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Pentraxin 3 is better than conventional inflammatory markers for disease activity assessment in takayasu arteritis

 Department of Clinical Immunology and Rheumatology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India

Correspondence Address:
Liza Rajasekhar,
Department of Clinical Immunology and Rheumatology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/injr.injr_95_18

Objective: The objective of this study is to measure plasma pentraxin 3 (PTX3) levels in Takayasu arteritis (TA) patients and to compare the accuracy of PTX3, high-sensitive C-reactive protein (hsCRP), and erythrocyte sedimentation rate (ESR) in distinguishing active disease from the inactive disease. Methods: In a prospective, cross-sectional study, TA patients fulfilling 1990 American College of Rheumatology criteria and healthy controls were enrolled in this study. The Indian Takayasu Clinical Activity Score (ITAS 2010) and ITAS ESR were recorded. Patients were divided into active, grumbling and inactive disease using physician global assessment. Plasma PTX3, hsCRP, and ESR were measured. Receiver operating curves for PTX3 (pg/ml), hsCRP (mg/L), and ESR (mm at 1 h) were constructed to differentiate active from the inactive disease. Inter-group comparisons were made using Mann–Whitney test. Results: Forty patients and 20 controls with median age of 26 and 24 years, respectively, were enrolled in this study. Median disease duration was 2 years. Fourteen patients had active, 8 grumbling, and 18 inactive disease. ITAS 2010 and ITAS ESR in active disease (5 [3–8.5], 7.5 [5–11.5]) were significantly higher than grumbling (0.6 (0–1.5], 2.5 [1–4.5]) or inactive disease (0.5 [0–1.3], 2 [1.7–3]) (P = 0.001). PTX3 (pg/mL) was higher in cases (505 [261–1358]) as compared to that of controls (317 [135–450]) (P < 0.026), in active disease (1335 [464–2128]) was higher than grumbling (689 [246–2114]), but significantly higher than inactive TA (369 [145–512]) (P < 0.001). ESR (mm/h) and hsCRP (mg/L) of 49 (33–61.2), 12.9 (4–21), respectively, in active disease was similar to grumbling (44 [31–63], 10.7 [3–14.7]), but significantly higher than inactive disease (38 [24–45], 1.8 [1.4–2.2]) (P = 0.03). Sensitivity, specificity, and area under the curve for ESR (>46 mm), hsCRP (17.1 mg/L), PTX3 (>745 pg/ml) was (55, 89, and 0.72), (46, 89, and 0.75), and (64, 95, and 0.82), respectively. Conclusion: Elevated PTX3 in TA demonstrates more accuracy than hsCRP and ESR in differentiating active from the inactive disease. These biomarkers may differentiate grumbling from inactive disease better than ITAS2010 or ITAS-ESR.

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    -  Devarasetti PK
    -  Irlapati RV
    -  Rajasekhar L
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