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Salivary antioxidants and metalloproteinases in juvenile idiopathic arthritis
Riva Brik1, Irit Rosen, Dana Savulescu
1Meyer Children's Hospital, Haifa, Israel.
Insights
Juvenile idiopathic arthritis (JIA) patients show higher salivary antioxidant status and lower matrix metalloproteinase (MMP) levels. Anti-TNF therapy further reduces MMPs in JIA, while active disease increases antioxidant activity.
Area of Science:
- Pediatric Rheumatology
- Immunology
- Biochemistry
Background:
- Juvenile idiopathic arthritis (JIA) is a common childhood autoimmune inflammatory disease characterized by joint inflammation.
- Understanding biomarkers in JIA is crucial for disease management and monitoring treatment efficacy.
Purpose of the Study:
- To investigate salivary antioxidant status and matrix metalloproteinase (MMP) levels in children with JIA.
- To assess the impact of anti-tumor necrosis factor (anti-TNF) therapy and disease activity on these salivary biomarkers.
Main Methods:
- Saliva samples were collected from 35 children with JIA (26 active disease, 14 on anti-TNF therapy) and 16 healthy controls.
- Analysis included total antioxidant status (TAS), and levels of MMP-9, MMP-3, and MMP-2.
Main Results:
- JIA patients exhibited significantly higher salivary total antioxidant status (TAS) compared to controls.
- MMP-9, MMP-3, and MMP-2 levels were significantly lower in JIA patients, with further reductions observed in those on anti-TNF therapy.
- Active JIA correlated with increased salivary antioxidant activity, while anti-TNF treatment was associated with decreased MMP levels.
Conclusions:
- Children with JIA present with altered salivary antioxidant and MMP profiles.
- Salivary analysis may offer insights into JIA pathogenesis and the effects of anti-TNF treatment.
- Anti-TNF therapy appears to modulate matrix degradation by inhibiting MMP activity in JIA patients.
Abstract:
Juvenile idiopathic arthritis (JIA) is the most common autoimmune inflammatory disease in children; joint inflammation is the hallmark of the disease. Thirty-five children with JIA were studied, of whom 26 had active disease and 14 were receiving anti-TNF therapy (5 with Infliximab, 9 with Etanercept). Sixteen healthy controls also were studied. Saliva samples were obtained for analysis of anti-oxidant status, metalloproteinases (MMPs) and sialochemistry. The total antioxidant status was significantly higher in the saliva of all JIA patients, whether treated (P = 0.014) or not treated (P = 0.038) with anti-TNF agents. The increase in antioxidant status (TAS) in the saliva of the active patients was nearly two times higher than that of non-active patients (P = 0.01). MMP levels were significantly lower in JIA patients than in controls. MMP-9, MMP-3 and MMP-2 were lower in JIA patients without anti-TNF treatment by 36.7% (P = 0.01), 30.0% (P = 0.0001) and 10.7% (P = 0.0001), respectively. A greater reduction in MMP levels was observed in the group of patients treated with anti-TNF drugs: MMP-9, MMP-3 and MMP-2 were lower than in controls by 51.1% (P = 0.0001), 61.5% (P = 0.0001) and 55.4% (P = 0.0001), respectively. Children with JIA exhibited a significantly higher salivary antioxidant activity and significantly lower MMP levels. Anti-TNF treatment was associated with a further decrease in MMP levels in the saliva of JIA patients while an active state of JIA was associated with a further increase in the salivary antioxidant activity. Anti-TNF treatment may modulate the degradation process during the course of arthritis by inhibition of the activity of MMP.
