proinflammatory cytokines, total cholesterol, LDL cholesterol, and PGF-2α (all p ≤ 0.01). Furthermore, blood pressure and cIMT were significantly increased (both p ≤ 0.01). After a 1-year treatment with non-steroid anti-inflammatory (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs), a significant reduction of all parameters was detected (all p ≤ 0.01). This was associated with a significant reduction in blood pressure and cIMT (both p ≤ 0.01). Within the JIA group, patients requiring etanercept presented worse laboratory values and cIMT measurements at baseline. Nevertheless, the same improvement of all parameters was obtained after a 1-year treatment. In stepwise multiple regression, LDL cholesterol and IL-1β were mainly related to cIMT.Chronic and systemic inflammation seems to lead to early atherosclerotic abnormalities even in pre-pubertal JIA children. Substantial improvement can be obtained with 1-year of appropriate therapy.