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Concerted Actions by PIICP, CTXII, and TNF-α in Patients with Juvenile Idiopathic Arthritis

Katarzyna Winsz-Szczotka1, Kornelia Kuźnik-Trocha1, Iwona Lachór-Motyka2

  • 1Department of Clinical Chemistry and Laboratory Diagnostics, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, ul. Jedności 8, 41-200 Sosnowiec, Poland.

Biomolecules
|April 30, 2021
PubMed

Insights

Biomarkers for cartilage turnover, procollagen II C-terminal propeptide (PIICP) and C-telopeptide of type II collagen (CTXII), can help diagnose and monitor juvenile idiopathic arthritis (JIA). Elevated levels indicate disease activity and correlate with inflammation.

Area of Science:

  • Rheumatology
  • Biochemistry
  • Pediatrics

Background:

  • Joint destruction in juvenile idiopathic arthritis (JIA) begins early and is diagnosed via clinical evaluation and imaging.
  • Circulating cartilage-matrix turnover markers can improve JIA diagnosis and treatment.
  • Type II collagen metabolism is central to JIA pathogenesis.

Purpose of the Study:

  • To investigate the diagnostic and monitoring utility of cartilage turnover markers in JIA.
  • To correlate these markers with disease activity and inflammatory indicators.
  • To assess the potential of these markers in guiding JIA treatment strategies.

Main Methods:

  • Measured serum levels of procollagen II C-terminal propeptide (PIICP) and C-telopeptide of type II collagen (CTXII) in 96 JIA patients.
  • Correlated marker levels with clinical evaluation, radiographic imaging, and inflammatory markers (CRP, ESR, TNF-α).
  • Analyzed marker changes in response to JIA treatment.

Main Results:

  • JIA patients exhibited elevated PIICP and CTXII levels, reflecting cartilage biosynthesis and resorption.
  • Non-responders to treatment showed particularly high marker levels.
  • Marker levels normalized in remissive patients post-treatment, but not in active JIA patients.
  • Significant correlations were found between PIICP, CTXII, and inflammatory markers like TNF-α.
  • TNF-α correlated strongly with PIICP before treatment in responding patients (r = 0.898, p < 0.001).

Conclusions:

  • Serum PIICP and CTXII are valuable biomarkers for assessing JIA activity and monitoring treatment response.
  • Changes in PIICP during therapy suggest its utility in assessing treatment efficacy towards remission.
  • Understanding type II collagen metabolism offers potential for new diagnostic and therapeutic strategies in pediatric JIA.

Keywords:
C-telopeptide of type II collagencartilage turnover markersjuvenile idiopathic arthritisprocollagen II C-terminal propeptidetumor necrosis factor-α

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