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Serum interleukin-6 receptor in polymyalgia rheumatica: a potential marker of relapse/recurrence risk
Lia Pulsatelli1, Luigi Boiardi, Elettra Pignotti
1Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, Bologna, Italy.
Objective:
To investigate the modulation of systemic levels of soluble interleukin-6 receptor (sIL-6R) and soluble gp130 (sgp130) in untreated and treated polymyalgia rheumatica (PMR) patients during a followup period of at least 24 months in order to evaluate the relationship of these molecules with clinical outcome and their feasibility to provide a prognostic tool in clinical practice.
Methods:
We analyzed sIL-6R and sgp130 serum levels in 93 PMR patients, and 46 age-matched normal controls, at disease onset and at 1, 3, 6, 12, and 24 months of followup during corticosteroid therapy by enzyme-linked immunosorbent assay.
Results:
No difference in sIL-6R and sgp130 levels was observed between PMR patients and normal controls at disease onset or during followup. A significant correlation was found between the number of relapses and sIL-6R concentrations at baseline and after 1, 3, and 12 months of therapy. No correlation was found between sgp130 levels and the number of relapses. Cox multivariate analysis indicated that the best model for predicting relapses was identified by sIL-6R levels and the hemoglobin value at baseline. We found that high sIL-6R levels combined with low hemoglobin values resulted in a 10.1-fold increased risk of relapse.
Conclusion:
Our data support the identification of a potential prognostic marker of PMR outcome that might have important implications in clinical practice. Because targeting sIL-6R with blocking antibodies has proven useful in other rheumatic disorders, our results could suggest the opportunity to evaluate sIL-6R-blocking treatment in patients with PMR and elevated levels of sIL-6R at disease onset.
Insights
Soluble interleukin-6 receptor (sIL-6R) levels correlate with polymyalgia rheumatica (PMR) relapses. High sIL-6R and low hemoglobin at baseline predict increased relapse risk, suggesting sIL-6R as a prognostic marker for PMR.
Area of Science:
- Rheumatology
- Immunology
- Biomarker Discovery
Background:
- Polymyalgia rheumatica (PMR) is an inflammatory condition.
- Understanding prognostic markers is crucial for managing PMR.
- Interleukin-6 (IL-6) signaling plays a role in inflammatory diseases.
Purpose of the Study:
- To investigate soluble interleukin-6 receptor (sIL-6R) and soluble gp130 (sgp130) levels in PMR patients.
- To evaluate the relationship between these molecules and clinical outcomes, including relapses.
- To assess their potential as prognostic tools in clinical practice.
Main Methods:
- Enzyme-linked immunosorbent assay (ELISA) was used to measure sIL-6R and sgp130 serum levels.
- 93 PMR patients and 46 controls were analyzed at baseline and during 24 months of follow-up.
- Corticosteroid therapy was administered to PMR patients.
Main Results:
- No significant differences in sIL-6R or sgp130 levels were found between PMR patients and controls.
- A significant correlation was observed between sIL-6R concentrations and the number of PMR relapses.
- Baseline sIL-6R levels and hemoglobin values effectively predicted relapse risk, with high sIL-6R and low hemoglobin increasing risk 10.1-fold.
Conclusions:
- Elevated sIL-6R levels at disease onset may serve as a prognostic marker for PMR.
- These findings suggest potential for evaluating sIL-6R-blocking therapies in PMR patients.
- sIL-6R could be a valuable tool for predicting PMR outcome in clinical settings.
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